State News

Roughly half of rural hospitals across Kentucky are in poor financial health – 16 of which are at high risk of closure, according to The Lane Report. Ten of the 16 hospitals are essential their communities, based on an analysis of trauma status, service to vulnerable populations, geographic isolation and economic impact. The financial strain on rural hospitals results from a number factors, including decreased demand for inpatient care and a loss of agricultural and manufacturing jobs in rural communities, leaving them with a shrinking population that tends to be older and poorer (and, therefore, more likely to be uninsured or on Medicaid or Medicare, which don’t pay for the total cost of care). Closures cost communities their immediate access to emergency and acute care and can also bring economic hardship from loss of employment. 

The New Jersey Department of Banking and Insurance announced that premiums sold on and off the ACA exchange will increase by an average of 8.7%, according to the Burlington County Times. State officials believe that rising medical costs were largely responsible for the increase, but also point to the reinstatement of a federal tax surcharge that had been suspended in 2019. Had this surcharge not been reinstated, the state's rate increases would have been 2.7% lower. Despite this increase, state officials say that on average, prices remain lower than they were in 2018. 

North Carolina’s Medicaid 1115 waiver allows the state to spend up to $650 million in state and federal Medicaid funding on “Healthy Opportunities Pilots,” designed to cover select services related to housing, food, transportation, and interpersonal violence that directly impact enrollees’ health outcomes, according to Managed Healthcare Executive. The state’s Medicaid managed care plans, known as Prepaid Health Plans (PHPs) have been set up in four regions of North Carolina to address these social determinants of health. Typically, Medicaid funds are not used to pay directly for non-medical interventions targeting social determinants of health, so this pilot will offer insights to how addressing social determinants of health may impact costs and health outcomes. 

Medicare cut payments to nine Montana hospitals as part of a program that aims to drive hospitals to reduce unnecessary patient readmissions, according to the Bozeman Daily Chronicle. This is the largest number of hospitals in the state penalized in a single year for failing to meet the federal standard, reports a Kaiser Health News analysis.

A rural safety net hospital and the only hospital serving Clark County, Wisconsin, managed to remain open by contacting city hall for help getting a loan, according to AP News, but other hospitals in other rural states are not as lucky. While 155 rural hospitals have closed in the past 15 years. However, as of 2017, 16 of Wisconsin’s 76 rural hospitals are operating on a financial deficit as their unpaid medical bills climb. Advocates and hospital administrators worry that Wisconsin may end up mirroring other states that have seen numerous rural hospital closures.

Nevada is imposing $17.4 million in fines on 21 diabetes drug manufacturers that have either failed to comply with or were many months late in complying with a drug pricing transparency law passed two years ago, reports The Nevada Independent. The law, which was passed by the Legislature in 2017, requires diabetes drug manufacturers to annually report to the state production costs, administrative expenditures, profits, financial assistance, coupons, and other information. It also requires manufacturers to provide additional information for drugs determined to have experienced a significant price increase, including a list of each factor that contributed to the increase and the percentage of the total increase attributable to each factor

The University of Missouri has created a week-long immersion program designed to inspire future doctors, pharmacists and nurses to practice in rural communities, reports KCUR. Program participants meet with local leaders and healthcare providers, as well as tour local businesses, to understand the role of a healthcare provider in the community at large. This program is different from the university’s other rural healthcare recruitment initiatives because it focuses on giving students a picture of life in a small town.

Alabama Medicaid reforms will bring regional control and coordination of primary care services through seven Alabama Coordinated Health Networks (ACHNs) serving more than 700,000 Alabama Medicaid enrollees, according to Alabama Arise. Every ACHN will have a Consumer Advisory Committee, a new accountability provision that advocates hope will increase consumer oversight. Moreover, each ACHN will receive funding to develop and implement Quality Improvement Projects focused on three initial priorities (childhood obesity, infant mortality and birth outcomes, and substance use disorders). Alabama’s Medicaid reforms are an encouraging move toward improved patient-centered care.

A report forecasting the implications of Medicaid expansion in Florida predicts that over 800,000 Floridians would gain coverage within the first five years of expansion. Additionally, the move could free up $119.3 million in state funds and fiscal gains may occur in corrections, public health, and uncompensated care for uninsured Florida residents.