The federal government approved Arizona’s 1115 demonstration targeted at expanding access to coverage and addressing nutrition and housing needs, report Healthcare Dive. The program will focus on making sure Medicaid beneficiaries have adequate housing with resources to help them transition from temporary to more stable living situations.
The California Advancing and Innovating Medi-Cal program, or Medi-Cal/CalAIM, aims to address social determinants of health by directly providing resources beyond healthcare, such as including housing and food, according to the Los Angeles Times. An extension of the Medi-Cal state Medicaid program, Medi-Cal/CalAIM aims to reduce health disparities for low-income beneficiaries, including homeless individuals struggling with serious mental illness or physical needs, as well as aiming to save the state money in the long term.
The Listening to Black Californians study found that many Black Californian respondents were intentional about their health and have a regular provider, but many have been treated unfairly by healthcare providers because of their race or ethnicity, according to the California Health Care Foundation. In addition, respondents reported avoiding care due to concerns about being treated unfairly or with disrespect. In terms of solutions, respondents reflected on strengthening patient-provider relationships, increasing Black representation among healthcare leaders and providers and expanding community-based education, among other initiatives.
Nearly 30 percent of farmers, surveyed by the New Connecticut Farmers Alliance, describe their health insurance as “unaffordable” or “very unaffordable,” reports Connecticut Public Radio. The article also explains that only 5 percent of farmers or farm workers surveyed in Connecticut receive health insurance through their employer. The challenges surrounding affordable health insurance negatively impact health outcomes and financial security, discourages potential farmers from pursuing the profession and may lead to underinsurance in the population.
More than half of Connecticut residents with private insurance are enrolled in a high deductible health plan, according to the Connecticut News Junkie. Patients covered by high deductible plans are one-third times more likely to have medical debt, and their debts average $4,000 higher, than people without high deductibles. Medical debt impacts Connecticut residents across the socioeconomic demographic—the Hartford Foundation for Public Giving, which operates a charity fund for individuals struggling with medical debt in the state, reports that the majority of their applicants receive insurance coverage through their employer but are underinsured at the time of receiving care.
Nearly four in five Connecticut residents are concerned about healthcare affordability, reports the Connecticut Mirror. In addition to this statistic, the survey also demonstrated that, among those surveyed, the issue of affordability extends across the political aisle—68 percent of Republicans, 75 percent of Democrats and 67 percent of residents who identified as neither party agreed the healthcare system needed change.
Leaders in Illinois are working to eliminate racial healthcare disparities through a new program and cultural bias training, reports the State Journal-Register. The Illinois Department of Public Health has awarded grants totaling $3.7 million to organizations working to address health inequities, many of which were brough to the forefront by the COVID-19 pandemic. Beyond improving access to vaccines, some hospitals have adopted cultural bias training and equity, diversity and inclusion teams to help individuals better navigate the healthcare environment and work to reverse disparities. Hospitals and community groups within the state acknowledge that cultural and language barriers must be addressed to better serve their patients and ensure equitable access to care, and hope that these efforts will be led by those involved in their communities.
The 2022 RAND 4.0 study found that Indiana has the seventh highest hospital costs, relative to Medicare prices, of all states measured, according to WFYI Indianapolis. Around the time of the study, Indiana legislators issued a letter to healthcare providers and insurers stating they would likely take steps to reduce healthcare costs in the next session if the providers and insurers do not make efforts to do so.
Uninsurance rates in Kansas have not changed since 2019, despite nationwide decreases across the country, reports the Kansas Reflector. Kansas now has a higher uninsurance rate than the national average rate for the first time in years. Racial disparities in coverage permeate the state—health insurance divides in Kansas showed the greatest gaps in coverage for people of color and working adults, especially regarding Hispanic and Black Kansans.
The average health insurance premium for small business will fall by 0.8 percent from 2022 to 2023, the first such reduction since 2001, according to Health Affairs Forefront. The state has taken several steps to reduce costs, including a 1332 State Innovation Waiver to merge the individual and small group market and extend reinsurance to small businesses purchasing through the merged market.
Beginning in September, Maryland residents will have the opportunity to present to the Prescription Drug Affordability Board how they’ve been impacted by the cost of medications, as the board prepares to present their ideas in the coming months, reports Maryland Matters. In 2019, Maryland lawmakers launched an effort to force down the price of prescription drugs by creating a Prescription Drug Affordability Board, making Maryland the first state to do this. However, after three years, the board’s initial mandate remains narrow—to determine which medications cost too much, then to set up a legally defensible method of capping the amount that state and local government health plans can be forced to pay to provide these medications to employees. There is hope, however, now that a funding source has been identified, an executive director hired and a Stakeholder Council put in place to provide community and industry input..
