State News

A recent bill has opened the doors for a new pilot program allowing emergency medical services to provide Community Integrated Healthcare, according to ABC Fox Montana. It's hoped that this pilot will allow paramedics and emergency medical technicians to operate more as primary caregivers when taking care of patients. Great Falls Emergency Services believes this pilot will save the healthcare system money in the long run by managing medical issues with scheduled visits with community paramedics at home rather than waiting for the problem to progress into a 911 emergency. 

Massachusetts second and third largest insurers, Harvard Pilgrim Health Care and Tufts Health Plan, have signed an agreement to merge, according to Mass Live. The two insurers combined would present a formidable challenger to the state's largest insurer, Blue Cross Blue Shield, as the combined company would have revenue excess of $8 billion. However, the merger still requires approval from state regulators, including the Health Care Policy Commission, which oversees healthcare mergers and acquisitions. 

The Chesapeake Regional Health Information System for our Patients (CRISP), a health information exchange covering Maryland and Washington DC, announced plans to expand technical integration of its advance care planning solution, according to EHR Intelligence. CRISP will use advance care planning provider ADVault to try to give providers access to meaningful patient health information during patient encounters. It's hoped the data will help improve clinical efficiency during patient encounters to improve patient health outcomes across the state.  

Kansas has threatened to cancel insurer Aetna’s Medicaid contract if the company fails to resolve a number of long-running problems, reports KCUR. The state’s written complaint to Aetna in July stated that doctors and others struggle to secure provider credentials from the insurer, and that discrepancies in Aetna’s records mean Kansas can’t judge the adequacy of the company’s provider network for the state’s 100,000 Medicaid recipients. Additionally, providers claim they sometimes don’t get paid because Aetna demands advance permission for certain basic procedures and that the company hasn’t put together a complete directory of physicians and specialists. Aetna has reported that it has fixed several issues and that many of the other problems “are well on their way to compliance.”

California hospitals provide significantly less free and discounted care to low-income patients since the Affordable Care Act (ACA) took effect, according to Kaiser Health News. As a proportion of their operating expenses, in 2017 general acute-care hospitals spent less than half as much on charity care as they did in 2013. Experts believe that the ACA is largely responsible for the reduction in charity care spending–with fewer uninsured patients, fewer patients seek financial assistance through the charity care programs. Currently, neither the state nor federal governments impose minimum requirements for charity care spending by hospitals, although the California Attorney General has created standards for a few nonprofit hospitals that have changed ownership in recent years. 

A new law in New Hampshire will expand the scope of telehealth services covered under Medicaid, enabling primary care providers and pediatricians to use these services, according to mHealthIntelligence. Previous legislation restricted telehealth services to specialists, making it difficult for patients to access physicians with expertise in real-time. Services that are now allowed include a direct-to-consumer telehealth portal, which allows for on-demand treatment of non-urgent issues, which is proving to be popular with health systems. 

The Center for Disease Control & Prevention recommends that Iowa spend $30 million annually on tobacco prevention efforts, but the state spends just $4 million, according to the Telegraph Herald. A report by the American Cancer Society shows that about 5,100 adults die in Iowa each year due to smoking and that Iowa has a relatively low tobacco tax rate: just $1.36 per pack, while the national average is $1.81.

A new law in New Hampshire seeks to add primary care physicians and pediatricians to the list of doctors who can bill Medicaid for visits that happen by phone or video conference, according to New Hampshire Public Radio. Previously, only certain specialists could bill Medicaid for telemedicine visits - in 2018, less than 1 percent of all doctors' visits for people on Medicaid happened via telemedicine. Supporters hope this law will increase access to healthcare in rural areas of the state. 

A looming physician shortage in Ohio could make it difficult for patients to see a primary care physician, increase health disparities and raise costs as people are forced to turn to emergency room care, according to The Plain Dealer. By 2025, Ohio is projected to be short 1,200 primary care physicians (those in family medicine, internal medicine or pediatrics), estimates the U.S. Department of Health and Human Services. Recruiting primary physicians can be challenging due to pay inequities (primary care physicians make 30 percent less than specialists) and increased workload. Medical schools such as Case Western Reserve University School of Medicine are changing their recruitment and curriculum strategies to encourage more students to choose primary care.