Category Archives: Health-care Policy

Texas strives to lure mental health providers to rural counties

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200px-Flag-map_of_TexasBy Lauren Silverman, KERA

In her third year of medical school, Karen Duong found herself on the other side of Texas.

She had driven 12 hours north from where she grew up on the Gulf Coast to a panhandle town called Hereford.

“Hereford is known for being the beef capital of the world,” she says, laughing. “There’s definitely more cows than people out there.”

Medical student Karen Duong worked in Hereford, Texas, with Dr. Akinyele Lovelace, an instructor with the University of North Texas Health Science Center's rural medical education program.

Medical student Karen Duong worked in Hereford, Texas, with Dr. Akinyele Lovelace, an instructor with the University of North Texas Health Science Center’s rural medical education program.

It’s even named after a breed of cattle. Out here, there aren’t many people who provide mental health care. In fact, there aren’t any psychiatrists.

That’s the reason Duong went there – she’s studying psychiatry as a medical student at the University of North Texas Health Science Center. This assignment showed her just how severe the state’s mental health care shortage is.

“You have a patient that comes in and they need immediate care or something more acute, and then you tell them that the soonest they can get in for an appointment is six months from now,” Duong says. “It’s not really what we want to tell our patients.”

Hereford is one of many areas in Texas lacking adequate access to mental health care.

Of the 254 counties in Texas, 185 have no psychiatrist, according to Travis Singleton, who tracks physician shortages for Merritt Hawkins, a Texas-based consulting firm. “That’s almost 3.2 million [people],” he says. Continue reading

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Patience, persistance serve Alaska’s Health Commissioner well

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Alaska’s health commissioner spends her summers working on policy issues by day and fishing for salmon for the winter on nights and weekends with her family who belong to the Yup’ik people.

By Annie Feidt, Alaska Public Media

Valerie Davidson, Alaska's health and social services commissioner, drives her 1983 Chevy truck to pick up salmon for a dinner party for 50 people.

Valerie Davidson, Alaska’s health and social services commissioner, drives her 1983 Chevy truck to pick up salmon for a dinner party for 50 people.

In less than 24 hours, Valerie Davidson has 50 people coming for dinner to her house in the remote western Alaska town of Bethel. She had planned to catch and cook enough salmon for the main course, but she’s hit a snag.

Early in the morning, the state opened the Kuskokwim River to commercial fishing, which means subsistence fishermen can’t fish on it. So Davidson and I are in “the orange beast,” her 1983 Chevy pickup, stalking the free fish containers around town. That’s where state biologists deposit their test catches after they conduct their daily studies.

We have been here for an hour, but Davidson is exceedingly patient and persistent. It’s a strategy she used as she worked to expand Medicaid in Alaska, as health commissioner. During this year’s legislative session lawmakers blocked Medicaid expansion from coming to a full vote. She says it was a real low point for her. Continue reading

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Q&A: Vermont Gov. Peter Shumlin on attacking the drug epidemic

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VermontBy Elaine S. Povich
Stateline

In January 2014, Vermont Gov. Peter Shumlin devoted his entire State of the State address to the opiate drug scourge ravaging his state. While Vermont is not the only state to experience the growing addiction problem, it arguably has been the most aggressive in tackling one aspect of it — offering treatment to residents who agree to participate.

Gov. Shumlin

Gov. Shumlin

Within six months of his speech, Shumlin, a Democrat, signed bills and executive orders that included $6.7 million for a “hub and spoke” treatment program of central facilities and small treatment outposts, a medication-assisted addiction therapy program, tougher sentences for drug traffickers and new regulations for prescribing and monitoring prescription drugs. One of biggest changes is giving people who are picked up by police the choice of treatment instead of criminal prosecution.

In January 2015, the state reported that medically assisted drug treatment had increased by 40 percent. Of those who completed treatment plans, 75 percent showed improved functioning. But the report also said more treatment opportunities are needed, citing the difficulty in hiring and retaining clinicians and other health care providers as a major obstacle.

A year and a half after his groundbreaking speech, Stateline checked in with Shumlin to talk about his progress and what remains to be done. Continue reading

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Private money saves successful Colorado IUD program

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By Katie Kerwin McCrimmon, Health News Colorado

A Colorado birth control program that has cut unintended pregnancies and abortions by nearly half since 2009 will stay alive for at least one more year thanks to $2 million in donations from private foundations.

Women and health advocates held a rally at the Capitol to urge approval of a program that provides IUDs and long-acting birth control devices to young women (Photo by Katie Kerwin McCrimmon/Health News Colorado).

Women and health advocates held a rally at the Capitol to urge approval of a program that provides IUDs and long-acting birth control devices to young women (Photo by Katie Kerwin McCrimmon/Health News Colorado).

The rescue of the highly-touted program comes after Republican lawmakers earlier this year killed a bill that would have provided $5 million in public funding for IUDs and other long-acting reversible contraceptives for low-income teens and young women.

