State News

The Governor of Wisconsin, through an executive order, created a task force focused on reducing prescription drug prices in Wisconsin, according to WEAU News. The Governor's Task Force on Reducing Prescription Drug Prices is charged with gathering and analyzing data on development, pricing, distribution and purchasing of prescription drugs, analyzing other states' strategies in reducing prescription drug prices and identifying opportunities to work with other states and the federal government. The Task force is also charges with making recommendations for reducing prescription drug prices in Wisconsin. 

More than 110 rural hospitals have closed nationwide since 2010, with profound consequences for the communities they served, according to Kaiser Health News. In Fort Scott, Kansas, ambulances responded to more than 80 calls for service and drove more than 1,300 miles for patients to get care in other communities during an 18-day period when the local emergency department was closed. In addition to delaying treatment for patients needing emergency care, the travel time prevented the crews from serving local needs and caused emergency vehicles to wear out faster. Increased reliance on air ambulances also causes problems for rural communities–though they can transport patients quickly, the dispatch system is not coordinated in many states and regions across the country. Moreover, many air ambulance companies do not participate in insurance networks, which can cost patients dearly.

Seattle’s City Council adopted the Sweetened Beverage Tax in June 2017 to improve the health of the city’s residents, and address persistent health and education inequities, reports The Seattle Times. Evidence to-date shows the tax is funding programs that increase healthy food access, support child health and aid in early learning. However, its impact on reducing sales of sugary beverages is currently unknown. Nevertheless, evaluations of similar taxes imposed in Berkeley and Philadelphia revealed that sales of taxed beverages dropped substantially — by 9.6% and 38%, respectively. 

Poplar Bluff Regional Medical Center has filed more than 1,100 lawsuits for unpaid bills in a rural corner of Southeast Missouri, where emergency medical care has become a standoff between hospitals and patients, according to The Washington Post. Three nearby hospitals closed for financial reasons in the past few years, leaving Poplar Bluff Regional as the last full-service hospital to care for five rural counties, treating more than 50,000 patients each year. As a result, the hospitals’ uncompensated care costs have risen from about $60 million to $84 million. Community residents are similarly at-risk of financial ruin. Over 35 percent have unpaid medical debt on their credit report, about double the national rate. The resulting lawsuits have become so routine that some people derisively refer to it as the “follow-up appointment.” 

California is facing a growing shortage of primary care physicians, according to Cal Matters. By 2030, the state could be short as many as 10,000 primary care professionals, including nurse practitioners and physician assistants. Some areas—the Central Valley, Central Coast and Southern Border region—will be hit especially hard. So too will be remote rural and inner-city residents, communities of color, the elderly, people with mental illness or addiction and those without health coverage. This could result in longer wait times and travel distances for doctor visits, as well as a reduction in preventative care and care for chronic conditions. 

Though high prices at specific Colorado hospitals may correlate with higher quality for some services, price does not appear to predict or even reflect quality on balance, according to an analysis by the Colorado Business Group on Health and the Colorado Consumer Health Initiative. The report notes that hospital quality varies nearly as much within hospitals as it does across hospitals. Furthermore, hospital prices for routine healthcare procedures in Denver varied by more than 800 percent in 2017. The hope is that “Hospital Value Reports” such as this one will incentivize value by examining price and quality measures in concert. 

WalletHub compared the 50 states and the District of Columbia across 30 key measures of cost, healthare accessibility and baby-friendliness and ranked Mississippi as the worst state to have a baby, according to WDAM7. The state ranked near the bottom on infant mortality rate, low birthweight, midwives and OB-GYNs per capita, pediatricians and family doctors per capita and parental-leave policies. More insurers in the state are working with high risk pregnant women to have access to a progesterone medicine can help prevent preterm births. An area where Mississippi moms struggle is access to care. A March of Dimes study last year revealed a major gap in nearly half the state’s counties.

California’s 2017 law addressing surprise medical billing for out-of-network (OON) non-emergency physician services at in-network hospitals is effectively protecting patients from surprise medical bills, according to a study in The American Journal of Managed Care. However, the law is also exacerbating provider consolidation, as a result of increasing insurers’ bargaining power in their negotiations with physicians. Specifically, an OON payment standard set at payer-specific, local average negotiated rates give insurers leverage to lower or cancel contracts with rates higher than their average as a means of suppressing OON prices. California’s experience demonstrates that OON payment standards can influence the payer–provider bargaining landscape, affecting network breadth and negotiated rates. 

Data from Colorado’s all-payer claims database show wide variation in the facility fees charged by hospitals and freestanding emergency departments, according to Modern Healthcare. For example, the Center for Improving Value in Health Care reports that for the highest severity level, the facility fees commonly ranged from $1,990 (25th percentile) to $4,700 (75th percentile), but can go as high as almost $48,000.