State News

The Pennsylvania legislature has passed a law intended to simplify how healthcare providers work with insurers, according to WSKG. The law bars prior authorization for most emergency department services. Insurers must state what they will authorize, and when insurers deny something, they must give written notice which patients can then appeal.

Montana’s reference-based pricing in their public employee health plan, which effectively set prices for all services across the state, has saved the state millions since implementation six years prior. Notwithstanding  its success, Montana legislators have announced that they are shifting to a new strategy, reports Stat News. The new model will allow private insurers to administer the public employee health plan beginning next year. Opponents of the strategy allege that the contract was awarded through an illegal bidding process and that it could cause healthcare costs to rise for Montanans.

Across North Carolina, an estimated 4 million residents don’t have access to reliable broadband service, reports NC Health News, which hinders their ability to access telemedicine. This issue particularly affects rural residents, many of whom live in communities that tend to suffer most from a low supply of health professionals. Although telehealth is often promoted as the solution to increasing access to healthcare, rural residents of North Carolina without reliable internet are often left behind, stymying attempts to improve access, equity and outcomes. In addition, Census data shows that roughly a quarter of people in Western North Carolina’s rural counties are 65 or older–one of the main goals of the state’s Office of Rural Health is to ensure digital literacy and internet connectivity for this population.

Leaders in Illinois are working to eliminate racial healthcare disparities through a new program and cultural bias training, reports the State Journal-Register. The Illinois Department of Public Health has awarded grants totaling $3.7 million to organizations working to address health inequities, many of which were brough to the forefront by the COVID-19 pandemic. Beyond improving access to vaccines, some hospitals have adopted cultural bias training and equity, diversity and inclusion teams to help individuals better navigate the healthcare environment and work to reverse disparities. Hospitals and community groups within the state acknowledge that cultural and language barriers must be addressed to better serve their patients and ensure equitable access to care, and hope that these efforts will be led by those involved in their communities.

Nearly four in five Connecticut residents are concerned about healthcare affordability, reports the Connecticut Mirror. In addition to this statistic, the survey also demonstrated that, among those surveyed, the issue of affordability extends across the political aisle—68 percent of Republicans, 75 percent of Democrats and 67 percent of residents who identified as neither party agreed the healthcare system needed change.

The average health insurance premium for small business will fall by 0.8 percent from 2022 to 2023, the first such reduction since 2001, according to Health Affairs Forefront. The state has taken several steps to reduce costs, including a 1332 State Innovation Waiver to merge the individual and small group market and extend reinsurance to small businesses purchasing through the merged market.

The California Advancing and Innovating Medi-Cal program, or Medi-Cal/CalAIM, aims to address social determinants of health by directly providing resources beyond healthcare, such as including housing and food, according to the Los Angeles Times. An extension of the Medi-Cal state Medicaid program, Medi-Cal/CalAIM aims to reduce health disparities for low-income beneficiaries, including homeless individuals struggling with serious mental illness or physical needs, as well as aiming to save the state money in the long term.

The federal government approved Arizona’s 1115 demonstration targeted at expanding access to coverage and addressing nutrition and housing needs, report Healthcare Dive. The program will focus on making sure Medicaid beneficiaries have adequate housing with resources to help them transition from temporary to more stable living situations.

New York state is doubling its spending to expand the physician workforce to include more people of color, bringing total efforts to $2.4 million, reports Spectrum News. The effort, first launched in 2017, has had moderate success, but just 12 percent of physicians are Black or Hispanic, despite compromising 30 percent of the state’s overall population. The COVID-19 pandemic further highlighted health inequities, which rallied support for this initiative. The program is meant to encourage students from diverse communities to pursue jobs in medicine, get accepted to and complete medical school in the state. Experts believe initiatives such as these will help provide trusted voices and more cultural understanding within the healthcare community, and, thus, improve equitable outcomes.