The Louisiana Department of Health completed 41 out of 45 goals and 234 out of 253
deliverables, according to the Louisiana Department of Health’s annual Outcomes Report. The
goals were selected from a range of policy priorities and include: addressing chronic disease;
improving maternal health; expanding Medicaid policies that address environmental health risks;
expanding the behavioral health system’s capacity; and improving services for citizens with
developmental disabilities.

New Orleans is partnering with the nonprofit RIP Medical Debt to wipe out millions in medical debt for eligible residents, reports Axios New Orleans. The program will buy debt owed by residents whose incomes are less than four times the poverty level, or who owe more than five percent of their annual income. About 22 percent of Louisianans have medical debt, which disproportionately affects people of color; the program could help an estimated 80,000 New Orleans residents by cancelling about $130 million in debt.

Healthcare in Louisiana averaged $9,796 per person in 2020 in Louisiana, the second most expensive in the country, reports New Orleans City Business. The report details how Louisiana residents with employer-sponsored insurance have some of the highest premiums in the country, with single employees paying $1,740 per year. Louisiana had the fifth highest increase in overall healthcare spending per person between 2016 and 2020—with about a 23 percent increase

Medicaid expansion in Louisiana was associated with decreased travel distance to healthcare providers, according to a study in Health Affairs. The authors studied this relationship among continuously enrolled Medicaid beneficiaries from 2015-2017, with Medicaid expansion occurring in July 2016. Distance traveled decreased across eight different types of services, ranging from −3.46 miles for general practices to −0.70 miles for specialty care. Black enrollees living in nonmetropolitan areas experienced the greatest decline in travel distance, with more than nine fewer miles traveled for primary care services. The authors argue that Medicaid expansion can be a tool to address racial and geographic disparities in healthcare access.

A new report from the Louisiana Department of Health examines health access disparities in Louisiana across demographic groups and insurance plans. Data from more than 8,500 households were compiled and assessed if their health insurance met their needs and allowed them to see the providers that they need,breaking down results by gender, race, health insurance plan and location. The report found that females have better insurance coverage than males; white Louisianans have better coverage than Black Louisianans and rural children are more likely to report less access and having coverage that does not meet their needs than those in urban areas.

Recently released 2019 data from the biennial Louisiana Health Insurance Survey (LHIS) found that the state uninsured rate for nonelderly adults age 19-64 (11.1%) measured lower than the national average, as did the state uninsured rate for children (3.8%). Moreover, 32 percent of respondents felt their costs were unreasonable a majority of the time. Other topics measured by the survey include whether respondents felt their healthcare needs were being met, healthcare provider availability and the reasonability of healthcare costs in the state.

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.

The lack of maternal care in many areas of Louisiana—forcing women to travel long distances for routine checkups, emergency visits and deliveries—likely contributes to one of the nation’s highest maternal mortality rates, reports NOLA.com. The research from March of Dimes found that 35 out of 64 parishes have little to no access to maternal care, including Evangeline Parish, where there is just one OB/GYN for a population of more than 33,000 people. Due to scarcity of care, researchers estimate that one in four pregnant women in Louisiana may need to travel outside of their parish for the many services necessary to monitor a pregnancy: ultrasounds, blood tests, glucose screenings, specialist appointments and delivery. Traveling is not always possible for women who have transportation or time constraints. Women in these "maternity care deserts" had a threefold higher risk for death directly related to the pregnancy, such as severe bleeding or preeclampsia, a dangerous complication involving high blood pressure.

The Louisiana Department of Health has released an interim report on its Reducing Maternal Morbidity Initiative, focused on reducing preventable maternal mortality and morbidity related to hemorrhage and hypertension, while also focusing on reducing racial disparities in these maternal outcomes. Preliminary outcomes indicated that severe maternal morbidity among women with hemorrhage and severe hypertension is decreasing in birthing facilities in the Perinatal Quality Collaborative.  

Louisiana's Medicaid expansion cut the state's uninsured rate among adults by half in two years, plummeting from more than 22 percent to just over 11 percent. According to FierceHealthcare, the lowest rate can be found in the Houma-Thibodaux region, where only 8.5 percent of adults lack coverage. This data was uncovered by the most recent Louisiana Health Insurance Survey, which is sponsored by the Department of Health and conducted by Louisiana State University. Medicaid expansion made geographic discrepancies in coverage across the state “much more muted in 2017,” the report notes, adding that the statewide uninsured rate “may drop further in future years as residents become more informed of Medicaid options and eligibility.” 

The Federal Trade Commission (FTC) has cleared a deal for UnitedHealth Group to purchase Peoples Health Inc., a Louisiana-based HMO operating in one of the few states where the health insurer isn't already one of the three largest sellers of Medicare Advantage health plans. According to the Star Tribune, UnitedHealth Group already runs the nation's largest health insurer, UnitedHealthcare, plus a fast-growing division for health care services called Optum. UnitedHealth wasn't in the top three in terms of market share in Louisiana, where Peoples Health ranked No. 2 last year, according to a Kaiser Family Foundation report.  

