State News

An analysis of 44 low value healthcare services in the Virginia All-Payer Claims Database revealed more than $586 million in unnecessary costs in 2014. The study found that low value, low cost services drove the bulk of wasteful spending, accounting for nearly twice the spending as low value, high cost services. Researchers assert that strategies to reduce waste should focus on low value, low cost services, as they are less controversial than low value, high cost services and can have a sizable impact on reducing unnecessary healthcare spending.

Governor Jerry Brown signed California's AB-265, which will limit the use of copay coupons and other discounting strategies for branded prescription drugs when a cheaper generic is available, reports FiercePharma. Brown authorized the bill on the same day he signed SB-17, a separate piece of legislation which will force drugmakers to give warning of and explain price hikes. Together, the bills represent two significant regulatory steps on drug pricing in a critical state. Other states could follow the model as many around the country look to take pharmaceutical prices into their own hands. 

The California Governor signed a sweeping drug price transparency bill to force drugmakers to publicly justify big price hikes, according to Kaiser Health News. The new law will require drug companies to give 60 days’ notice to state agencies and health insurers anytime they plan to raise the price of a drug by 16 percent or more over two years on drugs with a wholesale cost of $40 or higher. They must also explain why the price increases are necessary. The bill drew support from a diverse coalition, including labor and consumer groups, the hospital industry and even health insurers. But some experts say that transparency alone is not enough to bring down drug prices, and that California’s law may lack the muscle being applied in other states to directly hold drug prices down.

Experts from the University of North Carolina at Charlotte use big analytics to study emergency department usage and other social determinants of health, according to Healthcare IT News. Michael Dulin, MD, leads the project and says that understanding the social determinants of health that exist within their consumer population and creating connections to align those consumers to resources is a key component to improving overall health outcomes.

According to MaineBiz, the National Committee for Quality Assurance (NCQA)'s 2017-18 Health Insurance Plan Ratings ranks Maine as the third-best state in the country for the quality of its health insurance plans.

New Hampshire has a strong foundation for building telehealth and mHealth capabilities within the state because of a fairly robust telecommunications infrastructure and predominately rural areas, according to a report conducted by the Citizens Health Initiative and the Institute for Health Policy and Practice at the University of New Hampshire. The report highlights several areas including pilot programs, research opportunities and policy opportunities that would put New Hampshire in the forefront of telehealth.

Hawaii has asked the CMS to help it care for chronically homeless people more efficiently by addressing a major social determinant of health: housing, reports Modern Healthcare. Specifically, the state wants to use federal Medicaid funds to appoint state employees to help people find housing and provide moving assistance to beneficiaries. For doctors, stable housing means there is a greater likelihood patients will adhere to their medication regimen and comply with preventive care recommendations. Hawaii hopes to build off its success with the state-funded Housing First program that started in 2014 in the Honolulu area, which decreased healthcare costs for participants by nearly $5,500 per month. The waiver doesn't ask Medicaid to cover actual housing costs, which is prohibited by federal law.

Oklahoma formally withdrew its request for a 1332 waiver to begin a reinsurance program through the Affordable Care Act after federal officials failed to approve it on time, reports Oklahoma Watch. The reinsurance program would have created a pool of money to reimburse insurers for high costs on the exchange, which has seen average monthly premiums rise from $277 in 2015 to $571 this year. Several states have applied for similar waivers; the federal government has approved requests in Alaska and Minnesota.