State News

The Integrated Healthcare Association’s third California Regional Health Care & Cost Quality Atlas found that provider risk sharing arrangements are associated with higher quality, at the same or lower cost, reports State of Reform. This free report includes two dozen measures of cost, quality and utilization from more than 30 million Californians with commercial insurance, Medicare and/or Medi-Cal.

A new Colorado law protects patients from surprise medical billing by prohibiting healthcare providers from sending consumers a bill when they’ve unknowingly received out-of-network care. According to High Plains Public Radio, the law also sets a reimbursement rate that insurers pay to out-of-network hospitals and doctors. Researchers with the Center on Health Insurance Reforms at Georgetown University have found Colorado is more protective of consumers with respect to surprise medical billing, than other states in the region.

Kaiser Permanente will soon launch a new care network that connects the system's 12 million members to community services that address their social needs, according to Modern Healthcare. The Thrive Local initiative will be integrated into Kaiser's electronic health record, and will be regionally rolled out over the next three years. The program will allow healthcare providers and caregivers to connect patients with community resources that can help them address needs such as food insecurity or housing instability from an array of not-for-profit, public and private social services. In addition to community partner referrals, the network will track service outcomes to measure the degree to which participants' needs are met. Kaiser plans to eventually make Thrive Local's network of resources available to community-based organizations to help them reach out to non-Kaiser members in need.

Delaware state legislature easily passed a measure to establish the Interagency Pharmaceuticals Purchasing Study Group, according to the National Academy for State Health Policy. The group is tasked with an ambitious agenda, expected to submit recommendations to leverage bulk purchasing of pharmaceuticals to meaningfully lower drug prices by the end of 2019. The strategies to leverage the state’s combined purchasing power will hopefully help bring down the cost of health care in the state, where health care spending traditionally grows faster than the state’s economic growth and currently exceeds the national average.

The Arizona Health Care Cost Containment System (AHCCCS) announced a policy change, effective May 1, 2019, that allows transportation network companies (a.k.a. “rideshare” companies) to register as non-emergency medical transportation providers, according to a press release. Under the new AHCCCS provider category, rideshare companies are eligible to serve Medicaid members who do not require personal assistance during medically necessary transportation. Adding rideshare companies as providers of non-emergency medical transportation can add flexibility to the health care delivery system and increase transportation options for Medicaid members. 

An analysis of New York's 2014 surprise medical bill law found that insurer, provider, and consumer stakeholders generally agree that the implementation of the law went smoothly, and that consumer complaints declines dramatically, according to a report from the Georgetown University Health Policy Institute, Center on Health Insurance Reforms. However, there continue to be significant gaps within the law concerning surprise balance bills due to patient misinformation about a provider's network status and use of out-of-network facilities during emergencies. The law protects consumers from charges for out-of-network services not paid by an insurance plan in cases of emergency or circumstances in which the patient did not have a reasonable choice between an in-network and out-of-network provider. 

A study by AARP North Carolina found that more than 80 percent of family caregivers in North Carolina support expanded roles for advanced-practice registered nurses (APRNs). The survey, in response to the SAVE Act currently under consideration in the North Carolina legislature, also found that 90 percent of NC residents rated care they received from APRNs as “excellent” or “good.” The bill would allow APRNs to offer primary care services without physician oversight. Expanding the role of APRNs would help address doctor shortages in the state as well as increase access to care in the state’s rural communities, according to Public News Service.

Consumers in Illinois have been bogged down with steep price increases when buying health insurance on the Affordable Care Act (ACA) marketplace. According to the Chicago Tribune, new proposed legislation would give the Illinois Department of Insurance the power to say “no” to certain sky-high price increases proposed by insurance companies for plans sold to individuals and small businesses. The bill wouldn’t apply to plans offered by large employers. Opponents of the bill say it does nothing to address the rising prices of healthcare that can lead to higher insurance prices, and it could limit the types of plans insurers are able to offer.

The Medical Society of Delaware has announced a new partnership with Pennsylvania’s medical society, PAMED, reports Delaware Public Media. The goal of the partnership is for the two medical societies to negotiate with medical providers to achieve value-based contracts that will also financially benefit physicians. The medical societies are also partnering with Health EC, a data mining company, to track patient data as well as monitor for unmet need and/or duplication of effort.