State News

Illinois has renewed the Hospital Assessment Program and enacted the Health Care Affordability Act, according to WISC/WRSP. The Hospital Assessment Program has provided $450 million in additional funding for hospitals since the last assessment in 2016, with priority going to hospitals that serve large numbers of Medicaid patients. The Health Care Affordability Act eliminates and loosens requirements for Medicaid access and helps families enroll in and maintain coverage through the Children's Health Insurance Program and the ALL KIDS Act.

Colorado has four new health insurance laws focused on improving access and affordability for state residents, reports Summit Daily. The first law creates the Health Insurance Affordability Enterprise, which extends Colorado’s reinsurance program for five years and expands coverage to those who were initially left out. The law also aims to provide more access to insurance for low-income people who receive federal subsidies, as the program caused those individuals to spend more on health insurance than they had before. The second law deals with reimbursement for telehealth services and requires that insurance carriers cover telehealth visits for behavioral, mental and physical healthcare. The state has also simplified the health insurance enrollment process by enabling people to enroll while filing their taxes and allowing working adults with disabilities over the age of 65 to participate in the Medicaid buy-in program.

Insurance companies regulated by New York state have requested a premium increases averaging 11.5 percent due to the COVID-19 crisis, reports WSKG. Meanwhile, the number of claims submitted by patients during the Spring declined significantly, with elective surgeries across the state cancelled or postponed and people avoiding doctor’s offices and hospitals. Some insurance companies may have to issue rebates to premium holders. In past years, the state Department of Financial Services, which approves rate changes, hasn’t granted the increases that insurers have requested, but has granted premium hikes at lower rates.

New Jersey teachers will participate in a reformed health benefits system that supporters say is designed to save taxpayers hundreds of millions of dollars, reduce the cost for educators and protect the quality of their healthcare, reports NJ Spotlight. The new law seeks to reduce taxpayer costs for teacher benefits by at least $300 million by reducing the number of health plans options and shifting from an employee-contribution system tied to premium price to one linked to earnings. Teachers will have access to three plans in which premium costs are tied to salary.

The Massachusetts Board of Registration in Medicine has approved its first permanent telehealth policy, having previously approved the same policy on an interim basis in March 2020, reports JD Supra. The policy provides that a ‘face-to-face encounter’ is not a pre-requisite for a telehealth visit and that the same standard of care applies in both in-person and telehealth encounters. This permanent policy change is one of the first state actions to make permanent some of the temporary measures that were put in place to facilitate telemedicine use during the COVID-19 pandemic.

A study published in the American Journal of Accountable Care found that New Jersey's DSRIP program was successful in catalyzing many aspects of hospital industry transformation toward data-driven population health management. Specifically, hospital capacity for collection of data to fulfill DSRIP reporting requirements increased, data exchanges with outpatients partners facilitated use of rapid-cycle evaluation tools and the value of data sharing for improving quality of care and population health was perceived more positively over time. These findings may help inform future initiatives in value-based provider care in the Medicaid delivery system. 

Compared with Baltimore (an untaxed control city), Philadelphia experienced significantly larger declines in the amount of sugar-sweetened beverages sold in small independent stores after implementing a 1.5 cent per ounce tax, according to a study published in Health Affairs. The study also found that 120 percent of the Philadelphia beverage tax was passed on to purchasers of taxed beverages via price increases at small independent stores one year after the tax was implemented. Researchers concluded that excise taxes may be an effective policy tool for decreasing the purchase of sweetened drinks in small independent stores, particularly among populations at higher risk for sugar-sweetened beverage consumption.

An analysis performed by the Oregon Health Authority and the Oregon Health Leadership Council showed that 40 percent of evaluated services were found to be low-value and constituted more than $500 million in spending, according to a new report. Researchers reported that Medicare had the highest rate of low-value services per 1,000 members at 595.5, which is approximately 170 percent higher than the rate for the commercially insured population. The report examines 47 measures and includes actionable opportunities to address the rise in healthcare costs and improve the effectiveness of care that is delivered to patients in Oregon.

A 2019 report by Blue Cross Blue Shield of Massachusetts Foundation revealed that the state struggled to provide adequate access to behavioral health services despite having a high density of primary care practitioners and psychiatrists, an innovative Medicaid coverage and delivery system and a high rate of insured residents. The report noted opportunities to expand telehealth to improve access to these services. The Foundation’s latest report explores this telehealth potential, proposing a framework for an optimal telebehavioral health system of care, highlighting barriers to adoption for providers and consumers and identifying opportunities to promote and expand access across the state.