The State Treasurer of North Carolina, who manages the state employees’ health plan, has spent years trying to persuade hospitals to accept lower payments, but has struggled to discover the existing rates the plan pays each hospital and enact policies, reports Kaiser Health News. In North Carolina, hospital inpatient prices for private insurers, which typically drive health premiums, rose by 10 percent from 2014 to 2018. In an effort to help the state control healthcare costs, the Treasurer proposed to base prices on a percentage of Medicare rates, a form of reference pricing, giving hospitals 175 percent of what Medicare reimbursed for inpatient services and 225 percent for outpatient services—a move that would resulted in payment cuts to most hospitals. In response, the North Carolina Healthcare Association warned customers that if no agreement could be reached with the state plan, the hospitals would be considered out-of-network providers. In many states, hospital associations are political powerhouses, with lobbyists and influence from being the largest employer in many legislative districts.
Louisiana legislators passed several health-specific pieces of legislation during the latest special session, according to The Advocate. The legislature passed 71 bills in total, including: requiring the Department of Health to submit documentation to the CMS to receive financial relief for providers that provide care to people with developmental disabilities; directing the Louisiana Board of Pharmacy to study and make recommendations relative to pharmacists' ability to test, screen and treat certain health conditions; and authorizing a study of the decline in health insurance coverage among children in the state.
With no protections in place, Kansans remain among the most vulnerable in the country to surprise medical bills, reports KCUR. Studies cited in an issue brief by the Kansas Health Institute found that Kansas had the second highest rate of out-of-network charges for inpatient hospital care in 2016. Ultimately, one in four Kansas patients received out-of-network services through an in-network hospital. Another study analyzing claims from 40 states found that Kansas ranked fifth for out-of-network charges billed to emergency room patients. Despite ample evidence, the state has yet to take action to address surprise medical bills. A 2020 proposal to establish partial protections failed in the Legislature, in addition to a proposal to require doctors and hospitals to give patients better cost estimates prior to care.
Residents in North Carolina face serious hurdles to accessing dental care, reports the Carolina Public Press. In 2019, residents in 98 of the state’s 100 counties lived in a region designated by the federal government as a Dental Health Professional Shortage Area. Even if residents can find a provider, cost may still be a barrier. Many low-income residents may not have dental insurance and those who qualify for “medically necessary” dental care through Medicaid may have difficulty finding providers who take Medicaid.
UVA Health continues to rely on thousands of property liens to collect old bills, in contrast to VCU Health, another huge, state-owned medical system that pledged to remove all property liens, according to Kaiser Health News. Property liens are the hidden icebergs of patient medical debt, legal experts say, lying unseen, often for decades, before they surface to claim hard-won family savings or inheritance proceeds. Earlier this year, UVA Health temporarily suspended patient lawsuits and wage garnishments, increased discounts for the uninsured and broadened financial assistance after a 2019 Kaiser Health News examination found that the health system had sued patients 36,000 times over six years for more than $100 million–an amount far higher than what insurers would have paid.
Of the ten counties nationally with the highest death rates from COVID-19, five are in Georgia, reports Georgia Health News. Hancock County is first on the list, with a COVID-19 death rate of 45.7 per 10,000 residents and a population where 3 in 4 residents are people of color. These counties are located in rural areas and have high levels of poverty and chronic disease, high uninsured rates, more older residents and large proportions of racial and ethnic minority groups. They also have a long history of systemic racism, which has served as a pre-existing condition for high COVID-19 death rates. Morehouse School of Medicine, an Atlanta school, is using a $40 million federal grant to implement an initiative to fight COVID-19 in minority rural communities.
Georgia’s new Medicaid Section 1115 demonstration program, “Pathways to Coverage,” has been approved, the Centers for Medicare & Medicaid Services (CMS) announced. This program will allow working-age Georgia residents (ages 19-64) who are otherwise ineligible for Medicaid to opt into Medicaid coverage by participating in qualifying activities, such as working 80 hours a month. The program applies to individuals with incomes less than or equal to 100% of the federal poverty level (FPL). The state expects over 30,000 Georgia residents will receive Medicaid coverage during the first year of this demonstration program.
Arkansas Health & Wellness and Arkansas Total Care will be deploying FirstNet to rural healthcare providers and federally qualified health centers (FQHCs) in Arkansas to expand access to telehealth services, according to the companies' press release. FirstNet is a high-speed broadband communications platform built for America's first responders and the extended public safety community. This program will help rural providers and FQHCs integrate virtual care into their workflows and will better enable providers to serve patients in rural areas.
A new report from the University of Alabama’s Education Policy Center found that physical access to healthcare is a luxury that Black Belt communities don’t enjoy, reports the Alabama Political Reporter. The Education Policy Center defines the Black Belt of Alabama as comprising of 24 counties. Of those, 17 have fewer than the statewide average of 3.9 hospital beds per 1,000 people, according to the report. Indeed, four of the Black Belt counties have no hospitals, with some hospitals over an hour away. Even before the COVID-19 pandemic, access to healthcare for rural residents was tenuous. Researchers note that hospitals in states that chose to expand Medicaid were 84 percent less likely to close, because the increased coverage for poorer rural residents encouraged care access and boosted revenue for hospitals that care for high numbers of uninsured residents.
The Latino Impact Plan examines inequities and barriers within the Rhode Island Latinx community across three issue areas: economic equity, health and education, with an additional emphasis on the impact of the pandemic, according to a press release from the Latino Policy Institute. The plan surfaces healthcare access and insurance coverage disparities and highlights how holistic care serves a critical role in communities. The report made several recommendations to address inequities, including healthcare coverage for all children and inclusive statewide communications and engagement.