Beginning on Oct. 1, 2022, Maryland’s state-designated health information exchange (HIE) connecting healthcare providers and the Maryland Department of Health will have authority to operate as a health data utility (HDU), reports Business Wire. This is the first legislation of its kind to be signed in the U.S. As such, the HIE will be required to provide data in real-time to individuals and organizations involved in the treatment and care coordination of patients and to public health officials to support public health goals. The law also required the Maryland Department of Health, nursing homes, electronic health networks and prescription drug dispensers to provide data to the HIE. Experts note that state designation is key for allowing HIEs to clarify, defragment and secure individual health data before sharing it with the state health department – it also allows enhanced partnership with state public health departments to use data to guide, elevate and ultimately enhance outcomes of public health interventions and state-specific health equity goals.
Montana’s reference-based pricing in their public employee health plan, which effectively set prices for all services across the state, has saved the state millions since implementation six years prior. Notwithstanding its success, Montana legislators have announced that they are shifting to a new strategy, reports Stat News. The new model will allow private insurers to administer the public employee health plan beginning next year. Opponents of the strategy allege that the contract was awarded through an illegal bidding process and that it could cause healthcare costs to rise for Montanans.
New York state is doubling its spending to expand the physician workforce to include more people of color, bringing total efforts to $2.4 million, reports Spectrum News. The effort, first launched in 2017, has had moderate success, but just 12 percent of physicians are Black or Hispanic, despite compromising 30 percent of the state’s overall population. The COVID-19 pandemic further highlighted health inequities, which rallied support for this initiative. The program is meant to encourage students from diverse communities to pursue jobs in medicine, get accepted to and complete medical school in the state. Experts believe initiatives such as these will help provide trusted voices and more cultural understanding within the healthcare community, and, thus, improve equitable outcomes.
Upon realizing that their white patients fared better than patients of color, the North Carolina Association of Free & Charitable Clinics launched a new initiative focused on health equity in 2021, reports NC Health News. The initiative brought together a 29-member Health Equity Task Force composed of association staff, board members and clinic leaders for discussions about health equity. As a result, many of the member clinics undertook intentional equity work, often focusing on narrowing gaps in access to vaccines and COVID testing and treatment. The next steps for the Association include creating a long-term task force focused on health equity, rather than one that is time limited.
Across North Carolina, an estimated 4 million residents don’t have access to reliable broadband service, reports NC Health News, which hinders their ability to access telemedicine. This issue particularly affects rural residents, many of whom live in communities that tend to suffer most from a low supply of health professionals. Although telehealth is often promoted as the solution to increasing access to healthcare, rural residents of North Carolina without reliable internet are often left behind, stymying attempts to improve access, equity and outcomes. In addition, Census data shows that roughly a quarter of people in Western North Carolina’s rural counties are 65 or older–one of the main goals of the state’s Office of Rural Health is to ensure digital literacy and internet connectivity for this population.
Oklahoma has approved and is in the process of implementing a 25 percent rate increase for providers who work with individuals with intellectual and developmental disabilities, reports The Oklahoman. Policymakers claim that the impetus for the increase is the 13-year wait list for intellectual and developmental disability services in the state, which lead to poor health outcomes and an increased reliance on private and unpaid caregiving across Oklahoma–which can be expensive and time consuming for families. DHS bumped its provider reimbursement rates to increase pay for a variety of medical professionals, including nurses, speech therapists, group home employees and direct care staffers who help developmentally disabled Oklahomans and those who help low-income seniors.
The Pennsylvania legislature has passed a law intended to simplify how healthcare providers work with insurers, according to WSKG. The law bars prior authorization for most emergency department services. Insurers must state what they will authorize, and when insurers deny something, they must give written notice which patients can then appeal.
People of color shoulder most of the medical debt throughout Knoxville, Tennessee, explains Kaiser Health News. Systemic racism and a history of segregation in areas such as East Knoxville have manifested in significantly worse health outcomes and higher rates of medical debt in communities of color; for example, more than 30 percent of the residents in the communities surveyed have a medical bill on their credit record, compared to fewer than 10 percent in white suburbs. Many of the gains in health insurance coverage due to the Affordable Care Act have remained out of reach in Knoxville.