State News

Just 10 treatment categories of drugs, including anti-asthmatic, cardiovascular and antiviral, accounted for over 70 percent of Massachusetts pharmacy claims from 2015 to 2017, according to MassLive. These statistics are available in a report on prescription drug use and spending from the Center for Health Information and Analysis (CHIA), an independent state agency that monitors the performance of Massachusetts’ healthcare system. The report found that anti-inflammatory tumor necrosis factor inhibiting agents, like Humira and Enbrel, which are used to treat difficult-to-manage diseases like rheumatoid arthritis, accounted for the largest portion of spending.

National surveys consistently rank Hawaii as one of the healthiest states in the nation, but commonly used metrics fail to recognize the stark inequities between Native Hawaiians and other groups, reports the Milwaukee Journal Sentinel. As the high cost of nutritious food has contributed to higher rates of preventable diseases, community leaders are emphasizing cultural traditions like indigenous farming practices and hula dancing as a means of improving health.

Colorado hospitals can operate effectively with commercial insurance rates that are at a drastically smaller percentage of the Medicare reimbursement rate  than what many are bringing in now under the state’s current healthcare system, according to State of Reform. The Colorado Department of Health Care Policy and Financing released an analysis showing that Colorado hospitals, on average, can cover their costs if reimbursed at 143 percent of Medicare rates. The conclusion is based on 2018 payment to cost ratio for Medicare payments and how much was needed to raise Medicare rates to ensure hospitals were paid their costs for seeing patients. The study also concluded that hospital across the nation, on average, cover the cost of providing care to patients at 115 percent. A RAND Corp. study found that Colorado hospitals charge privately insured patients for inpatient and outpatient, combined, on average, 269 percent of the Medicare rate, while inpatient services were billed at, on average, 221 percent of the Medicare price, indicating that commercial rates may be higher than they need to be.

The Oregon Sustainable Health Care Cost Growth Target Committee, assigned to set a statewide cap on the rise in healthcare spending, has agreed to a growth cap of 3.4 percent per year, according to the Lund Report. Committee members still have to decide how to measure quality and equity, ensure that the program is transparent and that the industry is held accountable. State advocates also asked the committee to prioritize affordability for consumers.

The highest numbers of vulnerable rural hospitals are in the South and Midwest, reports Advance Local. Researchers from the healthcare analytics firm Chartis Group issued a report that found that 12 of Alabama’s 45 rural hospitals are considered “most vulnerable” to closure based on several factors, including revenue, system affiliation and the lack of Medicaid expansion. Seven rural hospitals have closed in Alabama since 2010, and the overall percentage of rural hospitals nationally operating in the red has increased from 39 to 47 percent in the last five years, with Alabama being one of the most affected states for closures. 

In accordance with an unfortunate national trend, the non-profit hospital Jackson Hospital filed suit against at least 1,302 Alabamians in 2019, according to AL.com. At least a half dozen patients were sued for less than $200. As a non-profit hospital, Jackson has obligations to provide charity care for needy patients in exchange for tax exemption; however, there are few specific requirements for the level of charity care or how aggressively hospitals may pursue debt collections. Jackson Hospital sued more patients than any other non-profit hospital in Alabama in 2019.

Texas ranked low on healthcare affordability in a 2020 scorecard from Altarum, in part because it is “among the most expensive states, with private payer prices well above the national median.” Almost half of Texans had problems with out-of-pocket expenses and one third had trouble paying medical bills. Another report also found that Texas ranked last on access and affordability, according to Dallas News. The state legislature, and specifically its committee appointed to study healthcare costs, has an opportunity to identify state-based strategies that would address residents’ affordability and access needs. 

Kansas families struggling to pay exorbitant healthcare costs are falling prey to predatory collection practices by law firms representing local providers, according to CBS News. In rural Coffeyville, residents with unpaid medical bills must appear in court every three months for a "debtors exam." Failure to appear may result in jail time and bail money is commonly used to pay debt collectors and healthcare providers, rather than being returned to defendants when they appear in court.

North Carolina’s Medicaid system has found a way to save as much as $6,000 annually per patient with the help of a unique care management program, reports Health Data Management. The management program – provided by the Community Care of North Carolina (CCNC), a public-private partnership of healthcare providers and payers – focuses on providing medical homes, community support and data analysis to meet the needs of Medicaid beneficiaries in the state. CCNC’s report notes that the organization uses administrative data to create an “impactability score” for Medicaid members that focuses on Medicaid utilization patterns that go beyond medical care to include social determinants of health and other variables.