Colorado health officials estimate that the IUDs and other devices have saved at least $79 million in Medicaid costs for unintended births, but some opponents claimed that IUDs are abortifacients and refused to approve funding in the Republican-controlled Senate.

From mid-2009 to mid-2015, the Susan Thompson Buffett Foundation funded a pilot effort in Colorado with a $25 million grant. The Colorado Family Planning Initiative provided teens and young women with more than 36,000 free or low-cost IUDs or other long-acting birth control devices.

The newest data from the Colorado Department of Public Health and Environment show a 48 percent drop statewide in unintended pregnancies and abortions. Births among teens ages 15 to 19 fell from 6,201 in 2009 to 3,361 in 2014, while abortions declined from 1,711 to 939 in the same period.

The 48 percent reduction is up from a 40 percent drop through 2013. Continue reading

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Few health savings accounts owners invest, study

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HSA piggy bank 300By Michelle Andrews
KHN

Only a tiny fraction of the growing number of people with health savings accounts invests the money in their accounts in the financial markets, according to a recent study.

The vast majority leave their contributions in savings accounts instead where the money may earn lower returns.

People who have had their health savings accounts for a longer period of time are more likely to invest their contributions, suggesting that there’s a learning curve in grasping how the accounts work and how to use them, says Paul Fronstin, director of the Health Research and Education Program at the Employee Benefit Research Institute and the study’s author.

Forty-seven percent of HSAs with investments were opened between 2005 and 2008; in 2014, just 5 percent of HSAs that were opened had investments. Continue reading

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State health exchange will offer more plans for 2016

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From the Washington Healthplanfinder

Washington Healthplanfinder to Offer Residents More Health Plan Options This Fall

Coverage is hereThe Washington Health Benefit Exchange Board today provided final certification of Qualified Health Plans to be offered through Washington Healthplanfinder during the third open enrollment period.

The open enrollment period, which runs from Nov. 1, 2015, to Jan. 31, 2016, provides coverage starting Jan. 1, 2016.

Exchange Board Certifies More than 180 Health Plans to be offered Starting Nov. 1

Following approval by the Office of the Insurance Commissioner yesterday, the Board certified 12 health insurance carriers at the monthly Board meeting to offer 136 Qualified Health Plans for individuals and families.

Additionally, six insurance carriers will offer eight pediatric Qualified Dental Plans. Last year, 10 health insurers were approved to sell 82 plans for individuals and families.

Every county in Washington State will again see an increased number of health plan options this fall. In the first open enrollment period, only two counties had more than six carriers offering coverage. This year, 14 counties will have more than six carriers offering coverage.

Approved insurance companies that are new to the market include Dentegra, Health Alliance Northwest, Regence BlueShield and UnitedHealthcare of Washington. Health plans still under review by the Office of the Insurance Commissioner include Coordinated Care. If Coordinated Care is approved, the Board may provide final certification at a later date.

Approval from the Office of the Insurance Commissioner and Board certification for these plans is required under the Affordable Care Act to ensure that each plan meets the requirements for Qualified Health Plans and the 10 essential health benefits, including regular doctor’s visits, maternity care and hospital stays.

 

The following insurance carriers were approved to sell health and pediatric dental plans through Washington Healthplanfinder:

  • BridgeSpan Health Company
  • Columbia United Providers
  • Community Health Plan of Washington
  • Delta Dental of Washington – pediatric dental only
  • Dental Health Services – pediatric dental only
  • Dentegra – pediatric dental only
  • Group Health Cooperative
  • Health Alliance Northwest
  • Kaiser Permanente – health and pediatric dental plans
  • LifeWise – health and pediatric dental plans
  • Moda Health
  • Molina Healthcare of Washington
  • Premera Blue Cross – health and pediatric dental plans
  • Regence BlueShield
  • UnitedHealthcare of Washington

Washington Healthplanfinder Business, the state’s business marketplace, will expand its statewide coverage this year with two insurance carriers, Moda Health and UnitedHealthCare, and 47 plans available. Kaiser Permanente will continue to offer health plans to small businesses in Clark and Cowlitz counties.

Starting this November under the Affordable Care Act, Washington Healthplanfinder Business will expand its coverage from businesses of up to 50 employees to larger businesses of up to 100 employees. Washington Healthplanfinder Business allows businesses to compare plans, decide their contribution level and manage payment in one place. Eligible small business owners may also access tax credits when they enroll through Washington Healthplanfinder Business.

Five additional multi-state plans must be certified by the U.S. Office of Personnel Management (OPM) before they can be offered through Washington Healthplanfinder. Multi-state plans are provided by OPM and private insurance carriers to drive additional competition in health insurance marketplaces across the country.

More information about the health plans that will be offered on Washington Healthplanfinder is available by clicking here.

For more information about Washington Healthplanfinder, please visit www.wahealthplanfinder.org.

