State News

"The Birthday Rule" can generate large, unexpected medical expenses for emergency infant healthcare, according to a bill investigation by Kaiser Health News. When a baby is born covered by employer-based insurance from both parents, the child's primary coverage must be with the parent whose birthday falls earlier in the calendar year. If the early-birthday parent's coverage has a high deductible or is out of network for the infant intensive care services provided, parents may be charged thousands of dollars. Most states have adopted this regulation, and parents have no choice in which coverage their baby has apart from removing the child from the inferior coverage or dropping it altogether.

A new report from the Colorado Department of Health Care Policy & Financing found that specialty drugs represented less than two percent of drugs prescribed to patients in Colorado but accounted for almost 50 percent of total prescription drug expenditures, reports State Network. Additionally, the report on reducing prescription drug costs found that rebates paid to middlemen such as PBMs and insurance carriers are often retained as profits. Proposed solutions include creating an affordability board to study prescription drug prices, passing along rebates and savings to employers and consumers and increasing transparency in prices, profits and rebates.

D.C. Health announced changes to its COVID-19 vaccination distribution plan to ensure equitable distribution throughout the district, reports WJLA. Additional vaccination appointments will be made available to residents in wards that have a high proportion of BIPOC members and have been disproportionately impacted by the coronavirus. The plan to ensure equitable distribution comes after data from D.C. Health revealed that very few residents in wards that have had the most deaths from COVID-19 have been able to get a vaccine appointment, while residents in areas with the least deaths have been able to obtain the most appointments.

Medicaid plays an essential role in reducing health disparities and Minnesota has been a leader in longstanding public reporting of health disparities for the state and Medicaid program, including social risk factors, according to a report from AcademyHealth and the Disability Policy Consortium. The report, created in response to the disproportionate impact of COVID-19 on Black, Latino, Native American, Asian and other people of color, people with disabilities, and people living in poverty, explains how state Medicaid programs can respond to health disparities. Minnesota has continued to develop reporting measures on health disparities, particularly within the Medicaid population, to inform their Medicaid value-based payment model for the Integrated Health Partnership Initiative, which is required to propose a health equity measure tied to interventions intended to reduce health disparities. The report provides more information to support state Medicaid programs measure and address health disparities, emphasizes the importance of an intersectional approach to disparity measurement, and urges state Medicaid programs to invest in data and analysis to measure health disparities.

The Texas Health and Human Services Commission (HHSC) received federal approval for a 10-year extension through September 2030 for its Texas Healthcare Transformation and Quality Improvement Section 1115 demonstration waiver, according to The Texas Tribune. The federal funding agreement reimburses hospitals for the uncompensated care they provide to patients without health insurance. It also pays for innovative healthcare projects that serve low-income earners in Texas, often for mental health services.

The Pennsylvania Interagency Health Reform Council (IHRC) released recommendations to reduce costs, decrease disparities and improve healthcare delivery, reports the Pennsylvania Pressroom. The IHRC’s recommendations include creating a health value commission to institute healthcare cost benchmarking, developing regional accountable health councils to address health equity, integrating social services into healthcare delivery, making data dashboards public to drive quality improvement and leveraging state purchasing power. The IHRC will support legislative action related to these recommendations, continue to facilitate inter-agency coordination and track progress on the recommendations. 

Oregon health officials and lawmakers are seeking the legislature's approval on formal report describing a cost-growth-capping program that would hold insurers and large and medium-sized medical practices to annual per-patient cost growth caps, require formal justification if they exceed the cap, and potentially fine them if they exceed the cap, according to The Lund Report. Oregon would be the fifth state to adopt a cost growth target program. The Sustainable Health Care Cost Growth Target Implementation Committee hopes to address the root causes of healthcare cost growth, however, there is worry that some providers and insurers, anxious to come in under the cap, may try to cut the quality or volume of care.

The U.S. Department of Health and Human Services announced that a collaboration of federal agencies will supply $6.5 million in funding over three years to evaluate the broadband capacity of healthcare providers and patients in the hopes of improving access to telehealth services, according to State of Reform. The initiative will focus on four states – Alaska, Texas, Michigan, and West Virginia – and is targeted specifically to rural areas. Funding for this effort will support the measurement of bandwidth and the quality of connectivity in target communities, and additional funding will be needed to address the needs identified.

Several of Utah’s healthcare leaders have declared racism a public health crisis and developed a plan to eliminate it, reports The Salt Lake Tribune. Several of Utah’s large healthcare providers have committed to providing educational programs, services and personal protective equipment (PPE) to marginalized communities and creating avenues for hiring people of color in healthcare careers. The leaders noted several health inequities that people of color in Utah experience, especially from COVID-19, and their desire to achieve equitable healthcare for all Utahns.