State News

With no protections in place, Kansans remain among the most vulnerable in the country to surprise medical bills, reports KCUR. Studies cited in an issue brief by the Kansas Health Institute found that Kansas had the second highest rate of out-of-network charges for inpatient hospital care in 2016. Ultimately, one in four Kansas patients received out-of-network services through an in-network hospital. Another study analyzing claims from 40 states found that Kansas ranked fifth for out-of-network charges billed to emergency room patients. Despite ample evidence, the state has yet to take action to address surprise medical bills. A 2020 proposal to establish partial protections failed in the Legislature, in addition to a proposal to require doctors and hospitals to give patients better cost estimates prior to care. 

Behavioral health experts are partnering with primary care physicians in 30 UCHealth primary care clinics across Colorado so that patients can easily get their mental and emotional needs met in the same setting, reports KOAA News5. The goals of this program are to increase access to behavioral health services and decrease stigma by normalizing these services for patients.

Telehealth improved access to behavioral health and speech language pathology services in Maine, through usage still remained low, according to a study in the Journal of Rural Health. Telehealth usage increased to 0.28 percent of Maine’s population in 2016, up from 0.02 percent in 2008, based on data from Maine’s all-payers claims database. Telehealth usage varied by area: speech language pathology was the most common type of service among rural residents, while psychiatric services were most common among urban residents. Medicaid was the primary payer for more than 70 percent of telehealth claims in both rural and urban areas of the state, driving the increase of telehealth claims over time. The study identified provider shortages, broadband, and Medicare and commercial coverage policies as barriers to telehealth access and implementation in rural areas.

Residents in North Carolina face serious hurdles to accessing dental care, reports the Carolina Public Press. In 2019, residents in 98 of the state’s 100 counties lived in a region designated by the federal government as a Dental Health Professional Shortage Area. Even if residents can find a provider, cost may still be a barrier. Many low-income residents may not have dental insurance and those who qualify for “medically necessary” dental care through Medicaid may have difficulty finding providers who take Medicaid.

The lack of maternal care in many areas of Louisiana—forcing women to travel long distances for routine checkups, emergency visits and deliveries—likely contributes to one of the nation’s highest maternal mortality rates, reports NOLA.com. The research from March of Dimes found that 35 out of 64 parishes have little to no access to maternal care, including Evangeline Parish, where there is just one OB/GYN for a population of more than 33,000 people. Due to scarcity of care, researchers estimate that one in four pregnant women in Louisiana may need to travel outside of their parish for the many services necessary to monitor a pregnancy: ultrasounds, blood tests, glucose screenings, specialist appointments and delivery. Traveling is not always possible for women who have transportation or time constraints. Women in these "maternity care deserts" had a threefold higher risk for death directly related to the pregnancy, such as severe bleeding or preeclampsia, a dangerous complication involving high blood pressure.

UVA Health continues to rely on thousands of property liens to collect old bills, in contrast to VCU Health, another huge, state-owned medical system that pledged to remove all property liens, according to Kaiser Health News. Property liens are the hidden icebergs of patient medical debt, legal experts say, lying unseen, often for decades, before they surface to claim hard-won family savings or inheritance proceeds. Earlier this year, UVA Health temporarily suspended patient lawsuits and wage garnishments, increased discounts for the uninsured and broadened financial assistance after a 2019 Kaiser Health News examination found that the health system had sued patients 36,000 times over six years for more than $100 million–an amount far higher than what insurers would have paid.

Of the ten counties nationally with the highest death rates from COVID-19, five are in Georgia, reports Georgia Health News. Hancock County is first on the list, with a COVID-19 death rate of 45.7 per 10,000 residents and a population where 3 in 4 residents are people of color. These counties are located in rural areas and have high levels of poverty and chronic disease, high uninsured rates, more older residents and large proportions of racial and ethnic minority groups. They also have a long history of systemic racism, which has served as a pre-existing condition for high COVID-19 death rates. Morehouse School of Medicine, an Atlanta school, is using a $40 million federal grant to implement an initiative to fight COVID-19 in minority rural communities.

Georgia’s new Medicaid Section 1115 demonstration program, “Pathways to Coverage,” has been approved, the Centers for Medicare & Medicaid Services (CMS) announced. This program will allow working-age Georgia residents (ages 19-64) who are otherwise ineligible for Medicaid to opt into Medicaid coverage by participating in qualifying activities, such as working 80 hours a month. The program applies to individuals with incomes less than or equal to 100% of the federal poverty level (FPL). The state expects over 30,000 Georgia residents will receive Medicaid coverage during the first year of this demonstration program.

Arkansas Health & Wellness and Arkansas Total Care will be deploying FirstNet to rural healthcare providers and federally qualified health centers (FQHCs) in Arkansas to expand access to telehealth services, according to the companies' press release. FirstNet is a high-speed broadband communications platform built for America's first responders and the extended public safety community. This program will help rural providers and FQHCs integrate virtual care into their workflows and will better enable providers to serve patients in rural areas.