State News

Half of Ohio residents surveyed experienced healthcare affordability burdens in the prior year: they either went uninsured, struggled to pay for medical care, or avoided or delayed it, according to new Altarum Healthcare Value Hub survey data released by the Universal Health Care Action Network of Ohio. A quarter of respondents said they did not fill prescriptions, cut their medications in half or skipped doses due to cost, Statehouse News Bureau reports. Additionally, about a third of privately insured Ohioans said they'd gotten a bill they didn't anticipate, and only a third of those were solved satisfactorily. 

The Nebraska Health Information Initiative (NEHII), a nonprofit statewide health information exchange, has partnered with Secure Exchange Solutions (SES) to streamline communication among clinicians in Nebraska and neighboring states, reports EHRIntelligence. NEHII aims to facilitate community collaboration while also protecting the security and privacy of patient health information. SES Direct will provide an accelerated path to seamless integration of direct communications with any healthcare application. The solution will enable providers to exchange critical information at the point of care, allowing clinicians to optimize care transitions and accelerate provider-payer data exchange, review, and decision-making. 

The homeless population of New York City has long used the emergency department at higher rates than the non-homeless population, but new research indicated that this may be connected to first-time shelter use, according to the Wall Street Journal. Thirty-nine percent of adult homeless shelter users visited the emergency department for treatment or were hospitalized in the year before they entered a shelter. In fact, the number of hospital visits began to increase in the months leading up to shelter entry. The study, published in Health Affairs, also shows that in the year after leaving a shelter, 43.4 percent of first-time shelter users went to the emergency department or were hospitalized. These significant spikes in visits to the emergency department just before first-time shelter use and just after leaving a shelter indicate that these may be opportunities to connect individuals with interventions and social services to prevent individuals from becoming homeless.

Low-income adults in Texas were much more likely to be uninsured and to experience financial barriers to care than their counterparts in the three states that expanded Medicaid, according to a new analysis from the Commonwealth Fund. Moreover, most low-income Texans support Medicaid expansion, which could extend coverage to 1.2 million uninsured individuals and increase affordability. The report includes a discussion of potential expansion effects on hospitals and the state’s economy. Studies show that Medicaid expansion reduces the share of uncompensated hospital care, which totaled $6.8 billion in Texas in 2016. Expansion has also been associated with fewer rural hospital closures (80 percent of which happen in nonexpansion states), where these entities account for 14 percent of total employment on average. Since 2013, 19 rural hospitals in Texas have closed due to financial difficulties. 

Despite efforts to increase the number of doctors in rural areas, many Oklahoma counties still lack the physicians needed to provide sufficient care for residents, reports The Oklahoman. Seventy-two of the state's 77 counties are designated as primary health-professional shortage areas by the federal government and 30 of them have 10 or fewer doctors of any type. Oklahoma has been creating incentives for doctors to practice in rural areas since the 1970s, but big-city amenities and educational and professional resources draw many physicians to other areas. Additionally, new physicians are increasingly choosing specialty practice so they can earn more and pay off sizable debt from medical school more quickly. This exacerbates the rural-urban divide because most specialty practices are located in urban areas. As a result, the state is funding a $5 million, five-year program to help pay off doctors' student debts if they agree to practice in a rural area.

A Connecticut man received a bill for double the amount he was quoted for a hernia repair after contacting his hospital, surgeon and anesthesiologist prior to the procedure to determine the expense, according to Kaiser Health News. Unlike prices quoted in other industries, hospital estimates are often inaccurate and there is no legal obligation that they be correct, or even issued in good faith. After an emotionally draining process of dealing with billing departments and following up with his insurer, the bill was eventually written off. However, many other patients aren’t as proactive and wouldn’t fight a bill they could afford to pay.

A 2019 report from the Healthcare Association of Hawaii reveals that there are more than 2,200 healthcare jobs open across the state, reports State of Reform. This amounts to an average 10% vacancy rate across 76 patient-facing, non-physician professions. The survey also finds that most jobs take 6-12 months to fill, and that 19 of the 76 professions evaluated do not have a Hawaii-based education or training program. The positions in greatest demand in Hawaii are medical assistants, nurse aides, registered nurses, patient services representatives and phlebotomists. 

Federal officials rejected one of Idaho’s requests for a waiver for Medicaid expansion, reports the Associated Press. The Idaho governor said the state is already taking steps to submit additional information to get the waiver approved. The waiver would allow those earning between 100% and 133% of the federal poverty level to stay on the state’s health insurance exchange, called Your Health Idaho. Backers said it would save the state millions of dollars, while those opposed said it would leave poor residents unable to pay medical bills.

Connecticut is using certificate of need (CON) regulations to hold hospitals accountable for making meaningful investments in their communities’ health, according to the National Academy for State Health Policy. In a recent CON agreement, the Connecticut Office of Health Strategy mandated that merging hospitals: adopt evidence-based interventions to address community needs; explain how patient outcomes will be measured and reported to the community; and increase the total dollars spent on community benefit activities by at least one percent each year for the next five years. These activities must directly address the health and health-related social needs identified by the hospital’s Community Health Needs Assessment. While the CON conditions are time-limited, they demonstrate what is possible when states use their policy levers to maximize community benefits investments.