State News

CareFirst—an insurance company that provides plans in D.C., Maryland and Virginia—will pay $95 million to set up a fund in D.C. to address health disparities, reports the Washington Post. This comes as the result of a years-long legal battle between the District and CareFirst over the insurer’s surplus funds. CareFirst agreed to establish a Health Equity Fund for the District and will provide grants to reduce health disparities or to address social and environmental problems that affect D.C. residents’ health.

Rhode Island’s Office of the Health Insurance Commissioner (OHIC) released data on trends in health insurance enrollment, enrollment demographics, cost trends, claims and other important information to highlight trends and shifts in the Rhode Island market, reports AboutHealthTransparency.org. Findings included: the individual market has the highest cost-sharing; professional services represented almost one-third of the total fully insured market allowed claims; primary care allowed claims decreased in all markets except the individual market in 2020. The data from this market summary are intended to highlight the major cost drivers of health insurance premiums for advocates and policymakers.

Caitlin Wells Salerno was expecting a bill for the birth of her baby, but was shocked to see a significant charge for the highest level of emergency services, reports Kaiser Health News. Wells Salerno had a routine vaginal delivery and had only checked in at the ER on her way to labor and delivery—she didn’t receive any services in the ER that are reserved for the most serious cases and receive the highest amount of reimbursement. Wells Salerno tried contacting the insurer and fighting the charge, but eventually gave up and paid the bill, noting that she was at a very vulnerable place immediately postpartum and had been taken advantage of when she wasn’t in a position to fight back.

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.

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.

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.

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.

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 80^th 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.

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.