State News

Many Massachusetts physician groups are struggling to leverage telehealth as they continue to deal with lagging patient volumes, reports Modern Healthcare. Overall, there were more struggling small physician practices in Massachusetts than successful ones as of September and October, according to data released by the Massachusetts Health Policy Commission, as many providers found it difficult to use or clinically inadequate. Anecdotally, some providers are considering early retirement or joining larger practices.

Colorado has become one of the first states in the U.S. to allow pharmacists to prescribe HIV prevention drugs, as part of a public health effort to curb rising infection rates, reports the Colorado Sun. Pharmacies can now offer the daily preventive pill or an emergency version that can be taken within 72 hours of an exposure to the virus. While rural communities may have just two or three primary care doctors, they typically have about a dozen pharmacies, making this law a true expansion of access to the medication. This new HIV protocol also allows pharmacists to collect reimbursement from insurance companies for providing consultation to patients.

More than 40 percent of surveyed Coloradans with diabetes said that high insulin costs forced them to ration their own use of the lifesaving drug at least once a year, reports the Colorado Sun. According to a new report from the state’s Attorney General, insulin costs for Colorado patients rose 262 percent in the past 10 years, which could be the result of a lack of competition among drug makers and distributors. These ‘lockstep’ price increases that have drawn lawsuits over alleged collusion. The report was ordered as part of a 2019 bill that caps copays for insulin at $100 a month and zeroes in on the fact that the insulin market is dominated by just three manufacturers and three pharmacy benefit managers. The report recommends steps that the state or federal government can make quickly to ease consumer burdens.

Massachusetts’ Attorney General hosted a discussion summarizing a new report with recommendations on racial justice and equity in healthcare, reports CapeCod.com. The report highlights longstanding disparities, as well as the disproportionate effect that COVID-19 has had on Black, Hispanic and Latinx communities. The report calls for action in five domains: data to identify and address health disparities; equitable distribution of healthcare resources; telehealth as a tool for expanding equitable access to care; healthcare workforce diversity; and social determinants of health and root causes of health inequities.  

Telehealth has grown rapidly in Illinois this year, in part thanks to an executive order by the state’s governor requiring insurance companies regulated by the state to cover telehealth appointments like in-person office visits, reports WBEZ. The state also expanded telehealth coverage for Medicaid and Medicare patients, and the federal government has loosened restrictions as well. However, if the pandemic ends (along with it, the governor’s order) with no legislative action, Illinois would revert to prior rules and healthcare providers would not be reimbursed for the same services at the same rates. Though experts are still unsure about the long-term impact on costs, telehealth has helped increase access without increasing patient costs for rural residents. Similarly, there is concern about lack of internet access among Black, Latinx and senior patients, which may cause them to miss out on telehealth access.

A significant portion of patients at a crisis stabilization unit (CSU) had decreased emergency department visits, inpatient or outpatient hospital stays or jail bookings in the six months following CSU intervention, according to a study from the Arkansas Center for Health Improvement. Using data from the state’s all-payer claims database, the study focused on one of the state’s four CSUs, an alternative to jails and emergency departments that provide mental health support for people in crisis who encounter law enforcement. There was an overall decrease in the number of patients who experienced a medical stay or jail involvement post-CSU, and those who did, experienced them less often than pre-CSU intervention. Total and per-member per-month costs for Medicaid increased in the post-CSU period, while costs for patients with commercial coverage decreased, possibly due to changes in utilization of costly medical services. The study also found that patients experienced a 27.5 percent decrease in total jail days in the post-CSU period.

A new course at the University of Minnesota is teaching undergraduate medical students cultural competency skills, reports the Minnesota Daily. The course focuses on teaching medical professionals about differences in cultural practices and how to communicate with patients who may have a history of medical mistreatment. Leaders in the program say they hope teaching these skills will lead to broader reform in the medical field. The instructor is seeking to make the class a regular offering.

NorthPoint Health & Wellness Center has doubled the rates for childhood vaccinations and health screenings, resulting in prevention of disease and lower costs for treatment and care over its fifty-year history. The center is a community health and dental clinic and social services agency in Minneapolis that was founded to increase access to healthcare and social services in a community that is now 90 percent Black, Latinx or Asian, reports NPR. NorthPoint’s measures, including stocking a free-food shelf with healthy, culturally relevant food, has increased its reach in the diverse community—something many medical centers struggle with. NorthPoint is a community health clinic, not a hospital, so it does not face many of the commercial revenue pressures as many private hospitals and can focus on its mandate to improve public health through a lens of race in the community. This has allowed their community-oriented primary care approach to flourish and improve health outcomes and lower healthcare costs. 

Illinois health officials are worried about increasing disparities in maternal health and mortality, with higher maternal deaths than the national average coupled with recent hospital closures, reports the Chicago Tribune. Black women across America are significantly more likely to die from pregnancy-related conditions, as well as deliver infants pre-term and lack access to prenatal care—25 percent of Black women in Chicago do not get adequate prenatal care, compared with 11 percent of white women. State health officials reviewing cases of pregnancy-related deaths have deemed about 72 percent of cases preventable. The Illinois Senate’s Public Health and Health and Human Services committees are looking into ways to shrink the maternal health disparities gap; at a recent hearing, advocates brought up opportunities to tackle these health disparities, including more implicit bias training and diversity in healthcare workers, covering doula services under Medicaid and expanding home visits and creating a birth center.