State News

Colorado state officials will purchase six vans from New York-based Medical Coaches to expand the treatment of people with substance abuse issues, according to mHealthIntelligence. The vans will be equipped with connected health tools that allow healthcare providers to deliver Medication Assisted Treatment (MAT) therapy. Healthcare providers are increasingly turning to MAT therapy as a means of treating people with substance abuse disorder – Colorado is using a $30 million State Opioid Response (SOR) grant from the Substance Abuse and Mental Health Services Administration (SAMHSA).

A report from the California Health Care Foundation examines the legal and economic implications of collecting and releasing data on amounts paid for healthcare services, reviews the practices of existing all-payer claims databases (APCDs), and concludes with recommendations for California’s policymakers about best practices to ensure the effective use of increased transparency to control costs and increase access to healthcare services. Authors found that while some negotiated prices may constitute trade secrets in some circumstances, no court has definitively ruled on the issue of whether negotiated healthcare rates can be protected as trade secrets. Therefore, California can allow or require such disclosures if they are in the public interest. The authors also noted that, to date, no state with an existing APCD has experienced competitive harm and that public disclosure of negotiated rates resulted in increased competition in New Hampshire. Additionally, though all states with active APCDs collect information about paid amounts and release reports of aggregated information, a few states, including Maine and New Hampshire, disclose plan- and provider-specific median paid amounts for the most commonly used healthcare services on publicly accessible websites. Based on these findings, recommendations to California include: requiring the Office of Statewide Health Planning and Development (OSHPD) to provide data submitters with clear information on policies regarding data collection; monitoring annual claims for anticompetitive behavior; creating a data release committee and declaring that all information submitted to the APCD will be released in accordance with guidelines; and establishing guidelines for data release that weigh competitive effects and public interest.

Enabled by a 2015 state law creating the Arkansas Healthcare Transparency Initiative, the Arkansas all-payer claims database (APCD) now has several new types of data available to supplement healthcare claims and enrollment data, reports the Arkansas Center for Health Improvement (ACHI). This infographic provides an overview of what is available. The database is a key resource for pulling back the curtain on healthcare quality and prices. State agencies, academic researchers, analytic groups and private industry are using the Arkansas APCD to assess healthcare utilization, quality and price information.

To address the health system’s need to provide cost data at the point of care, Houston Methodist is piloting a program, Smart Ribbon, that provides real-time, patient-specific cost and risk data regarding medications, labs, radiology and observational status within the clinical workflow, according to Healthcare IT News. This information automatically appears and hovers over clinicians’ screens as they work within patients’ charts in the EHR. Since the pilot, Houston Methodist Sugar Land has reported approximately $717,000 in attributable cost savings with an average incremental cost reduction of $105 per admission. This early financial success was also accompanied by clinical efficiencies because Smart Ribbon is integrated with Epic EHR and VigiLanz pharmacy surveillance and antimicrobial stewardship products, and features a Controlled Substances app, thereby reducing provider clicks and cognitive burden associated with searching for data on opioid and antibiotic use.

Telemedicine is increasing at a significant rate across New Hampshire, but some experts warn that it may not be appropriate for all patients in all cases, according to New Hampshire Public Radio. Research out of Harvard Medical School suggests that the biggest growth in telemedicine is happening in direct-to-consumer telemedicine and that most of those televisits are from new patients, meaning they are not replacing in-person doctor’s appointments, but rather adding to them. Though telemedicine would allow patients in rural areas to get help, New Hampshire’s shortage of healthcare workers remains and may hamper telemedicine’s potential.

The Minnesota Hospital Association claims Blue Cross Blue Shield (BCBS) of Minnesota, the state’s largest not-for-profit health insurer, may be breaking the law by imposing a slate of new policies designed to deny or delay access to routine colonoscopies and hundreds of other hospital services, according to The Star Tribune. The hospital trade group has asked state officials to investigate these practices and stop the insurer from imposing new policies that do not comply with state law and discriminate against in-network providers by limiting coverage for patients who do not receive prior authorization for services and if there are cheaper in-network service options nearby. BCBS claims that healthcare costs continue to rise to unprecedented levels and hospitals must work with payers and plan sponsors to improve the sustainability of healthcare costs.

The Indiana State Health Commissioner and Family and Social Services Administration Secretary announced that Indiana would join 11 other states in covering tobacco cessation prescription drugs, such as Chantix and Zyban, free of charge. According to IndyStar, studies place Indiana in the top 10 states with the highest smoking rates. About 22 percent of Indiana residents smoke and 13 percent of expectant mothers. In an effort to encourage expecting and new mothers to quit smoking, state officials announced mothers on Medicaid will no longer have a co-pay for tobacco cessation products for up to a year after a child’s birth.

To improve access to care for low-income patients, California is paying off $10.5 million in student loans for 40 dentists who agree to ensure that 30 percent of their patient population is composed of Medi-Cal patients, who are among the state’s poorest and frailest residents, reports The Sacramento Bee. Currently, only one-third of California’s licensed dentists accept Medi-Cal patients due to low reimbursement rates. As a result, an estimated 13.4 million people eligible for the program struggle to obtain necessary care. This action compliments an earlier award that provided $58.6 million in student debt relief to 247 physicians.

The Arizona Health Care Cost Containment System released a Medicaid statistical snapshot revealing data on enrollment, costs, claims and utilization, reports State of Reform. The snapshot documented lower costs than the national average, with the state leading the way in cost-savings from opting for in-home care. In 2018, 87 percent of Arizona Long Term Care Services members received services in their own home or community, saving an average of $13,939 per member in Fiscal Year 2018. As a result, Arizona ranks 5th in the nation for utilizing home and community based services rather than institutional services.