State News

Wyoming’s governor has created a task force to come up with legislative policy solutions to tackle the state’s high healthcare costs, according to the Star Tribune. The group is made up of a diverse and broad set of healthcare, state and legislative officials and has established four priorities: evaluate current healthcare services in Wyoming; determining the service priorities that are needed for the state and assessing accessibility of service priorities within specific geographic areas; determining what factors are driving high healthcare costs; and formulating solutions to provide equitable, affordable access to high-risk populations. A variety of policy solutions are on the table—including an examination of what a single-payer system would look like in Wyoming.

An analysis of employer claims data by RAND found stark differences in the prices private health plans pay for inpatient and outpatient services at Kansas hospitals, reports KCUR. Prices at the University of Kansas Hospital and Overland Park Regional Medical Center were among the highest in the country, while prices at Lawrence Memorial Hospital were lower than those observed across the state and nationally. Additionally, private health plans paid more than twice the Medicare rate for hospital care in 2018. Unwarranted variation in healthcare prices, combined with a lack of transparency, makes it difficult for employers to make educated decisions when shopping for health plans to cover their employees. 

The presidential administration announced a rule allowing the importation of some prescription drugs from Canada, clearing the way for Florida and other states to implement programs to bring medications across the border, according to Kaiser Health News. Florida’s law—approved in 2019—would set up two importation programs. The first would focus on getting drugs for state programs such as Medicaid, the Department of Corrections and county health departments. The second program would be geared to the broader state population. Prices are cheaper in Canada due to limitations on how much pharmaceutical companies can charge for medicines. State officials said they expect the program to save the state about $150 million annually. The rule, however, does not allow states to import all types of medications, including biologic drugs such as insulin.

A Kentucky man who needed emergency treatment for a heart condition was sued by Baptist Health Louisville and forced to declare bankruptcy in his 20s after he couldn’t pay his hospital bills, despite having insurance, reports Kaiser Health News. The man, who was covered by a high deductible health plan, owed more than a quarter of his annual income after a life-saving procedure and was unable to keep up with the payment plan established by the nonprofit hospital. The man is one of many U.S. residents who are “functionally uninsured,” meaning that their insurance deductibles are greater than their savings. His account demonstrates the harm that can arise from high-deductible health plans that appear attractive because of their low premiums and may be the only plans that people earning low incomes can afford.

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.