State News

Colorado’s Center for Improving Value in Health Care released the first health care transparency tool of its kind in Colorado, showing how provider payments vary across the state, reports AboutHealthTransparency.org. The provider payment tool is the first comprehensive
analysis that identifies how much providers are paid for thousands of services, using claims information from the state’s APCD.

Ohio Governor DeWine announced a community-based program aimed at improving the health and well-being of moms, infants, and families, reports Cleveland.com. Obstetrical practices participating in the program are required to measure and engage with patients related to access to care, cultural competency, and communication methods. Practices are expected to formally assess practice strengths and patient needs to ensure resources and best practices available are used to achieve healthier outcomes. Practices that participate in the program will be reimbursed by the state’s Medicaid program in a payment structure that rewards providers who address family needs through prenatal, birth, and postnatal periods. Ohio Medicaid estimates the program will cost five million dollars by the end of this first year, reaching over 14,000 pregnant and postpartum patients and enrolling 77 medical practices.

A new report from the American Economic Liberties Project details the negative impacts of the University of Pittsburgh Medical Center’s (UPMC) control of the western Pennsylvania health care market, reports Fierce Healthcare. The report highlights UPMC’s practice of using market power to acquire and shut down competing hospitals and driving patients to its other facilities, thereby increasing their ability to raise prices for patients. It also includes specific policy recommendations to reform the Pennsylvania health care industry, such as increasing scrutiny over hospital mergers.

New Jersey will provide Medicaid coverage to all children, regardless of immigration status, effective January 1, 2023, reports The Daily Targum. The expansion is a part of the New Jersey Cover all Kids Campaign, which began in 2021. Since the New Jersey Cover all Kids Campaign began in 2021, 47,000 New Jersey children have become eligible for Medicaid and CHIP, and this expansion is expected to cover an additional 16,000 children across the state.

California’s Health Care Affordability Board started holding regular meetings in January 2023, according to State of Reform. Established within the California Office of Health Care Affordability (OHCA), the board will establish the state’s overall health care cost growth target for spending, as well as targets for different sectors including delivery systems, geographic regions, and individual health care entities. The board’s first report will capture baseline spending for 2022-2023, including data reported from health plans, health insurers, and fully integrated delivery systems. Notably, OHCA has the authority to enforce the cost targets through technical assistance and requiring performance improvement plans with escalating financial penalties for failure to meet targets.

The Milbank Memorial Fund assessed the effectiveness of several policies aimed at improving access to primary care in Columbia County, Arkansas, a primary care desert. Expanding Medicaid has made primary care more affordable, and the state has encouraged a Medicaid patient-centered medical home program that has helped practices deliver higher-quality primary care. However, the area’s lack of medical schools and residency programs have made it difficult for health systems and practices to recruit and retain new doctors. The county does not have any mobile clinics, federally qualified health centers, or school-based health centers, though it does have a rural health clinic that serves as a safety net provider. The pandemic encouraged usage of telehealth services, though the county’s lack of broadband has hindered widespread adoption. Furthermore, the county has a higher proportion of Black residents than the rest of the state, and many county residents lack trust in medical institutions and their providers.

Connecticut has received federal approval for a Section 1115 demonstration waiver that will support the Covered Connecticut program, reports the Connecticut Office of Governor Ned Lamont. The approval provides federal matching funds to sustain the existing program, which offers federal premium subsidies, cost-sharing reductions and eliminates out-of-pocket costs for enrollees.

Even with insurance, many Missourians face challenges affording healthcare, reports the Missouri Foundation for Health. Nine percent of Missourians remain uninsured and three-in-five Missouri adults struggle to afford healthcare due to high costs. These challenges are disproportionately shouldered by households that include a person with a disability.

The 2021 California Health Interview Survey results (released in 2022) show that Black or African American adults and American Indian and Alaska Native adults had disproportionately high rates of adverse childhood experience, according to State of Reform. In addition, 27 percent of Californians stated that they did not receive medical care due to cost or lack of insurance.