State News

Telemedicine is increasing at a significant rate across New Hampshire, but some experts warn that it may not be appropriate for all patients in all cases, according to New Hampshire Public Radio. Research out of Harvard Medical School suggests that the biggest growth in telemedicine is happening in direct-to-consumer telemedicine and that most of those televisits are from new patients, meaning they are not replacing in-person doctor’s appointments, but rather adding to them. Though telemedicine would allow patients in rural areas to get help, New Hampshire’s shortage of healthcare workers remains and may hamper telemedicine’s potential.

The Minnesota Hospital Association claims Blue Cross Blue Shield (BCBS) of Minnesota, the state’s largest not-for-profit health insurer, may be breaking the law by imposing a slate of new policies designed to deny or delay access to routine colonoscopies and hundreds of other hospital services, according to The Star Tribune. The hospital trade group has asked state officials to investigate these practices and stop the insurer from imposing new policies that do not comply with state law and discriminate against in-network providers by limiting coverage for patients who do not receive prior authorization for services and if there are cheaper in-network service options nearby. BCBS claims that healthcare costs continue to rise to unprecedented levels and hospitals must work with payers and plan sponsors to improve the sustainability of healthcare costs.

The Indiana State Health Commissioner and Family and Social Services Administration Secretary announced that Indiana would join 11 other states in covering tobacco cessation prescription drugs, such as Chantix and Zyban, free of charge. According to IndyStar, studies place Indiana in the top 10 states with the highest smoking rates. About 22 percent of Indiana residents smoke and 13 percent of expectant mothers. In an effort to encourage expecting and new mothers to quit smoking, state officials announced mothers on Medicaid will no longer have a co-pay for tobacco cessation products for up to a year after a child’s birth.

To improve access to care for low-income patients, California is paying off $10.5 million in student loans for 40 dentists who agree to ensure that 30 percent of their patient population is composed of Medi-Cal patients, who are among the state’s poorest and frailest residents, reports The Sacramento Bee. Currently, only one-third of California’s licensed dentists accept Medi-Cal patients due to low reimbursement rates. As a result, an estimated 13.4 million people eligible for the program struggle to obtain necessary care. This action compliments an earlier award that provided $58.6 million in student debt relief to 247 physicians.

The Arizona Health Care Cost Containment System released a Medicaid statistical snapshot revealing data on enrollment, costs, claims and utilization, reports State of Reform. The snapshot documented lower costs than the national average, with the state leading the way in cost-savings from opting for in-home care. In 2018, 87 percent of Arizona Long Term Care Services members received services in their own home or community, saving an average of $13,939 per member in Fiscal Year 2018. As a result, Arizona ranks 5th in the nation for utilizing home and community based services rather than institutional services.  

California lawmakers sidelined legislation that would have prohibited out-of-network hospitals from surprise billing privately insured emergency department patients, citing fierce pushback from hospitals, according to Kaiser Health News. Instead of billing patients directly, hospitals would have to work with health plans, leaving patients responsible only for their in-network copayments, coinsurance and deductibles. Hospitals’ opposition focused on a separate provision that limited the amount they could charge insurers for each service provided. An industry spokesperson criticized the provision as an unnecessary form of rate setting, however, proponents argue that protecting patients from high costs and capping what insurers pay hospitals are inextricably linked.

Florida has passed a law eliminating certificates of need before certain hospital facilities can be built, according to BISNOW. Certificate of Need (CON) programs were implemented in the 1960s when regulators worried that the cost of maintaining largely unused hospital facilities would be passed on to consumers. These laws require healthcare providers, primarily hospitals, to demonstrate to a public body the clinical need for a capital expense, for example, a new building or major piece of equipment, prior to making these investments. Critics have argued that CON programs stifle competition. However, the Florida Hospital Association asserted that removing CON regulations would allow for duplicative services to be offered in affluent communities, while lower income and uninsured populations lose access to vital hospital services. 

A survey of Virginia adults found that more than half of Virginia adults had problems affording healthcare during the last year, according to Virginia Business. Altarum’s Consumer Healthcare Experience State Survey also found that 78 percent of respondents worry about affording healthcare in the future. Data revealed that there was high support for government-led change crosses party lines. The top three healthcare priorities respondents want to see action on are addressing high costs (55 percent); preserving consumer protections (36 percent); and getting health insurance to those who cannot afford coverage (35 percent). The majority of respondents, regardless of political affiliation, indicated they supported government action to make it easier to switch insurance (89 percent); and requiring up-front patient cost estimates from healthcare providers (88 percent) and insurers (90 percent). Advocates agree that even with Medicaid expansion, healthcare affordability is still a top issue for all Virginians.

Heart attack patients treated at New Jersey hospitals with low hospital performance scores have a higher chance of having another heart attack or dying of cardiovascular causes than those treated at hospitals with high performance scores, according to NJ Spotlight. The study by Rutgers University, published in the American Journal of Cardiology, found that 3 percent of heart attack patients treated at low-scoring hospitals return to the low-scoring hospitals due to a new heart attack within 30 days. Those admitted to a teaching hospital were 25 percent less likely to be readmitted after a month than those admitted to a non-teaching hospital, and their chances of suffering cardiovascular death after a year were 10 percent lower.