State News

Oregon | Apr 26, 2021 | News Story

Time to Say Goodbye to Some Insurers’ Waivers for COVID Treatment Fees

Health insurers in Oregon that waived all deductibles, copayments and other costs for insured patients who fell ill with COVID-19 and needed hospital care, doctor visits, medications or other treatment are no longer waiving fees for COVID treatment, according to The Lund Report. In a study released in November, researchers found about 88 percent of people covered by insurance plans — those bought by individuals and some group plans offered by employers — had policies that waived such payments at some point during the pandemic. Waivers resulted in significant savings for COVID patients who fell seriously ill and wound up in the hospital. 

Tennessee | Apr 23, 2021 | News Story

Advocates Sue to Stop Tennessee Medicaid Block Grant Program

A group of Tennessee Medicaid recipients has filed a lawsuit seeking to halt a plan that would make contentious changes to the state's program designed to provide medical coverage to low-income earners in the state, according to Modern Healthcare. The Tennessee Justice Center — who is representing the recipients — claims the federal government exceeded its authority in approving the proposal. Block grant supporters argue that the current system gives states little incentive to control expenses because no state pays more than half the total cost. However, opponents and health advocates have expressed concern that spending caps might cause states to purge their rolls or reduce services.

Montana | Apr 21, 2021 | News Story

Montana Governor Signs Bill Allowing Direct Patient Care Contracts

A new Montana law aimed at reducing healthcare costs will allow healthcare providers to contract directly with patients for certain basic care, such as annual checkups, office visits, vaccines, bloodwork and stitches, reports the Flathead Beacon. Currently, eight clinics in Montana are working as direct primary care providers as allowed under a 2017 memo issued by the then-Insurance Commissioner. The new law allows dentists, chiropractors and other health providers to offer similar direct care contracts to patients. Supporters of the law argue that direct care coverage can be used in combination with lower-cost catastrophic health coverage or a healthcare sharing ministry to reduce costs. 

Tennessee | Apr 17, 2021 | Report | Rural Healthcare

Report Assesses Rural Hospital Closures in Tennessee

The Tennessee Health Care Campaign’s Rural Equity Report shows three-fourths of the state’s 25 remaining essential access rural hospitals are at high risk of closure in the next few years, reports The Rogersville ReviewThe report includes a toolkit for rural communities with vulnerable hospitals that offers solutions to rural health inequities, including: prioritizing infrastructure improvements in roads, broadband and emergency call centers; state oversight of hospital ownership transfers; increased financial investment in rural health; and increasing coverage for Tennesseans in rural areas. The report also includes interviews with stakeholders that share their experiences and perceptions of rural hospital closures. 

Massachusetts | Apr 16, 2021 | News Story

An ‘Automatic’ Solution to Keep People from Losing Health Coverage

An old Massachusetts policy called “automatic retention” stopped residents from losing their health coverage, reports Tradeoffs. The results of an NBER working paper show that this unique feature protected 14% of adults per year from losing health insurance coverage due to payment lapses. Because in CommCare (Massachusetts’ pre-ACA health insurance exchange) there was always one plan option with zero premium available to people making 100-150% of the federal poverty limit, if someone missed a payment for another plan, they were switched automatically to the premium-free plan. Researchers found that the adults who benefited from this policy were often younger and healthier, keeping the market risk pool balanced. 

Colorado | Apr 16, 2021 | News Story | Health Costs

Payments to Hospitals are Trending Downward in Colorado but Continue to Outpace National Averages in Most Regions

A new analysis found large variations in commercial health insurance payments compared to Medicare payments across Colorado hospitals, reports the Center for Improving Value in Health Care. Colorado hospitals received commercial payments for inpatient and outpatient services that were anywhere from 108% to 508% of Medicare rates for the same services at the same hospitals. In particular, outpatient services in Colorado are among the most expensive in the state and a driver of rising healthcare costs.

New York | Apr 15, 2021 | Report | Social Determinants of Health

Social Determinants Matter for Hospital Readmission Policy: Insights from New York City

Omitting social determinants of health (SDOH) data from CMS’ Hospital Readmissions Reduction Program misallocated penalties attributable to SDOH to hospitals with the largest share of high-risk patients, according to a Health Affairs study. Researchers used 2012-2016 data from New York City to project the program’s penalties by augmenting CMS’ readmission model for heart attack, heart failure and pneumonia with SDOH scores created to measure geographic levels and individual-level social risk. They found that including these scores affects projected penalties for hospitals treating the highest proportion of patients with high SDOH scores. If CMS continues to omit this relevant patient and geographic data from this readmission model, penalties due to SDOH and social risk factors are misallocated to hospitals serving the largest share of these populations.

Maryland | Apr 15, 2021 | News Story | Equity

New Grant Program Will Reduce Healthcare Inequality, Advocates Say

Newly passed legislation in Maryland, the Maryland Health Equity Resource Act, will reduce inequality in health, reports Maryland Matters. The bill will fund grants in neighborhoods that have suffered from health disparities and poor health outcomes, offering communities in those neighborhoods funding opportunities for programs to reduce health disparities, improve outcomes, boost access to primary care, prevent illness or reduce hospital use. The neighborhoods eligible for the grants will likely mirror those that qualified for Maryland’s previous Health Enterprise Zone program in 2016. 

Hawaii | Apr 15, 2021 | Report

Hawaii is Top State in Children’s Health and Access to Healthcare

study from WalletHub ranked states across many key health metrics, including children’s health and access to healthcare—where Hawaii earned the top rank, reports State of Reform. Hawaii earned second place overall for children’s healthcare, only just behind the District of Columbia. The state also earned a high score for lowest percentage of uninsured children, children with unaffordable medical bills and percentage of overweight children. However, Hawaii had the second to last ranking for children’s oral health.

West Virginia | Apr 15, 2021 | News Story

State Moves Ahead on Medicaid Extension to Improve Maternal Health

West Virginia has passed legislation to extend Medicaid coverage to low-income women up to one year after giving birth, reports U.S. News & World Report. The state’s Governor indicated that the state’s health department will opt into the state plan option indicated in the American Rescue Plan, noting that the state’s population has many lower-income families and pregnant women in need of comprehensive health coverage.