State News

Public and private employers and two purchasing coalitions have joined the Colorado Purchasing Alliance and Purchaser Business Group on Health, reports Modern Healthcare. The goal of the group is to negotiate directly with health systems to set prices for common procedures. Larimer County, who joined the group, hopes that the partnership will drop its $25 million annual healthcare costs by another 10 percentage points. The group hopes that by staying local, they can get better care for people with chronic conditions and allow regional employers to enter a common purchasing coalition but still customize their individual companies’ benefits. The group will identify high-quality medical providers in Colorado, and the not-for-profit's national employer members will also be able to opt in to the contracts that the local business group negotiates.

Though breast cancer screenings dropped sizably among all Washington women, women of color and those living in rural communities experienced the steepest drop-offs, according to a study by researchers at Washington State University Health Sciences Spokane and a not-for-profit healthcare system, MultiCare. The study, published in JAMA Network Open, used medical records data from MultiCare patients who had screening mammograms completed between April and December of 2019 and during the same months in 2020, after the World Health Organization declared COVID-19 a global pandemic. The number of completed screening mammograms across Washington fell by 49 percent, but these results were not consistent across racial groups. Breast cancer screening declined by 64 percent in Hispanic women and 61 percent in American Indian and Alaska Native women. In addition, screenings dropped by almost 59 percent for rural women, versus about 50 percent for urban women. This is the first study to examine racial and socioeconomic differences in missed cancer screenings during the pandemic.

The Community CAre Transitions (C-CAT) clinical trial, which paired community health workers with patients admitted to Massachusetts General Hospital, found that fewer intervention group participants were readmitted within 30 days than control group participants. The study, published in JAMA Network Open, revealed a significant effect for patients discharged to short-term rehabilitation but not for those discharged home. In the study, community health workers trained in basic knowledge of clinical conditions provided health coaching and connected patients to specific low and no-cost resources (like food, transportation and housing) that were contributing to gaps in their care, seeking to strengthen patient connections to primary care while addressing unmet needs. Just 12.6 percent of intervention group participants were readmitted in the 30 days following hospital discharge, compared to 24.5 percent of control participants. In addition, fewer intervention than control patients had missed appointments (22% vs. 33.7%) and ED visits (11.2% vs. 16.8%).  

The Wisconsin Department of Health Services has announced the creation of a new branch to improve health outcomes of historically underrepresented groups—The Office of Health Equity—reports Spectrum News 1. The Office of Health Equity will conduct research and policy analysis to address the social determinants, or root causes, of health, including access to housing, stable income and healthcare. The new Office will coordinate existing and new efforts on equity and inclusion across the Department of Health Services, including implementing strategies to build an infrastructure and culture committed to equity and inclusion along with minimizing the impacts of health disparities in Wisconsin communities by evaluating and proposing changes to Department of Health Services policies and budget.

Montana recently passed a law, SB 374, that would allow all Montana physicians, starting in Fall 2021, to dispense medications they prescribe to patients, not just those whose offices are at least 10 miles away from a pharmacy, reports U.S. News and World Report. The new law requires physicians who dispense medication to be regulated like a pharmacy and requires opioids to be dispensed by pharmacies. Another new law, SB 395, aims to reduce prescription drug prices by allowing the state to regulate pharmacy benefit managers. The Governor hopes that by increasing transparency and oversight of the middlemen in the pharmaceutical supply chain, the state will bring generic drugs to market faster, increase pricing transparency and promote accountability.

When he found himself suddenly without insurance, Cory Dowd signed up for what he thought was a regular insurance plan at a lower price than others offered, reports MPR News. However, he had actually signed up for a short-term limited duration plan, which he learned upon receiving the bill for his emergency appendectomy due to appendicitis. The initial hospital bill totalled more then $41,000, with the final hospital statement showing that insurance had paid just $1,682 and Dowd still owed $33,600.  After contacting the hospital and insurance company multiple times, Dowd was finally informed that his outstanding hospital bill would be covered by his insurance company. 

OSPIRG is highlighting the experiences of many Oregonians who are spending too much on healthcare and receive too little in return in the Voices for Better Care project. Jordan R. doesn’t “want to refill [their] expired epi pen because it’s so expensive. It hurts to know it’s not as expensive in other countries, but it is here.”

The Tennessee General Assembly passed a certificate of need reform bill to reduce requirements and costs associated with opening, reopening or expanding a hospital, reports the Murfreesboro Post. The law changes the fee schedule associated with obtaining approval for a new healthcare service or facility, reduces the application process from 135 days to 60 days, exempts services in counties with populations above 175,000 people and allows rural hospitals to reopen without restarting the certificate of need application process.

Health insurers in Oregon that waived all deductibles, copayments and other costs for insured patients who fell ill with COVID-19 and needed hospital care, doctor visits, medications or other treatment are no longer waiving fees for COVID treatment, according to The Lund Report. In a study released in November, researchers found about 88 percent of people covered by insurance plans — those bought by individuals and some group plans offered by employers — had policies that waived such payments at some point during the pandemic. Waivers resulted in significant savings for COVID patients who fell seriously ill and wound up in the hospital.