Alabama’s rural areas are at particular risk for not being prepared for disasters, given that the large number of rural hospital closures since 2010, according to WBHM. Many of the hospitals that remain open are struggling with financial problems – 88 percent of rural hospitals in the state have negative operating margins, making the necessary spending during a disaster more challenging. Alabama is among the states with the most rural hospital closures, according to a study from the Chartis Center for Rural Health, which describes the difficulty of maintaining hospital revenues when they have large uninsured populations but their state has not expanded Medicaid.
Massachusetts will direct another $800 million to the state’s healthcare industry, supplementing $840 million in previously announced assistance as the state works to bulk up its front line of defense against COVID-19, according to WGBH. Half of the new funding will be split between 28 safety-net and high-Medicaid-population hospitals. This plan will also increase rates paid to hospitals for COVID-19 care by 20 percent and 7.5 percent for all other hospital services. The Massachusetts Health and Hospital Association estimated that hospitals across the state are losing $1 billion per month due to the pandemic as revenue has “evaporated.”
Connecticut's governor issued an executive order prohibiting hospitals from charging uninsured patients more than the Medicare price for their COVID-19 care, according to Modern Healthcare. The order also aligns payment for emergency and non-emergency out-of-network care by requiring insurers to pay out-of-network providers in-network prices for care during the COVID-19 public health emergency, and protects healthcare workers and facilities from lawsuits if they are “acting in good faith” to provide COVID-19 care despite shortages or capacity issues.
Wisconsin has issued two emergency orders that suspend some administrative rules for the Wisconsin Department of Health Services to help maximize the state’s healthcare workforce while ensuring patients continue to get the care they need, according to WeAreGreenBay.com. The executive order adjusts training and license renewal deadlines, as well as paramedic-level ambulance staffing levels for emergency medical services. It suspends staff orientations at home health agencies and hospices, adjusts nurse aide training hours, relaxes criteria for resident care staff at community-based residential facilities and adult family homes and ensures nursing homes cannot discharge patients who are unable to pay. The law allows healthcare provider licenses that would have expired during the public health emergency to remain valid until 30 days after the emergency is over and gives providers who are licensed in other states, but assisting in Wisconsin, time to apply for a Wisconsin license.
Froedtert Memorial Lutheran Hospital, Inc. has sued at least 46 people in small claims court since March 12, though a hospital spokesperson says they have suspended filing in small claims court as of March 18 in response to COVID-19, reports Kaiser Health News and Wisconsin Public Radio. Indeed, court records show at least 18 lawsuits filed on the hospital’s behalf since then, including 15 filed on March 31 alone, and that at least six additional health systems have also sued patients during the pandemic. ABC for Health, a nonprofit public-interest law firm in Madison, explains that facing a medical debt lawsuit is stressful under normal circumstances and is much more so given that many people have lost their jobs and health insurance during the pandemic.
Hospitals in Maryland have been given permission to temporarily raise rates patients are charged to help pay for emergency care related to COVID-19, reports KIRO7. Normally, the amounts hospitals can charge for surgeries and childbirth are regulated in Maryland, but due to the coronavirus, medical facilities are adding capacity without offsetting costs with other health services.
Since 2017 the North Carolina Department of Health and Human Services has been incorporating whole-person care into all of its priorities, focusing on food, housing, transportation, employment and interpersonal safety/toxic stress. An article in Health Affairs describes four, interconnected initiatives that aim to (1) better align financial incentives for healthcare providers and Medicaid health plans to address both medical and nonmedical drivers of health; (2) introduce a standard screening process to identify people with unmet resource needs; (3) establish NCCARE350, an innovative technology platform that allows healthcare providers and human services organizations to connect people with social resources and track outcomes; and (4) launch large-scale Healthy Opportunities Pilots to evaluate the impact of nonmedical health interventions on the health outcomes and healthcare costs of high-need Medicaid beneficiaries.
Two health and housing consortia in New York City offer a model for better integrating the health and housing sectors, according to this article in Health Affairs. The Bronx Health and Housing Consortium is a collaborative network of healthcare, housing, social services and government organizations and agencies that seek to strengthen and integrate healthcare and housing systems at the policy, operational and individual patient/client levels. However, researchers note that structural changes are needed. Researchers believe this model could be replicable in not just large cities, but smaller and nonurban areas, as well.
A study published in Health Affairs provides an overview of early progress with California’s Whole Person Care Pilot Program, a Medicaid demonstration project focused on improving the integrated delivery of healthcare, behavioral health and social services for Medicaid beneficiaries. The pilot demonstrated significant progress in developing partnerships, data-sharing infrastructure and services needed to coordinate care for identified patient populations. Barriers to implementation included difficulty identifying and engaging eligible beneficiaries and the lack of affordable housing. These findings offer insights to leaders and policymakers interested in testing new approaches for improving the health and well-being of medically and socially complex patients.
While crisis walk-in mental health centers and mobile response teams across Colorado remain open during the coronavirus pandemic, most clinical therapy sessions have gone virtual, according to the Colorado Sun. While therapists say virtual sessions don’t provide the same level of human connection, they do have other benefits, including making it easier for clients to get to their appointments and allowing people to ease into therapy from home. Mental health professionals are operating under temporary guidance approved by federal and state agencies that will allow them to bill Medicaid, Medicare and other insurance providers the same amount for a telemental health appointment as they could for an in-person session. This is drastically different from previous rules in Colorado around telehealth, including one rule stating that therapists could only use telemental health if the client lived in a town with a population under 50,000, or that the client had to travel at least 30 miles to visit their therapist.