State News

People who lost Medicaid coverage when Arkansas’ Medicaid program implemented work requirements experienced significant trouble affording care, according to a study in Health Affairs. Fifty percent of people had serious problems paying off medical debt, 56 percent delayed care because of cost and 64 percent delayed taking medications because of cost. These rates were significantly higher than among people who remained on Medicaid during the entire year. The study also found that most coverage losses were reversed after the work requirements were stopped, that the requirements did not increase employment rates and that awareness of the policy change remained poor—potentially hindering people from accessing Medicaid coverage even after the work requirements were no longer in effect.

A study to understand perceptions of how medical students and institutions can meet the needs of the self-identified houseless community found that people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level, according to the Social Interventions Research & Evaluation Network at the University of California, San Francisco. Authors concluded that medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems and institutions should change their approaches to healthcare delivery and advocacy.

Uninsured New York City residents in all five boroughs can now enroll in a city program that gives them access to a physician and other health services, reports Patch. The program, NYC Care, expanded into Manhattan and Queens four months ahead of schedule. Regardless of immigration status or ability to pay, residents can enroll in the program and receive a card that helps them connect with guaranteed low or no-cost services. New Yorkers who are eligible for health insurance will be directed to the city’s public choice health plan, MetroPlus. About 30,000 New Yorkers have enrolled in the program since its launch last year and have used it for 85,000 provider visits and to fill 30,000 prescriptions. 

The federal Health Resources & Services Administration (HRSA) has ranked Idaho the fourth best state in the nation for the quality and performance efforts of its critical access hospitals, reports Idaho County Free Press. HRSA’s measures are from its Medicare Beneficiary Quality Improvement Project, which includes more than 1,350 hospitals across 45 states. The program is intended to reduce hospital closures in rural areas, promote a process for improving rural healthcare and focus on community needs.

At the height of the coronavirus pandemic, a majority of Connecticut residents worried they would not be able to cover their medical bills if a family member were to contract COVID-19, reports the Hartford Courant. Additionally, a survey of nearly 1,000 Connecticut adults revealed that most had experienced one or more healthcare affordability burdens—such as delaying or canceling medical appointments because of high costs, opting to go without insurance entirely or struggling to pay medical bills after receiving care—in the past year. Respondents strongly supported state and federal action on healthcare affordability problems; 92 percent said the government should expand health insurance options so that everyone can afford quality coverage.

Tennessee state officials said that while a private data firm's initial findings that state health plans erroneously paid $17.58 million in medical bill overcharges were "helpful," a planned "deep dive" is necessary before drawing firm conclusions, according to Chattanooga Times Free Press. In its preliminary report in June, Connecticut-based ClaimInformatics says it found state health plans' third-party administrators BlueCross BlueShield of Tennessee and Cigna overpaid at least $17.58 million over a three-year period in bill claims by professional providers such as physicians. 

Across Massachusetts’ cities and towns, Latino and Black communities are experiencing higher rates of COVID-19 cases, and a recent study in Health Affairs identifies important factors that are independently associated with higher COVID-19 case rates in the state. The proportion of foreign-born, non-citizens was the strongest predictor of the burden of COVID-19 cases within a community, while household size and food service occupation were also strongly associated with the risk of developing COVID-19. Some factors, however, such as occupation in an essential service field, did not affect Black and Latino communities in a similar matter. The authors posit that other factors not examined in the study, such as structural inequities like disproportionately high incarceration rates, residence in areas with a higher concentration of multi-unit buildings and defacto neighborhood segregation, may contribute to the spread of COVID-19 in Black communities.

A new report from the Center for Community Solutions found prices for the same medical procedures varied widely among hospitals in Ohio, reports AboutHealthTransparency.org. The research found that not only did the price vary widely from hospital to hospital, but also, for each procedure the average cost in Ohio was much higher than the national average. The authors highlighted recommendations for controlling prices in Ohio, including one to create an independent oversight entity to set a cost benchmark.

Months after having an emergency appendectomy and a second surgery to remove a large blood clot that was likely a complication from the appendectomy, Shannon Harness is still fighting to negotiate and pay off his hospital bills. In this edition of Kaiser Health News’ Bill of the Month, we learned that as an uninsured patient Shannon was charged $80,232 for both surgeries, which is three to four times what an insurer would pay for the same surgeries. Paradoxically, uninsured patients have the highest medical bills because they don’t benefit from the discounted rates negotiated by insurers. After months of negotiation with the hospital, Shannon was able to lower the bill down to $22,304.17 and is working on a payment plan with the hospital.