Louisiana is evaluating a subscription-based payment model for high-cost drugs targeting Hepatitis C, according to the state’s Department of Health. The cost of Hepatitis C treatment, which affects 30,000 people in the Louisiana Medicaid program and prison system, creates barriers for the most vulnerable populations suffering from the disease. Under this payment model, the state would pay a drug manufacturer or manufacturers for unlimited access to the treatment for the individuals in Louisiana who are enrolled in Medicaid or in Louisiana’s correctional system. The total payment to the manufacturer would be equal to or less than what the state is currently spending, but by paying less per person, would reach many more patients. 

Two new Louisiana laws aim to regulate drug pricing and providing more transparency in how prices are set. According to NOLA.com, the legislation (SB 282 and SB 283), requires pharmaceutical benefit managers (PBMs) to share more information about how they operate in Louisiana. PBMs negotiate rebates from drug makers to insurers in exchange for lower co-pays, but often do not pass rebates on to the consumer. A recent Altarum study estimated that health insurers nationwide received an estimated $86 billion in rebates in 2016 alone. PBMs will now be required to release an annual report that discloses the percentage of any rebates received from drug manufacturers. Additionally, insurers will have to let enrollees know when they are being charged more for a prescription drug than the insurer itself pays.

Louisiana Insurance Commissioner James Donelon says he is supporting a bill that would create an insurance pool to help stabilize the state’s individual market for health insurance. According to Insurance Journal, House Bill 472, which has already passed in the House, would create a program to provide reinsurance for high dollar claims in the state. In the last five years, the number of health insurers in the Louisiana individual marketplace have declined from 16 to 2, while rates have more than doubled, Donelon stated. The Louisiana Department of Insurance estimates that the reinsurance program, which was part of the Affordable Care Act for three years, could reduce insurance rates by about 15 percent.  

In the American Journal of Managed Care, Travis Broome leads rapid and detailed analysis of new regulations pertaining to Medicare and affecting Aledade ACOs. He argues that CMS should move from a national benchmark for Medicare Shared Savings Program ACOs to a regional one to improve quality measures of healthcare value.

According to Policy and Medicine, in mid-June 2017 Governor John Bel Edwards of Louisiana signed two drug price transparency measures. HB 436 requires manufacturers engaging in the marketing of prescription drugs in the state to make quarterly reports of the wholesale acquisition cost (WAC) prices to the Louisiana Board of Pharmacy, while SB 59 requires the Louisiana Board of Pharmacy to post on a website those WAC prices, organized by therapeutic category.

Public outcry over high-priced Hepatitis C drugs has prompted Louisiana officials to propose using an obscure federal law to get medicines at a lower cost, according to Kaiser Health News.  Hepatitis C treatment in Louisiana would cost the state a staggering $764 million for the 35,000 uninsured and Medicaid enrollees with Hepatitis C. Under existing federal law, the Trump administration could sidestep patents and contract with a generic supplier to offer a lower-priced version of the expensive antiviral drugs. The government would have to pay the drugmaker only  “reasonable compensation” and prove that using the product benefits the U.S. government.  

A new study by WalletHub identified Louisiana as the second-worst state for healthcare cost and quality, according to New Orleans City Business. Specifically, the state ranked 34th for healthcare access, 37th for healthcare costs, and 51 for health outcomes.

Beginning June 1, 2016, Medicaid expansion will allow residents with incomes up to 138 percent of the federal poverty level to enroll in Medicaid. More than $1 billion over a decade may be saved by the state of Louisiana as a result of federal matching funds provided by the expansion, according to CNBC.

Budgetary shortfalls are expected to be balanced, at least in part, by newly expanded sin taxes for cigarettes and alcohol, according to KPLC. The cigarette tax is anticipated to bring in $46 million next year.

The public-private partnerships the state has developed to keep Louisiana's former charity hospitals operating could crumble if the state is forced to cut funding to the Department of Health and Hospitals, according to the Time-Picaqune. The cuts have been fiercely fought by private-public partnership hospitals. Should these cuts take place, hospitals claim they would no longer be able to provide care to the poor, including the newly eligible through the Medicaid expansion that occurred in July 2016.

The Louisiana Health Information Exchange provides real-time clinical data across more than 300 providers, according to the 2015 annual report from the Louisiana Health Care Quality Forum. These data, among other things, are used to track ED utilization which can be used to reduce costs and improve outcomes through initiatives such as care management. The state also implemented a statewide patient portal connecting all patients and providers on a single, unified platform.

Louisiana’s market experienced the largest drop in the country in competition among commercial insurers between 2010-2013, according to an analysis by the AMA featured in Becker’s Hospital Review. Louisiana also ranked in the 10 least competitive HMO and PPO markets in the United States.

The former state-owned charity hospital system transitioned to a private-public partnership model, referred to as the Alliance of Partnership Hospitals, beginning in April 2012. According to this legislative update, the Alliance touts improvements including the reduction in ED wait times, increase in outpatient visits, and reduction in costs per patient day, among other things.  

The largest such pharmaceutical recovery ever received by Louisiana was awarded as a result of two lawsuits over claims of off-label promotion to physicians, according to NOLA.com. Physicians prescribing off-label medications leave patients vulnerable to the potentially serious consequences of using non-approved, ineffective and unsafe treatments. A total of $229 million was split among eight states filing suits against the pharmaceutical company.