A study published in the American Journal of Accountable Care found that New Jersey's DSRIP program was successful in catalyzing many aspects of hospital industry transformation toward data-driven population health management. Specifically, hospital capacity for collection of data to fulfill DSRIP reporting requirements increased, data exchanges with outpatients partners facilitated use of rapid-cycle evaluation tools and the value of data sharing for improving quality of care and population health was perceived more positively over time. These findings may help inform future initiatives in value-based provider care in the Medicaid delivery system.
Compared with Baltimore (an untaxed control city), Philadelphia experienced significantly larger declines in the amount of sugar-sweetened beverages sold in small independent stores after implementing a 1.5 cent per ounce tax, according to a study published in Health Affairs. The study also found that 120 percent of the Philadelphia beverage tax was passed on to purchasers of taxed beverages via price increases at small independent stores one year after the tax was implemented. Researchers concluded that excise taxes may be an effective policy tool for decreasing the purchase of sweetened drinks in small independent stores, particularly among populations at higher risk for sugar-sweetened beverage consumption.
An analysis performed by the Oregon Health Authority and the Oregon Health Leadership Council showed that 40 percent of evaluated services were found to be low-value and constituted more than $500 million in spending, according to a new report. Researchers reported that Medicare had the highest rate of low-value services per 1,000 members at 595.5, which is approximately 170 percent higher than the rate for the commercially insured population. The report examines 47 measures and includes actionable opportunities to address the rise in healthcare costs and improve the effectiveness of care that is delivered to patients in Oregon.
A 2019 report by Blue Cross Blue Shield of Massachusetts Foundation revealed that the state struggled to provide adequate access to behavioral health services despite having a high density of primary care practitioners and psychiatrists, an innovative Medicaid coverage and delivery system and a high rate of insured residents. The report noted opportunities to expand telehealth to improve access to these services. The Foundation’s latest report explores this telehealth potential, proposing a framework for an optimal telebehavioral health system of care, highlighting barriers to adoption for providers and consumers and identifying opportunities to promote and expand access across the state.
Dental therapists are now able to obtain licenses to practice in Maine, reports the Pew Charitable Trusts. Dental therapists are midlevel providers who can perform preventative care and basic restorative procedures and can help address barriers to accessing oral health services. They have been used as effective tools in increasing access to care in rural areas and for patients on public insurance as well as improving oral health outcomes in other states. The Maine Board of Dental Practice’s ruling establishes education and licensure requirements so that schools can create training programs and enables dental therapists in other states to relocate and practice in Maine.
The Colorado Center for Improving Value in Health Care has expanded Shop for Care, a transparency tool that allows consumers to compare price and quality information for select services and procedures at Colorado healthcare facilities, according to AboutHealthTransparency.org. The newly improved tool includes updated 2018 prices for imaging services like X-rays, CT scans and MRIs, as well as episode prices for 11 new hospital and outpatient procedures including hysterectomies, colorectal resections and more. The tool shows that price and quality vary significantly across Colorado, and higher prices do not necessarily signal better patient experience or outcomes.
Practice-level participation in innovative care models led to a $30 per member per quarter decrease in spending for three Arkansas Blue Cross and Blue Shield value-based primary care programs, according to a Milbank Memorial Fund issue brief. The brief examined changes in healthcare spending and utilization (years 2011 through 2018) associated with practice-level participation in one of the three Arkansas Blue Cross and Blue Shield value-based primary care programs. Estimated savings suggests a 2:1 return on investment, indicating that each dollar spent on care management fees among this commercially insured adult population resulted in a $2 savings in beneficiary spending. Reductions in acute inpatient stays and emergency department use likely account for the program savings. Savings were greater for participating practices in later years for each of the programs, suggesting that return on investment may increase over time.
A new law in New Jersey extends the time period for which individuals can receive coverage and providers can bill for services using telemedicine and telehealth for 90 days following the end of the COVID-19 public health emergency and the state of emergency. Included in the law are telehealth and telemedicine services delivered under the Medicaid and NJ FamilyCare programs.
A collaboration between Duke University, the Health Care Cost Institute (HCCI) and Blue Cross and Blue Shield of North Carolina combined healthcare spending data for North Carolina residents in 2016 and 2017, combining healthcare spending across several distince sources of healthcare insurance coverage with data held by different institutions. The project includes Medicare, Employer-Sponsored Insurance and North Carolina Medicaid data to calculate total healthcare spending by county and per-person spending, broken down across counties, populations, age groups and service categories. The data and it's visualizations present detailed windows into healthcare costs and spending characteristics in the state.
A new resource, WisCovered.com, aims to guide consumers seeking health insurance, reports the Wisconsin Examiner. The site is starting up as hundreds of thousands of Wisconsin residents have lost their jobs and potentially their health insurance, as well. Set up by the Office of the Commissioner of Insurance, WisCovered.com includes links to a variety of resources to help users learn about their insurance options, including free telephone counseling on health insurance alternatives through the nonprofit Covering Wisconsin or the United Way's 211 service.