State News

California | Sep 26, 2019 | Report | Surprise Medical Bills

California's Surprise Billing Law is a Success

A study of California’s 2017 surprise billing law – which requires fully-insured plans to pay out-of-network physicians at in-network hospitals – found significant reductions in the share of services delivered out-of-network by certain specialties at inpatient hospitals and ambulatory surgical centers since the law went into effect. The decline ranged from 15 percent (for pathology services) to 31 percent (for neonatal-perinatal medicine). Additionally, the share of emergency medicine services delivered out-of-network dropped by 5 percent in the period after the law took effect.


Missouri | Sep 26, 2019 | Report | Consolidation

A New Report Says Springfield, MO Has Something Close to a Healthcare Monopoly

A nationwide study measuring 112 U.S. metropolitan areas for the degree of concentration in their hospital markets ranked Springfield, Missouri the most concentrated of them all, reports the Springfield News-Leader. In Springfield, the increase in concentration has a lot to do with healthcare systems buying up smaller doctors' offices. While consolidation is linked to higher healthcare prices, the report authors note that Springfield's prices are relatively low, at 6 percent below the national median. The lower prices may be a reflection of Springfield's generally low wages and overall cost of living.


Connecticut | Sep 26, 2019 | News Story | Health Costs

CT Moves Closer to Healthcare 'Excellence' Referral Network

Connecticut’s “Centers of Excellence” network will enable state residents to identify which providers perform best for certain procedures, helping them make informed decisions about where to receive their care, reports The CT Mirror. By steering patients to providers who offer cost-effective treatments, the state hopes to reduce its healthcare costs by millions of dollars in the 2019 and 2020 fiscal years combined. The resource will be released in 2020 and will serve an estimated 210,000 state employees, retirees and dependents.  


North Carolina | Sep 23, 2019 | Report

NC's Uninsured Gap 9th Highest in the Nation

For the third year in a row, the number of people without health insurance in North Carolina remained roughly the same, according to North Carolina Health News. More than 1 million North Carolinians, or 10.7 percent, did not have health insurance in all of 2018, reports the U.S. Census Bureau, who attributed the national trend in increasing uninsured rates to a decline in Medicaid enrollment. By contrast, North Carolina's Medicaid enrollment hasn't changed significantly in three years, and the state has the 9th highest uninsured rate in the country. It's estimated that expanding Medicaid in North Carolina would reduce the state's uninsured rate by 3 percent. 


California | Sep 20, 2019 | News Story | Health Costs Social Determinants of Health

Some Sacramento-area Patients are Getting Free Lyft Rides to Doctor Appointments, Lab Visits

Blue Shield of California launched a 12-month pilot program that will allow more than 1,300 Sacramento-area residents to get free Lyft rides to primary care appointments; X-ray or lab visits; and to pick up prescriptions at the pharmacy, reports The Sacramento Bee. Blue Shield will pay for eligible members’ rides directly and will allow members to bring a caregiver to help with walkers and other aspects of their medical care. The program, called RideQ, will be evaluated on its ability to improve health outcomes and care experience, reduce costs and increase physicians’ job satisfaction. RideQ is part of a larger initiative to identify and eliminate the non-medical barriers that keep people from receiving needed care.


New Hampshire | Sep 20, 2019 | News Story | Consolidation

AG's Office: Proposed merger of Exeter, Dover hospitals violates anti-trust laws

A proposed merger between the parent companies of Exeter Hospital and Wentworth-Douglass Hospital in Dover is being called unlawful by the Attorney General's office, according to the New Hampshire Union Leader. The Charitable Trusts Unit of the Attorney General's office claims that the merger threatens even higher healthcare costs for New Hampshire consumers, owing to the fact that they are only 18 miles apart, offer many of the same inpatient and outpatient services and both own a significant number of healthcare professional practices. 


Michigan | Sep 20, 2019 | News Story |

Michigan Healthcare Regulators Restricted Access to Promising New Cancer Treatments

Certificate of need (CON) laws are restricting access to innovative cancer immunotherapies in Michigan, according to Reason. Immunotherapies attempt to program the body's own immune system to attack and kill cancer cells, and have become an increasingly attractive way to combat cancer. However, under new rules adopted by the Michigan Certificate of Need Commission, hospitals will need to go through third-party accreditation processes before being able to offer these CAR T-cell therapies. Though cancer research organizations, patient advocates and pharmaceutical companies oppose the new accreditation requirements, the University of Michigan Health System, the largest in the state, argue they are necessary for patient safety. CON laws vary from state to state but require that hospitals get a state agency’s permission before offering new services, expanding facilities or installing new medical technology. 


Maryland | Sep 19, 2019 | News Story | Health Costs Affordability

Maryland's Healthcare Premiums to Decline for Second Year

For the second year in a row, Marylanders will see cheaper premiums for Affordable Care Act policies purchased on Maryland's health insurance exchange, according to the Washington Post. State officials announced that over 190,000 people will experience lower premium costs, with an average decline of 10.3 percent for individual plan prices. Insurance regulators attribute the decline to the healthcare reinsurance plan that state officials created in 2018, paid for by a tax on insurance companies. However, the cost for around 269,000 small-group plans in the state will increase by 3 percent, significantly less than what insurance companies had proposed. 


Wisconsin | Sep 18, 2019 | Report | Rural Healthcare Equity

2019 Wisconsin Health Disparities Report

The Wisconsin Collaborative for Healthcare Quality issued a report identifying where gaps in health outcomes and care exist within the state. The report highlighted widespread racial and ethnic disparities, with American Indian/Alaskan Native children experiencing much lower childhood vacination rates, Asian/Pacific Islander adults having much lower rates of breast and colorectal cancer screenings and Black adults with diabetes or heart disease being much less likely to be tobacco-free. The report also highlighted payer disparities, noting that those with Medicare had much lower cervical cancer screening rates. Finally, the report noted limited rural/urban disparities, but that these ay have been related to the use of only two categories to describe rural and urban areas, potentialy masking disparities in these areas. 


Vermont | Sep 17, 2019 | News Story | Health Costs

Regulators Allow 2020 Hospital Budgets to Exceed Growth Target

Vermont’s hospitals are expected to collect $2.72 billion in revenue in 2020, exceeding a revenue growth target that officials set earlier this year, according to the VTDigger. The budgets, approved by the Green Mountain Care Board, authorize hospital revenues — and therefore the amount that Vermont spends on hospital care — to grow by about $100 million in fiscal year 2020. While hospitals argue that the increased revenue will improve access to care, consumer advocates fear that growing hospital budgets will increase consumers’ insurance premiums. Evaluation is needed to understand the impact of the decision on costs, quality and access.