Under a new Medi-Cal program, California hopes to help vulnerable patients, such as those experiencing homelessness, better manage their care and address their social determinants of health, reports Kaiser Health News in the LA Times. Under the program, patients will be assigned a personal care manager to coordinate their treatments and daily needs, such as paying bills and buying groceries. These patients will receive services that aren’t typically covered by insurance, such as getting security deposits paid, receiving deliveries of fruit and vegetables and having toxic mold removed from homes to reduce asthma flare-ups. Eligible individuals include homeless individuals or those at risk of losing their homes, heavy users of emergency rooms, children and seniors with complicated physical and mental health conditions and people in expensive institutions such as jails, nursing homes and mental health crisis centers. In addition, California is forcing Medi-Cal managed care plan providers to reapply and meet stricter standards to remain in the program, in an effort to hold these companies more accountable for the quality of care they provide.
A survey conducted by Consumers for Quality Care found that Coloradans are increasingly worried about the rising cost of healthcare, reports Public News Service. Many families report struggling to pay medical bills, even with insurance coverage. Communities of color disproportionately experience a healthcare affordability burden, with nearly half of Latinx Coloradans having an unpaid medical bill.
Colorado’s Office of Saving People Money on Health Care released a report documenting the burden that out-of-pocket expenses causes consumers and the importance of addressing it. The report reflects the voices of Coloradans, particularly those with chronic illnesses, who have faced affordability burdens with whom the Office engaged in research about their experiences with health challenges. The report aims to foster conversations among community members, policy makers and providers to collectively take action to further equitable access to affordable healthcare and improve the wellbeing of Coloradans.
A study by USC Brookings Schaeffer Initiative for Health Policy reveals preliminary evidence concerning Connecticut's 2016 Surprise Billing Law, reports AboutHealthTransparency.org. The law requires that a patient’s out-of-pocket costs be no greater than their in-network cost-sharing amounts if they are unknowingly treated by an out-of-network provider at an in-network facility. Researchers observed a stark and sudden increase in allowed amounts for fully insured plans within the state, coinciding directly with the implementation of the law. These findings suggest that the law, by pegging the minimum out-of-network payment requirement to the 80th percentile of provider charges, may have driven a substantial increase in allowed amounts paid to emergency physicians from fully insured plans. These increased allowed amounts are likely to be passed to consumers in the form of higher premiums.
DC Mayor Bowser announced the awardees of the Health Innovation QuickFire Challenge that are aimed at addressing racial and socioeconomic health disparities within the District of Columbia. Grantees proposed potential solutions to transform patient outcomes in maternal mortality, cardiovascular diseases, autoimmunity and kidney diseases.
70 percent of Georgia adults reported having burdensome healthcare costs in the last year and 80 percent are worried about being able to afford healthcare in the future, according to The Current. Specifically, 58 percent of adults encountered cost-related barriers to getting needed care, including skipping doses of medication and foregoing care altogether. Results were drawn from the Altarum Healthcare Value Hub's CHESS survey.
Hawaii stands out nationally for the detailed data on specific race groups under the Asian American and Pacific Islander umbrella for its COVID-19 data, reports the Honolulu Civil Beat. Advocates argue that the disaggregated data is necessary to better understand what’s driving health disparities and develop culturally appropriate interventions to address the disparities. A CDC analysis of the data found Marshallese, other Micronesians and Samoans had the highest rates of COVID-19 between March 2020 to February 2021.
A recent study in JAMA Network Open shows that Maryland’s reimbursement model—that sets annual statewide caps for hospital spending—reduces costs and the incidence of avoidable complications, reports Rice University. Maryland’s model holds hospitals to a global budget for total expenditures related to the care of state residents across all sites (inpatient, emergency department and outpatient), and also requires the state to meet spending and savings targets, such as $330 million or more in Medicare savings, as well as quality-of-care-targets. The study also found that in the first three years following the adoption of the all-payer model, Maryland patients undergoing common surgical procedures had significantly fewer avoidable complications and the rate of growth of hospital bills was lower.
After the second consecutive year that healthcare cost growth exceeded a state target, Massachusetts’ Health Policy Commission recommended a series of steps intended to respond to the continually rising cost of care, reports the State House News Service in the Patriot Ledger. The recommendations, from the Commission’s annual cost trends report, include price caps for the most expensive providers, greater scrutiny around hospital outpatient and ambulatory care expansions and new affordability standards for health plans. The Commission noted that price growth is a primary driver of the state’s overall spending growth and that premiums and out-of-pocket spending are rising faster than incomes.
More than half of Massachusetts adults said they had experienced healthcare cost hardship in the past year, and almost three-quarters said they were worried about their ability to afford care in the future, according to a State House News Service article in The Patriot Ledger. Results were drawn from the Altarum Healthcare Value Hub’s CHESS survey.
Multiple Michigan behavioral health clinics will now be able to seek Medicaid reimbursement for mental health services, according to MLive News. Thanks to the new "transforming behavioral health initiative," thirteen selected Certified Community Behavioral Health Clinics will be reimbursed through Medicaid for expanded services, including 24-hour psychiatric crisis services. The new model, supported by both federal and state funding, is intended to address disparities in who can afford and/or access mental health services.
The Health Policy Institute of Ohio released a fact sheet on the connections between racism and health, aimed at engaging policymakers to take action to advance health equity. The fact sheet highlights three key findings for policymakers: racism is a health crisis; racism manifests itself across all levels of society; and many opportunities exist to dismantle racism. In addition, it details the health impacts of racism and health disparities across Ohio. Finally, the fact sheet details ways for policymakers and others to take action to dismantle racism and achieve health equity for all Ohioans.
A new report found that the sixty percent of people who file for bankruptcy in Oregon have medical debt, according to The Lund Report. Furthermore, medical debt accounted for more than half of their debt. The report’s authors argue that the high percentage of those with medical debt who filed for bankruptcy is due to the high cost of healthcare and health insurance and recommend several strategies for the state to pursue to lower costs for consumers.
Texas is expanding telehealth services for children through a grant of more than $530,000 to rural health clinics, according to State of Reform. The grants will help four hospitals expand or implement telehealth pediatric services through video chats and phone calls. The funding is part of a grant program to establish and administer a tele-connectivity resource program for children’s health in rural Texas.
Texas has recently enacted laws improving hospital price transparency and evaluating ambulance surprise billing, according to AARP. SB 1137 mirrors federal price transparency requirements but levies harsher penalties for non-compliance. SB 790 requires the state to study ambulance surprise medical billing and allows counties and municipalities to outlaw balance billing for claims by counties or municipalities.
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