State News

Montana’s state employee health plan has experienced significant savings in the two years since the transition to reference-based pricing, reports NASHP. The independent analysis of the program reveals no evidence that utilization artificially increased as a result of the new payment model, which would occur if hospitals needlessly push more services onto patients to offset lower reimbursement rates. Furthermore, the report notes that there have been no hospital closures in Montana. Prior to implementing reference-based pricing, Montana’s third-party administrator negotiated hospital reimbursement rates as a discount off of a hospital’s chargemaster rates. Before the transition, Montana paid a range of 191 to 322 percent of Medicare rates for inpatient services and 239 to 611 percent of Medicare rates for hospital outpatient services. After the reference-pricing went into effect, Montana pays 220 to 225 percent for inpatient services and 230 to 250 percent for outpatient services.

A nonprofit incorporated by the president of the Mississippi Hospital Association and others has filed preliminary paperwork to start a ballot Initiative that would put Medicaid expansion in the state constitution, according to Mississippi Today. Mississippi is one of just 12 states that has refused to expand Medicaid, leaving hundreds of thousands of citizens without the ability to afford healthcare coverage and rejecting at least $1 billion per year in federal funds. The planning stages of the ballot initiative signals a broad coalition may be on board with the effort.

Before the COVID-19 pandemic hit, Minnesota medical providers were improving on care metrics for low-income Minnesotans, reports the Mankato Free Press. These findings stem from MN Community Measurement’s latest report, which compared treatment quality for patients on public Minnesota Health Care Programs to patients with other types of insurance. Overall, care gaps for patients with public health insurance plans narrowed in 2019, with a greater percentage of patients with these plans receiving diabetes care, breast cancer screenings and colorectal screenings than in the previous year. All other health measures in the report showed similarly narrowed gaps where comparisons were possible. However, researchers posit that post-pandemic findings could look drastically different, with postponement of care and increases in telehealth potentially playing large roles.  

The Illinois Department of Healthcare and Family Services and Department of Insurance released a feasibility report that explores policy options to make health insurance more affordable for low- and middle-income residents in Illinois. The report notes that racial and ethnic disparities in health insurance coverage and access are reflected in people of color being more likely to be uninsured and more likely to go without care due to cost. The study included six policy options for the state to consider to achieve its goals of reducing the number of uninsured, increasing affordability of care and improving health equity: a Basic Health Program; state premium and cost-sharing subsidies; a public option plan, a Medicaid buy-in; transitioning to a state-based marketplace; and state-supported marketing and outreach.

The Oregon Health Authority (OHA), along with the Oregon Health Leadership Council, announced that 40 organizations have signed a compact to adopt “value-based payments” which reward healthcare quality rather than healthcare quantity, according to OHA. The agreement targets moving to 70 percent of payments following advanced value-based payment methods over five years and supports the work of the cost growth target program, which is beginning implementation this year. In Oregon’s healthcare transformation efforts, value-based payments are one of a few key tools to achieve meaningful cost containment while prioritizing quality care. 

A federally commissioned study found that Indiana’s Medicaid expansion program had mixed results in improving health and access to care, reported Kaiser Health News. Indiana’s Medicare expansion program, called the Healthy Indiana Plan, requires eligible beneficiaries to make monthly contributions to a health savings account that is then used to pay for covered healthcare services. A federally funded study found that although the program increased healthcare coverage, it did not improve healthcare access, affordability or health status compared to both states that did and did not expand Medicaid.

Delaware’s Department of Health and Social Services (DHSS) released its first healthcare Benchmark Trend Report, detailing total healthcare spending for 2019 and comparing it to baseline data collected for 2018, according to a DHSS press release. The report follows Executive Order 25, signed by the governor in late 2018, which established a state healthcare spending benchmark, a rate-of-growth benchmark and several healthcare quality measures. The first spending benchmark went into effect on Jan. 1, 2019 and was set at 3.8%, with the target expected to decrease gradually to 3% over the following three years.

A report from Hawaii State Department of Health reveals many COVID-19 inequities, particularly among Pacific Islanders, Native Hawaiians and Filipinos, reports State of Reform. Pacific Islanders accounted for a quarter of Hawaii’s COVID-19 cases, despite making up four percent of the state’s population, and had the highest age-adjusted mortality rate in the country. The report also shows that while Native Hawaiians and Pacific Islanders make up a quarter of the state’s population, they have received 13 percent of the state’s vaccinations. The report includes several recommendations, including collaborating with community organizations and stakeholders and increasing the representation of historically marginalized communities in government leadership positions and workgroups. 

The Washington Health Alliance released its 15th Community Checkup report that comprehensively reviews medical claims data to measure progress toward improving health outcomes for Washington residents. The report summarizes information from 1,869 clinics, 322 medical groups, 105 hospitals, 15 health plans, 39 counties and all nine Accountable Communities of Health on more than 100 performance measures in order to: (1) compare Washington’s performance with national benchmarks; (2) rank providers’ performance on primary care delivery; (3) monitor opioid prescribing and healthcare spending trends; and (4) spur action by health plans, healthcare professionals, and purchasers like employers and union trusts.