State News

Commercial inpatient healthcare spending has increased in Massachusetts despite declining volumes, according to Modern Healthcare. Commercial inpatient spending across the state grew 10.7 percent from 2013 to 2018, while service use decreased by 12.8 percent, according to a report from the Massachusetts Health Policy Commission. In addition, the average commercially insured patient risk score increased 11.3 percent from 2013 to 2017, which theoretically should have increased intensive care unit and cardiac care unit volumes and lengths of stay. Instead, the data suggest that hospitals are maximizing coding rather than treating sicker patients.

Air ambulance companies have begun advertising memberships to rural Kansans in the wake of recent hospital closures, prompting concerns that the companies are exploiting vulnerable patients, reports KCUR. Although the membership programs promise to protect customers from out-of-pocket expenses, the contractual fine print often undermines the advertised intent. For example, privately insured patients who purchase memberships would still receive a bill and must work through their insurance company’s claims, denial and appeal processes. Additionally, air ambulance companies can end memberships at any time without obligation to notify the customer. North Dakota and Montana ban or heavily regulate the memberships in attempt to better protect consumers.

Due to a recently-legislated incremental minimum-wage increase from $8.85 in 2019 to $15 by 2024, some New Jersey workers could lose Medicaid eligibility, according to a report by the Urban Institute. However, the report notes that the number of those who will lose eligibility and coverage will be small relative to the number who will experience a wage increase. Those at risk of losing Medicaid coverage constitute less than 5 percent of all nondisabled, nonelderly adult Medicaid enrollees in the state, and all of those who would lose Medicaid eligibility would remain in the income range allowing them to qualify for subsidized coverage on the marketplace.

A new rural health research center in Tennessee will focus on breaking the cycle of inter-generational behavior that contributes to poor health. The Center for Rural Health Research will be housed at the College of Public Health at East Tennessee State University in Johnson City, TN, according to Daily Yonder. The center will also work to become a source for policymakers – providing the data from which those in government and other policy making organizations can make decisions to help improve the health of those in rural and nonurban communities.

Washington D.C.’s Department of Health Care Finance (DHCF), the District’s Medicaid agency, announced that it will transition nearly 22,000 individuals currently in the Medicaid fee-for-service program to a Medicaid managed care program in addition to launching two major changes that will improve equity and value for the Medicaid, Alliance and Immigrant Children’s Programs. First, DHCF will expand value-based purchasing requirements in the managed care program to promote an enhanced focus on health outcomes for Medicaid enrollees. Second, DHCF will implement universal contracting for critical providers in the city’s healthcare market to even the playing field and improve access to needed healthcare providers for all Medicaid enrollees. Given DHCF’s role as the payer for 40 percent of the District’s population, these changes are expected to have a broader positive impact for the District’s healthcare delivery system, as well.

States use the Commonwealth Fund’s 2019 Scorecard on State Health System Performance to identify places where their health care policies are on track, and Rhode Island particularly made strides in the areas of coverage and behavioral health, reports the Commonwealth Fund. The state uninsured rate among adults dropped from 17 percent in 2013 to 7 percent in 2015 and 6 percent in 2017. In addition, the percentage of adults with any mental illness reporting an unmet need dropped from 27 percent in 2010–11 to 18 percent in 2014–16. The state also saw significant reductions in the percentage of children with unmet mental health needs.

A new Colorado law will establish a legally protected process for communication with patients and/or their families and a format for resolution after an adverse healthcare incident, according to the National Law Review. Participation by healthcare facilities and providers is voluntary and the process must be initiatied by the healthcare provider involved in the adverse incident or by another provider jointly with the health facility involved. If the process is initiated by the patient or their family/representative, the discussion will not be protected. If followed correctly, this complicated process can significantly benefit nursing homes and assisted living facilities in investigating, communicating and resolving compensation issues related to adverse resident outcomes. 

Private insurance companies are expecting to pay out a record of at least $1.3 billion in rebates to consumers this year based on their share of premium revenues devoted to healthcare expenses in recent years, according to a Kaiser Family Foundation analysis. In the individual market alone, insurers will pay out the highest rebates in Virginia, followed by Arizona and Texas. Arizona’s individual market rebates are expected to reach $92.3 million.

Montana has received a $19 million awared from the Centers for Medicare and Medicaid Services (CMS) to support a statewide health information exchange (HIE), according to HIT Consultant. The HIE will give providers access to patient data in real-time with participating providers across the state to improve quality of care and reduce healthcare costs. A coalition of healthcare providers and public and private health plans created a nonprofit organization, Big Sky Care Connect, to develop the HIE, which will begin sharing healthcare data in 2020.