State News

A $1 million grant to the University of Arkansas for Medical Sciences (UAMS) from Arkansas Blue Cross and Blue Shield will enable the UAMS Institute for Digital Health & Innovation to advance digital health statewide to provide more streamlined access to healthcare for patients, reports UAMS News. The first phase of the plan will focus on urgent care, in which patients will be able to consult with a medical professional by voice or video call to determine whether they need immediate care and how to obtain follow-up care. The second phase will develop digital approaches to providing primary care and certain specialized care, such as gynecology, ophthalmology, gastroenterology, oncology and orthopedics. Digital health approaches can reduce the cost of healthcare and improve access for patients, especially in a largely rural state like Arkansas.  

Dozens of Oklahoma hospitals have filed more than 22,000 lawsuits against their former patients over unpaid medical bills since 2016, according to Oklahoma Watch. These billing practices highlight a heated debate in the medical community across the country. Consumer advocates argue that hospitals, especially those that are nonprofits, sue too often and should prioritize their moral obligation to their patients. Hospital officials say they already offer millions of dollars in charity care for those who meet certain income standards and that they only take legal action when necessary.  Patients sued are at a disadvantage in court, because few people in these situations can afford a lawyer or know what steps to take.

Connecticut’s Office of Health Strategy launched a free, online tool intended to help consumers, businesses and healthcare providers navigate the state’s vast system of care, reports The CT Mirror. The website’s two key elements–a quality scorecard and a cost estimator–will allow users to compare the quality and cost of medical care at 19 of the state’s healthcare organizations. Organizations are also evaluated on patient experience in four categories: office staff, provider communication, timely care and overall patient experience. In addition, users can compare the overall performance rating of provider networks across all quality measures. Connecticut is one of the first states to create a rating system that evaluates the performance of provider networks rather than individual providers. 

Horizon Blue Cross Blue Shield – New Jersey’s largest health insurance company – has developed a software tool that enables prescribers to get quick access to a list of lower-cost drug options tailored to address a patient’s unique needs and definitively covered by their specific prescription drug plan, according to NJ Spotlight. The rising price of prescription drugs has triggered problems for patients and their physicians: high out-of-pocket costs can lead individuals to skip or ration their medications. The pilot, launched in April, has since spread to some 5,000 prescribers, with Horizon hoping to double that usage by the end of 2019.

The Centers for Medicare and Medicaid Services approved North Dakota’s request to develop a state-based reinsurance program under Section 1332 of the Affordable Care Act, according to a Health Affairs blog post. North Dakota’s reinsurance program will operate through 2024 and is expected to reduce 2020 premiums by 20 percent. The North Dakota Insurance Department waiver application stated that this program will encourage additional insurers to write business in North Dakota’s individual market, improve consumer access and lower rates.

Wyoming’s 1115 waiver application proposes to treat air ambulances like a public utility, with high fixed costs and universal service, and rely on free-market principles like competitive bidding and price transparency. Under the plan, Medicaid would: issue competitive bids; set up a centralized call center; make periodic flat payments to air ambulance providers; and articulate clear and transparent cost-sharing requirements. Though the state will assume short term risk to pay for this system, it will ultimately be self-funded. Health insurers would continue to cover air ambulance through up-front subscriptions or get billed by a state contractor on a fee-for-service basis. However, a Center on Health Insurance Reforms blog notes that the federal government still needs to approve the waiver proposal, after which Wyoming’s legislature would have to enact state-level legislative changes to enact the program. 

Oklahoma’s legislature enacted HB 2351, entering the state into the Interstate Medical Licensure Compact (IMLC), effective November 1, 2019, reports The Oklahoman. The IMLC is an agreement among more than 25 states that allows qualified physicians to obtain expedited medical licenses in any compact-member state, reducing barriers to the provision of telemedicine services across state lines. This flexibility expands access to specialists for patients living in rural, frontier and other underserved areas.  

Following months of negotiations, the contracts are set to expire between UnitedHealthcare and several University of Alabama Birmingham Health System entities this month, according to WSFA12. UnitedHealthcare claims that the UAB Health System is more expensive than other facilities – if no agreement is reached, UnitedHealthcare members who receive care at UAB facilities may be personally responsible for the cost of services received, though the emergency department at each hospital will remain open to members without additional out-of-pocket costs.

The state of Washington is praised for creating the country’s first “public option,” but a closer look at the law reveals tradeoffs that could curb potential savings for consumers, reports The New York Times. Although the law allows the state to regulate some healthcare prices, the prices were set significantly higher than drafters originally hoped in order to gain enough support to pass. As a result, the public option may not deliver the steep premium cuts that supporters want. Estimates suggest that individual market premiums will fall 5-10 percent when the new public plan begins.