State News

Dr. Gajendra Singh has filed a lawsuit in the North Carolina Superior Court arguing that the state's certificate of need (CON) law gives hospitals a monopoly over MRI scans and other services and leads to high prices. According to an article in Vox, after Singh decided to post his prices, as low as $500 for an MRI, he ran into the state’s certificate of CON law, which prevented him from buying a permanent MRI machine. As a result, his office couldn’t always offer patients one of the most important imaging services in medicine. Americans can sometimes be charged as much as $24,000 if they get an MRI at a hospital emergency department. 

In response to extreme racial disparities in maternal death rates, New York City launched an initiative to reduce maternal deaths and complications among women of color, according to a news report from ProPublica. The city will improve their data collection on maternal deaths and complications, fund implicit bias awareness trainings for medical staff at private and public hospitals, and will launch an awareness campaign. Over the next three years, the city will spend $12.8 million on the initiative, to eliminate the black/white racial disparity in deaths related to pregnancy, and cutting the number of complications in half over the next five years. The city’s health department is targeting two dozen public and private hospitals, focusing on neighborhoods with the highest complications rates in the South Bronx, North and Central Brooklyn, and East and Central Harlem. Hospitals will study the data from cases that led to bad outcomes and hospital officials will run drills aimed to recognizing and preventing these outcomes. This initiative is an accountability measure and a positive first step towards addressing the concerns and needs of women of color and pregnant women.

Huntsville-based Sam Houston State University thinks it can address Texas’ critical shortage of doctors in rural parts of the state. According to an article in The Texas Tribune, the school seeks to open a college of osteopathic medicine to recruit students from rural areas. An official at the proposed school emphasized that patient-centered care is one of the main tenets of osteopathic medicine. The school is still waiting for approval from the Higher Education Coordinating Board.  

Ohio Attorney General Mike DeWine is ramping up his investigation into the costly practices of pharmacy middlemen, hiring outside counsel to assist with a probe he expects to lead to litigation against companies managing drug benefits for Medicaid and other tax-funded health insurance programs. According to The Columbus Dispatch, DeWine stated that “today, I am putting PBMs [pharmacy benefit managers] on notice that their conduct is being heavily scrutinized, and any action that can be taken and proven in court will be filed to protect Ohio taxpayers and the millions of Ohioans who rely on the pharmacy benefits provided.” The announcement was applauded by the Ohio Pharmacists Association but criticized by political opponents who characterized the move as an empty gesture designed to shore up votes before the election.

California’s recently passed health spending bill includes a number of provisions, including a one-time grant of $60 million to fund a state-wide all-payer claims database, reports State of Reform. According to an earlier post, the California Health Care Payments Database will collect information relating to the utilization, pricing and social determinants of health with the purpose of using “the information to inform policymakers in making decisions regarding how to reduce healthcare costs while improving quality and reducing disparities.” The Health and Human Services Secretary will use the database to compile annual reports to the California Legislature, which will (1) compare prices by payer and providers, (2) make recommendations to contain healthcare costs, reduce health disparities and improve the quality of healthcare and (3) offer strategies to increase transparency of healthcare costs.

An initiative that would have attempted to cap drug prices in South Dakota was removed from the statewide ballot by a judge, the second time that a court has prevented such a measure from going before voters in the 2018 election. According to STAT, the ruling came after a court determined the measure’s supporters had improperly gathered some of the signatures necessary to qualify it for the ballot. The legal complaint that stopped the South Dakota initiative was filed by South Dakotans Against the Deceptive Rx Ballot Issue. Joni Johnson, the group’s chairwoman, is the executive director of South Dakota Biotech, the state affiliate of the Biotechnology Innovation Organization, a Washington trade group. Similar measures were rejected in Ohio in 2017 and California in 2016.  

More than half (55 percent) of Texas residents say it is difficult for them and their family to afford healthcare, and roughly six in ten say someone in their household has postponed or skipped medical care in the past year because of the cost. According to new survey data from the Kaiser Family Foundation, problems with healthcare affordability are much more commonly reported among Texans with lower incomes, those with health problems and the uninsured. In addition to general difficulty affording care, about four in ten Texans (38 percent) say they or someone in their household had problems paying medical bills in the past 12 months. 

There is increasing awareness that social determinants of health affect physical and mental health outcomes, especially in early childhood.  Social determinants, particularly those that can lead to toxic stress, can stunt young children’s brains leading to long-term development challenges. A new study from the United Hospital Fund examining the effects of a learning collaborative called Partnerships for Early Childhood Development (PECD). PECD is a two-year grant that provided $700,000 to 11 New York City hospital-based primary care practices to build partnerships with 17 community-based practices. These clinical-community partnerships designed and implemented their own social determinants of health projects to screen families for social needs. Over 5,500 families were screened and at least 1,900 families were determined to have one or more social needs. In the first year of the project, referral rates to community based practices were high, but follow up was low due to various barriers the teams encountered in tracking referrals, sharing information and other social hurdles that kept the families from seeking services. Strengthening the referral approach and closing this feedback loop is the focus for the upcoming second year of the grant. 

Many online healthcare transparency tools are new and vary widely in the information they contain and how it is displayed. New York state is continuing to invest in resources to ensure that residents have access to timely and meaningful information they need to make decisions about their health, including the state’s all-payer claims database, as described by a new report that contains a national inventory of transparency tools to guide state policy. In addition, a new online database evaluates national tools in four categories: physicians, hospitals, prescription drug pricing and health insurance purchasing. The inventory, which examines more than 230 healthcare transparency tools across the US, offers best practices and recommendations to help consumers make value-based healthcare decisions. The online platform includes tools containing quality information for physicians and physician groups, though price features are lacking.