State News

Legislators in Oregon have called for the development of plan to achieve a “predictable and sustainable” annual growth rate for statewide healthcare spending, according to Milbank Memorial Fund. The plan would be developed by a public-private advisory group and implemented, at least initially, by the Oregon Health Authority within existing laws. Enforceable limits on cost growth will take effect in 2022. Other states, like Massachusetts, Rhode Island, and Delaware, have already implemented healthcare cost growth benchmarking.

There is momentum and support to continue to build telehealth commercial coverage. Massachusetts legislators filed five new telehealth bills for consideration, according to the National Law Review. Four of these proposed bills directly compete with each other, so it will be important to monitor their progress through committee and reconciliation. All of the bills state that insurers (including Medicaid MCOs, Massachusetts Group Insurance Commission, Individual plans, Hospital service plans, HMOs and PPOs) must not decline to provide coverage for health care services solely on the basis that the services were delivered through telemedicine. While it is not yet clear which bill will prevail, it is clear that Massachusetts is continuing to explore ways for policy to drive innovation in health technology, while balancing patient safety and the insurance industry. 

Community health workers have the potential to help improve health outcomes, reduce costs and reduce health disparities. Despite this, the role of community health workers in the healthcare system remains precarious and not widely understood. A report released by the Connecticut Health Foundation aims to shed light on the work community health workers are doing in Connecticut and their potential to bridge gaps between clinical care and patients’ lives. This report complements previous research published by the Connecticut Health Foundation, including a brief and report identifying specific ways community health worker services can produce a positive return on investment and a report detailing how 15 other states handle certification for community health workers.

California healthcare giant Sutter Health has failed in its attempt to persuade a San Francisco Superior Court judge to dismiss key claims in the Attorney General’s (AG’s) antitrust lawsuit alleging that Sutter has used its market power to control prices and exclude competition, reports the Sacramento Bee. Sutter argued that the AG’s lawsuit would favor insurance carriers and increase their negotiating power, and that the AG’s demands would make doing business especially onerous by forcing Sutter to use lengthy arbitrations to determine future contract terms. They also fear that they will have to negotiate contracts with insurers at staggered times, using separate teams that may not communicate with one another. This decision marks the most recent action in the lawsuit, which was filed in early 2018.

A new report from MedStar Health Research Institute and the Rutgers Center for State Health Policy describes early lessons from Mountain-Pacific Quality Health’s innovative “ReSource Teams” designed to expand access to care in three rural Montana communities. The ReSource teams consist of community health workers and volunteers who visit patients in their homes and consult remotely with registered nurses, pharmacists and behavioral health providers. ReSource Team members shared their perspectives on accessing and combining data sources to track patients’ hospital and social services needs and utilization; using ICD-10 Z-codes to monitor and respond to patients’ social determinants of health needs; and connecting patients to care in the context of limited and highly fragmented community resources.

A new report from the United Hospital Fund, supported by the New York State Health Foundation, examined patient and family decision making around post-acute care, which includes service provided by home health agencies, inpatient rehabilitation facilities, skilled nursing facilities, and long-term care hospitals. The analysis found a robust evidence base around improving post-acute decision support and provided a number of policy recommendations and solutions to increase supports for patients and their families when making decisions about where to receive post-acute care.

A new Arizona law, set to take effect 90 days after the 2019 legislative session ends, extends the maximum time that residents are allowed to have a short-term insurance plan from one to three years, according to AZ Central. Consumer advocates oppose the “junk plans,” arguing that they hurt consumers because they cover far fewer services than regular coverage. Increasing the contract time, they say, enables insurers to financially benefit at the expense of consumers for longer periods of time. Some states have passed laws restricting short-term plans in an effort to protect consumers. California banned short-term insurance plans altogether and Delaware issued rules limiting short-term plans to three months, with no extensions or renewals.

Three Kansas City-area hospitals are among 17 in Missouri and seven in Kansas that are being penalized by Medicare this year for high infection and patient-injury rates, reports KCUR. Truman Medical Centers, Research Medical Center and Belton Medical Center will see their Medicare payments reduced by one percent because of high rates of complications, as part of the Affordable Care Act’s effort to improve patient care. The article lists the 24 Missouri and Kansas hospitals that have been penalized this year (out of 800 general hospitals nationwide).

Three Kansas City-area hospitals are among 17 in Missouri and seven in Kansas that are being penalized by Medicare this year for high infection and patient-injury rates, reports KCUR. Truman Medical Centers, Research Medical Center and Belton Medical Center will see their Medicare payments reduced by one percent because of high rates of complications, as part of the Affordable Care Act’s effort to improve patient care. The article lists the 24 Missouri and Kansas hospitals that have been penalized this year (out of 800 general hospitals nationwide).