The United Hospital Fund published a report identifying the most effective ways to present meaningful and user-friendly pricing information to New York consumers, following a 2020 directive to create a consumer-friendly website, NYHealthcareCompare. Some recommendations include: using the “allowed amount,” as it best reflects the actual underlying price of healthcare services, using commercial claims data for the first iteration of the transparency website, and displaying pricing information for public insurance programs.
Maryland’s unique healthcare financing model may have helped providers financially weather the pandemic storm, report experts at a panel held by State of Reform. Maryland’s global budget system for hospitals provided stability and allowed providers to focus on responding to the pandemic, but the payment services system struggled, experts acknowledge. However, the flexibility the financing system in Maryland allowed healthcare systems to focus on social determinants of health and could be implemented elsewhere.
The Centers for Medicaid & Medicaid Services approved Illinois’ 1115 waiver allowing for the extension of full Medicaid benefits from 60 days to 12 months postpartum, reports the Illinois Office of the Governor. Illinois is the first state to extend full Medicaid benefits to this extent. It is hoped that this extension will strengthen continuity of care to improve health outcomes for mothers in Illinois and reduce the rate of maternal morbidity and mortality, particularly reducing the significant health disparities for Black women. Women with incomes up to 208% of the federal poverty level will have continuous Medicaid eligibility through 12 months postpartum.
The District of Columbia was ranked the best state for children’s healthcare in a study from WalletHub. The study assessed states on 35 indicators of cost, quality and access to children’s healthcare. D.C. ranked number one in children’s oral health, number two in children’s health and access to healthcare and number seven in children’s nutrition, physical activity and obesity.
Ohio ranks 47th in the nation in health value as compared to other states and D.C., according the Health Value Dashboard from the Health Policy Institute of Ohio. The Dashboard found that the majority of Ohio’s healthcare spending is on downstream factors of health to treat health problems, particularly due to a lack of investment in children, equity and prevention. The equity profiles highlight many health disparities experienced by Ohioans, including that Black, Hispanic and Ohioans with disabilities are more likely to be unable to see a doctor due to cost than white Ohioans or Ohioans without disabilities. The Dashboard recommends nine policies to improve health value in Ohio, including: strengthening the public health workforce; training on racism and discrimination; and increasing eligibility for a childcare subsidy.
New Mexico’s governor signed a bill creating the Health Care Affordability Fund and eliminating cost sharing for behavioral services covered by health insurance plans, announced the Office of the Governor. The Health Care Affordability Fund will be used to invest in initiatives to make health insurance and healthcare services more affordable for working families, such as lowering premiums and out-of-pocket costs for individuals who purchase health insurance from the state marketplace and uninsured residents who do not qualify for federal assistance. The Urban Institute estimates that investing in these initiatives could provide up to 23,000 uninsured New Mexicans with affordable healthcare coverage.
New Mexico’s governor signed the Patients’ Debt Collection Protection Act into law, reported KRWG. This law will protect patients from medical debt by requiring hospitals and other healthcare facilities to screen uninsured patients for public insurance and other financial assistance programs. In addition, the law also protects patients whose household income is at or below 200% of the federal poverty level from being sent to debt collectors or sued by healthcare facilities for unpaid medical bills.
Maine’s governor announced that it would be establishing an Office of Population Health Equity within the Maine Center for Disease Control and Prevention, reports Maine Public Radio. The mission of the office is to identify and address health disparities for certain populations. State health officials noted that there were plans to establish the Office before the pandemic and that the health disparities caused by the public health emergency highlighted the need for it. A health equity office had existed within the Maine CDC for years under different names, including the Office of Minority Health, but was dissolved in 2015.
Montana’s state employee health plan has experienced significant savings in the two years since the transition to reference-based pricing, reports NASHP. The independent analysis of the program reveals no evidence that utilization artificially increased as a result of the new payment model, which would occur if hospitals needlessly push more services onto patients to offset lower reimbursement rates. Furthermore, the report notes that there have been no hospital closures in Montana. Prior to implementing reference-based pricing, Montana’s third-party administrator negotiated hospital reimbursement rates as a discount off of a hospital’s chargemaster rates. Before the transition, Montana paid a range of 191 to 322 percent of Medicare rates for inpatient services and 239 to 611 percent of Medicare rates for hospital outpatient services. After the reference-pricing went into effect, Montana pays 220 to 225 percent for inpatient services and 230 to 250 percent for outpatient services.
A nonprofit incorporated by the president of the Mississippi Hospital Association and others has filed preliminary paperwork to start a ballot Initiative that would put Medicaid expansion in the state constitution, according to Mississippi Today. Mississippi is one of just 12 states that has refused to expand Medicaid, leaving hundreds of thousands of citizens without the ability to afford healthcare coverage and rejecting at least $1 billion per year in federal funds. The planning stages of the ballot initiative signals a broad coalition may be on board with the effort.