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.
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.
Wyoming residents shared stories of people who died without healthcare at a vigil held to advocate for Medicaid expansion, according to Oil City News. Attendee Linda Jones's friend Earl lost his job and insurance while recovering from a fall injury, eventually selling his prized car to pay medical bills. His health declined rapidly and he was found dead in his home.
At the beginning of the coronavirus pandemic, insurers announced that they would cover all of the costs for COVID-19 treatment, but now, most insurers have reinstated co-pays and deductibles for COVID-19 patients, reports The Washington Post. Jamie Azar, who was hospitalized with COVID-19 in July, is facing thousands of dollars in co-pays, deductibles and out-of-network charges for her hospital and rehab stays for her treatment, with potentially thousands of dollars more in uncovered expenses as her recovery continues. The financial burden of COVID-19 is falling unevenly on patients across the country: health plan coverage varies widely across states, with only two states (Vermont and New Mexico) mandating complete insurer coverage of treatment. Azar—whose insurer reinstated patient cost-sharing on Jan. 31—now joins millions of other Americans with serious illnesses who face uncertain, confusing and expensive medical billing and insurance practices.
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.
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.
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.
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.
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.
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.