A new report commissioned by the California Future Health Workforce Commission assesses financial support offered to Californians training to become non-physician providers and the data collected on these efforts to help overcome barriers to meeting workforce needs across the state. Recommendations include expanding state-level opportunities for financing educational debt for primary care non-physician providers and making primary care more appealing to offset trends toward specialization.
The Washington State Health Care Authority, governor’s office, state medical association and insurance companies signed a memorandum of understanding committing to improve primary care and develop a new payment model in Washington state, according to a press release. The goals of the initiative are to: increase primary care expenditures while decreasing total health spending; align payment and incentives across payers; align quality metrics across both payers and providers; promote and incentivize integrated, whole-person and team-based primary care, physical and behavioral healthcare and preventive services; improve provider capacity and access; and work with interested public and private employers to spread and scale the model throughout the state.
Fewer infants died in South Carolina last year, but data published by the state’s Department of Health and Environmental Control shows that all improvement was observed exclusively among white babies, reports the Post and Courier. This data highlights the widening and significant racial gap between white and Black infant deaths. In 2019, Black infants born in South Carolina were nearly three times as likely as white babies to die before their first birthday. Infant mortality has long been considered an important metric in evaluating broader public health. A variety of factors contribute to these statistics, including a mother’s preexisting conditions, access to prenatal care and more.
The transition from hospital fee-for-service to a population-based revenue system in Maryland is proceeding successfully, according to a Health Affairs Blog. The state’s Medicare savings performance in 2019 was the best since hospital global budgets were implemented in 2014. COVID-19 has provided an unforeseen stress test, which the state responded to with swift collaboration and communication with the Centers for Medicare and Medicaid Innovation, hospitals and other stakeholders, to ensure they could fulfill the promise of guaranteed level of revenue without dramatically increasing prices for payers, employers and consumers. COVID-19 has shown the weaknesses of the fee-for-service payment model, while Maryland’s Total Cost of Care model has allowed hospitals to fare relatively well during the pandemic.
Fees levied on insurers and patients for health services provided in hospital-owned facilities in Connecticut totaled $437.2 million last year, reaching their highest level since the state began tracking the charges in 2015, according to the Harford Business Journal. The increased revenue generated from the fees was partially driven by an 11.4 percent increase in the number of patient visits subject to a facility fee, with digestive-system and cardiovascular procedures generating more fee revenue than other service categories across the state. The average facility fee was $147 for visits billed to Medicaid, $213 for visits billed to Medicare and $426 for visits billed to commercial insurers. It is not clear what portion of the facility fees commercially insured patients ended up paying, compared to their insurer.
Starting in December 2020, low-income immigrants age 65 and older in Illinois will be eligible for Medicaid-like coverage, regardless of immigration status, reports the Chicago Tribune. Initially, between 400 and 2,000 people are expected to sign up for the program, which was part of the state budget passed earlier this year. An unpublished study by Rush University Medical Center shows the 75 to 85 age group without legal immigration status should increase elevenfold in the next 10 years. Currently, undocumented older adults are being served by a patchwork of organizations that are having to make exceptions to find solutions to help patients that would otherwise go without needed services. Advocates hope this program will provide preventive care benefits and provide a safety net that is currently inaccessible to this population.
The Governor of Pennsylvania signed an executive order to set up new councils in an effort to control healthcare costs, improve access to medical care and address treatment disparities, reports the Pittsburg Post-Gazette. The Governor also plans to create five Regional Accountable Health Councils to develop ways to reduce disparities in the healthcare system and promote the purchase of healthcare services based on the highest value to the consumer. The Governor will also work with the state legislature to create a Health Value Commission, charged with keeping healthcare payers and providers accountable for spending growth and ensuring the long-term affordability and sustainability of the healthcare system by setting spending benchmarks.
The Ohio Department of Medicaid seeks to update its managed care setup with a focus on population health, meeting the needs of children with complex needs and reducing administrative hurdles for patients and healthcare providers, according to Health Policy Institute of Ohio. The state has invited privately operated managed care organizations to submit applications. These changes are the result of comments provided by beneficiaries, physicians, hospitals and other healthcare providers. Many highlighted concerns with the current system that forced families with children in need of intensive and costly services to relinquish custody for their children to be eligible for Medicaid. Under the plan, Ohio Rise, some youth would qualify for modified eligibility requirements, allowing them to receive assistance while remaining in their family’s custody
California will join 28 states that allow nurse practitioners to practice independently, in an effort to address workforce shortages creating barriers to care, according to The Sacramento Bee. The new law will allow nurse practitioners to open their own practices after a three-year period of operating under a doctor’s supervision, beginning in 2023. The state’s Board of Registered Nursing will establish a commission to oversee implementation and practice requirements, including nurse practitioners’ obligation to notify patients that they are not physicians.
Citing challenges to addiction treatment access in Colorado, a new state program has transformed six RVs into mobile clinics to reach isolated communities, reports Kaiser Health News. As brick-and-mortar addiction clinics have closed or stopped taking new patients due to COVID-19, these mobile clinics have become more crucial to rural residents seeking addiction care. Each RV has a nurse, a counselor and a peer specialist who has personal experience with addiction. And because broadband access is often limited in rural areas, these RVs provide a telehealth bridge to medical providers in cities, so that rural residents can be prescribed medicine to fight addiction and overdose.