State News

A new interactive Community Dashboard provides information on the cost of care, quality of care, access to care, and utilization of services across payers by region and county in Colorado, reports the Center for Improving Value in Health Care. In general, the data show that quality of care in Colorado has been improving over time, but costs of care continue to rise and people in Colorado aren’t always using their healthcare benefits. From 2013 to 2018 the percentage of people who don’t use their health insurance at all has increased by 3 percent, and percent of users who don’t have chronic conditions and use preventative care has decreased by 24 percent.

The Colorado Governor and Behavioral Health Task Force have released a blueprint for making substance use and mental health services more accessible and affordable, reports the Office of the Governor. Although over 1 million people in Colorado have a behavioral health condition, Colorado performs poorly on measures of access to mental healthcare compared to other states. The blueprint recommends a number of reforms, including creating a statewide behavioral health administration, increasing telehealth for behavioral health services, and creating a regional care coordination system to help consumers navigate care in the state.

Arizona’s Medicaid agency announced that it will no longer pursue a planned Whole Person Care Initiative to address social determinants of health in its December 2020 1115 waiver renewal request, according to State of Reform. Due to the COVID-19 public health emergency and budget limitations, the agency will instead focus on a series of smaller-scale, cost-effective initiatives within the parameters of the existing Medicaid program. One initiative is a partnership with Health Current, Arizona’s Health Information Exchange, to source a new "closed-loop referral system” that providers can use to identify social risk factors and manage referrals to community-based agencies to address health-related social needs. In the future, the agency plans to continue to seek opportunities to address social risk factors and explore new strategies to expand initiatives outside of 1115 waiver authority.

In 2020, Washington State finished a phased, regional process to transition from three fragmented Medicaid systems for physical health, mental health and substance use disorder services into one integrated system to improve care coordination and health outcomes for individuals with physical and behavioral health needs. A webinar hosted by the Center for Health Care Strategies explored Washington’s transition to physical-behavioral health integration, with a focus on how this approach was tailored to the strengths of different regions. Speakers shared lessons for stakeholders interested in integrating care, presented emerging data on resulting outcomes and addressed the evolving role of public regional behavioral health systems.

Envida, a local nonprofit, offers a ride service to those experiencing a mental health crisis in El Paso and Teller Counties, as transportation can often be a barrier to care for some individuals, reports KOAA News 5. The service was rolled out as a test program last year, and Envida has seen their ridership quadruple since the COVID-19 pandemic hit. The drivers are trained in behavioral and mental health issues, and the program also provides home healthcare services to people with disabilities, older adults and those experiencing financial challenges.

Native American communities across the country are experiencing five times the hospitalization rates and 40 percent more deaths than whites due to COVID-19, concerning state officials in Colorado, reports 9 News. The executive director of Denver Indian Health and Family Services, Adrianne Maddux, notes that factors such as food insecurity, lack of access to fresh water, healthcare and PPE make the communities even more vulnerable to the disease. The Colorado Department of Public Health and Environment is partnering with Denver Indian Health and Family Services to create a COVID-19 Native Responses team, that will be made up of community members trained in crisis counseling and will work to provide resources and mental health services to support the communities. The state will also provide free testing for Native Americans across Colorado and is working to develop culturally responsive public service announcements related to prevention.

Horizon Blue Cross Blue Shield of New Jersey and Atlantic Health System have seen early success in their payer-provider shared accountability program in which they tie payments for services directly to outcomes in achieving quality and cost goals, reports New Jersey Business Magazine. The program represents a step away from traditional “fee for service” models and have has resulted in more than a 9 percent reduction in unnecessary hospitalizations and a 5 percent reduction in the total cost of care for patients and members in its first program year. The program used prior cost trends to jointly set a total cost of care target for certain members, and the reimbursement is adjusted annually based on performance as compared to cost targets, quality of care and patient outcomes.

The Centers for Medicare and Medicaid Services issued a warning after Vermont failed to meet performance targets for the state’s all-payer model, reports the VTDigger. The experiment—which combines money from Medicare, Medicaid and commercial insurance to fund healthcare services on a per-patient basis, rather than a fee for services rendered—aims to incentivize preventive care and to lower the growth of healthcare spending, neither of which has been realized in the three years since the program began. OneCare Vermont, a for-profit hospital and provider group that manages the all-payer system, has also failed to meet enrollment targets. If the state is unable to provide a satisfactory response within 90 days, the federal government will draw up a corrective action plan. Vermont’s Agency of Human Services has asked state healthcare leaders to develop a “complete plan for rebooting the all-payer model” within 45 days.

Black people in Georgia are dying from COVID-19 by as much as 3-4 times the rate for white people across all age groups, according to a new analysis in the Augusta Chronicle. The disproportionate impact of COVID-19 on Black people likely stems from systemic inequities in employment, education and access to healthcare, as well as the higher prevalence of chronic diseases among minorities.