State News

Pennsylvania | Mar 6, 2019 | News Story | Drug Costs Health Costs Affordability Consumer Voices

Health Costs Are Crushing Pennsylvanians; A New Survey Shows How Much

survey conducted by the Healthcare Value Hub found that one in two Pennsylvania adults struggled to afford healthcare, according to the Philadelphia Inquirer. Alarmingly, Pennsylvanians are coping with their affordability burdens by making decisions that may jeopardize their health such as: delaying care, avoiding getting care, skipping a test or treatment, failing to fill prescriptions or skipping doses. Pennsylvania adults pointed to, in particular, the rising cost of prescription drugs as a “major reason” for high healthcare costs. This is supported by other data that show that prescription drugs are one of the key drivers of high healthcare costs in the U.S. Other data show that certain populations – including medically vulnerable and older Pennsylvanians – are particularly hard hit by soaring drug prices. The survey revealed that there is support across party lines for government actions to curtail unfair prescription drug pricing and unreasonable price hikes.

Nebraska | Mar 5, 2019 | News Story | Surprise Medical Bills

Bill Would Help Protect Nebraskans from Surprise Out-of-Network Insurance Costs

Nebraskans would get some help avoiding surprise health care bills under a bill heard by the Banking, Commerce and Insurance Committee, reports the Omaha World-Herald. Legislative Bill 569 targets situations in which patients go to a hospital or doctor who is part of their health insurance plan, only to find out when the bills come that part of their care was provided by a laboratory, an anesthesiologist, a pathologist or other provider who is not part of that network. The patient then is saddled with paying higher out-of-network costs, which can be significantly higher than in-network costs.

District of Columbia | Mar 1, 2019 | News Story

District will No Longer Guarantee Ambulance Rides for Non-Emergency Patients

D.C. residents who call 911 are no longer guaranteed an ambulance ride to hospitals if responding medics and a nurse determine that their ailments are minor, according to The Washington Post. Instead, after an assessment by firefighter and EMT crews, patients who are not in serious straits will be connected (by phone) with a nurse, who will help them find care at a clinic or a primary care facility. The new policy is the city’s latest attempt to deal with a crippling call volume that frequently causes emergency responders to be unavailable for life-threatening situations.

Maryland | Mar 1, 2019 | News Story | Health Costs Population Health

Maryland Total Cost of Care Model: Transforming Health and Healthcare

The state of Maryland and CMS signed an agreement to implement the Maryland Total Cost of Care Model, which marks the first time CMS will hold a state accountable for total cost of care incurred by resident Medicare fee-for-service beneficiaries, according to JAMA. This 8-year model began on Jan. 1, 2019, and will test whether accountability for Medicare spending will spur statewide healthcare delivery transformation, potentially reducing expenditures, preserving or enhancing quality for beneficiaries and improving individual and population level outcomes. This model builds on Maryland’s All-Payer Model, providing incentives for hospitals to increase high-value care for patients seeking care from their institutions and their community services by centering improved population health as the foundation for the model to achieve savings.

Minnesota | Feb 28, 2019 | News Story | Health Costs

Minnesota Health Costs Could Double to $94 Billion

The overall cost of healthcare in Minnesota grew at a relatively low rate during 2016, but the broader trend points toward a doubling of expenses over the next decade, reports the Star Tribune. A report by the Minnesota Department of Health projected that annual health costs – totaling $47.1 billion in 2016 – will reach $94.2 billion by 2026. This means that Minnesota would spend $1 out of every $6 generated by the state's economy on healthcare. Spending growth will likely result from higher prices, greater use of services and advanced technology costs. Additionally, demographic shifts will boost Medicare enrollment and spending for people with multiple chronic ailments.

Texas | Feb 25, 2019 | News Story | Consumer Voices

'Pain & Profit' Investigation Spurs Sweeping Bipartisan Fix for Texas' Medicaid Managed Care Mess

Lawmakers from both parties are rolling out a package of bills to overhaul the Texas Medicaid system, introducing protections for vulnerable patients who are denied treatments, increasing state oversight and signaling a crackdown on healthcare corporations that get richer by providing less care, according to Dallas News. One such bill would address the state’s broken medical appeals system. In light of limited state oversight that allowed managed care companies to refuse medically needed services and force families with sick or disabled children to pursue endless appeals, other bills would allow parents of children with disabilities to opt out a managed care program called STAR Kids and receive traditional Medicaid. The omnibus bill some lawmakers call the "Managed Care Accountability Bill,” would overhaul the state’s system for fining managed care companies when they fail to properly serve patients, empower the health commission’s Office of the Inspector General to assist in financial review of managed care companies and beef up the state’s tracking of company refusals to provide care. 

Colorado | Feb 24, 2019 | News Story | Drug Costs Health Costs Affordability Consumer Voices

Survey: Coloradans Skipping Healthcare Because of High Cost

new survey conducted by the Healthcare Value Hub discovered that more than half (58%) of Coloradans were burdened by healthcare costs, according to the Durango Herald. Healthcare continues to be an important topic of conversation for Coloradans, especially those outside the Denver metro area, where nearly two-thirds of those surveyed indicated they were burdened by these high healthcare costs. The survey found that the majority of Coloradans (82%) agreed that the healthcare system needed to change to better meet the needs of the consumers. Coloradans should not have to delay or forgo healthcare due to cost: more than 40 percent delayed going to a doctor or having a procedure done, 38 percent avoided going altogether, 21 percent did not fill a prescription and 19 percent cut pills in half or skipped doses to save money.

California | Feb 21, 2019 | News Story | Social Determinants of Health

New State Law is Forcing San Diego to Grapple with Its Lack of Options for Homeless Patients Post Discharge

A new law requires California hospitals to establish plans for discharging homeless patients and provide resources that might keep them from returning to the street, according to KPBS. For example, hospitals must provide meals and weather-appropriate clothing to homeless patients when needed and offer them transportation to their destination after discharge if it is within 30 miles or 30 minutes of the hospital. The law does not, however, require that homeless Californians be given temporary housing or provide new resources to deliver it. The legislation has spurred conversations among numerous stakeholders on how to better address homelessness in California communities.

New Mexico | Feb 13, 2019 | News Story | Health Costs Affordability

New Mexico Reverses Course on Medicaid Charges for Patients

The Governor of New Mexico announced that the state will seek federal approval to reverse cost-sharing and enrollment provisions instituted by the previous Governor that were designed to conserve state spending on Medicaid, reports AP News. Specifically, the state will reverse course on its plans to charge some Medicaid patients a monthly insurance premium of $10 and co-payments of $8 on certain brand-name drugs and visits to the emergency room for routine medical care. According to the Governor, these provisions threaten to limit access to emergency services and disrupt health coverage for hundreds of thousands of state residents who are poor and disabled.

North Dakota | Feb 12, 2019 | News Story

Dental Therapist Bill Fails in the House

North Dakota lawmakers voted down legislation that would have enabled dental therapists to practice in the state by a margin of 2 to 1. Report by The Bismarck Tribune, the bill would have allowed dentists to hire dental therapists, mid-level clinicians comparable to physician assistants and nurse practitioners, in certain settings including Indian Health Service clinics and nonprofit dental practices. Sponsors and advocates of the legislation believed that it would increase access to dental care for vulnerable populations such as Native Americans, children, the elderly, and low-income families, while opponents cited quality and safety concerns as the main reason for voting against the bill.