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Activists sought private abortion details using Washington state public records laws

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ProPublica LogoBy Charles Ornstein ProPublica
This story was co-published with the Washington Post.

A few years back, Jonathan Bloedow filed a series of requests under Washington state’s Public Records Act asking for details on pregnancies terminated at abortion clinics around the state.

For every abortion, he wanted information on the woman’s age and race, where she lived, how long she had been pregnant and how past pregnancies had ended. He also wanted to know about any complications, but he didn’t ask for names.

This is all information that Washington’s health department, as those in other states, collects to track vital statistics.

What has been your experience with patient privacy? Do you think your medical information was shared by your doctor or health-care provider? Do you think it was involved in a breach? Tell us your story.

Bloedow, 43, isn’t a public health researcher, a traditional journalist or a clinic owner. He’s an anti-abortion activist who had previously sued Planned Parenthood, accusing the group of overcharging the government for contraception. Continue reading

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States look for more effective ways to encourage vaccinations

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Boy gets shot vaccine injectionBy Michelle Andrews
KHN

When kids start school this fall, it’s a sure bet that some won’t have had their recommended vaccines because their parents have claimed exemptions from school requirements for medical, religious or philosophical reasons.

Following the much publicized outbreak of measles that started in Disneyland in California in December, these exemptions have drawn increased scrutiny.

That outbreak, which eventually infected 147 people in seven states, was a wake-up call for many parents, who may not have realized how contagious or serious the disease can be, and for states as well, say public health officials.

“States are beginning to realize that they have effective measures to combat these outbreaks, and philosophical exemptions are eroding these protections and resulting in significant costs to states,” says Dr. Carrie Byington, professor of pediatrics at the University of Utah and chairwoman of the American Academy of Pediatrics Committee on Infectious Diseases. Continue reading

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Are you missing out on co-pay, deductible assistance?

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Study: 2 Million Exchange Enrollees Miss Out On Cost-Sharing Assistance

By Michelle Andrews
KHN

Twenty-dollar bill in a pill bottleMore than 2 million people with coverage on the health insurance exchanges may be missing out on subsidies that could lower their deductibles, copayments and maximum out-of-pocket spending limits, according to a new analysis by Avalere Health.

Those who may be missing out are people with incomes between 100 and 250 percent of the federal poverty level ($11,770 to $29,425).

Under the health law, people at those income levels are eligible for cost-sharing reductions that can substantially reduce their out-of-pocket costs. But there’s a catch: the reductions are only available to people who buy a silver-level plan. Continue reading

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Providence and Walgreens to open new retail clinics

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29897_Logo3_310x137Walgreens and Providence Health & Services increase the number of their retail clinics Oregon and Washington to 25.

“Providence and Swedish Express Care at Walgreens will offer a fast, easy and affordable option for treating common illnesses and injuries.

The clinics will operate extended hours seven days a week, allow for walk-ins and same-day scheduling and provide an after-hours option for care on evenings and weekends,” Providence said in a statement.

The clinics will be owned and operated by Providence and its affiliates, and become the first to open at Walgreens stores under a new collaborative services model.

Providence Express Care at Walgreens, or Swedish Express Care at Walgreens in the Seattle area, will open three clinics in both the Portland and Seattle areas in early 2016, with plans for further expansion within the next two years.

In the first six clinics, Swedish providers will staff Issaquah, Kirkland and Renton, Wash. locations and Providence providers will staff Beaverton and Milwaukie, OR. and Vancouver, WA locations.

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Americans favor government action on drug prices – poll

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KHN

Most Americans value the prescription products the drug industry produces, but they sure don’t like the prices and want the federal government to take action, according to a new survey.

Kaiser Health Tracking Poll: August 2015

Just over half of Americans (54 percent) are currently taking a prescription drug. While most say their drugs are easy to afford, consumers in general (72 percent) believe drug costs are unreasonable, according to the poll by the Kaiser Family Foundation. (Kaiser Health News is an editorially independent part of the foundation.)

More people (51 percent) think competition would do a better job of controlling prices than federal regulation (40 percent).

But large majorities said they would favor allowing Medicare to negotiate with companies on prices and allowing people to buy medicines imported from Canada. Continue reading

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Washington exchange customers must pay premiums to insurers directly beginning September 24th

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WA_Healthplanfinder_RGB

 Healthplanfinder Announces Premium Payment Change for Customers

Health, dental plan customers must pay insurance companies beginning Sept.

Washington Healthplanfinder today announced that current Qualified Health Plan and Qualified Dental Plan customers must pay their monthly premium payment directly to their insurance company beginning Sept. 24.

Washington Healthplanfinder will no longer accept premium payments after Sept. 23. Continue reading

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The hospital is in network, but not the doctor – New York tries a fix

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The Hospital Is In Network, But Not The Doctor: N.Y. Tries New Balance Billing Law

By Elana Gordon, WHYY

He thought it was pneumonia. Michael Trost, 52 and seemingly healthy, just wasn’t feeling right. During a chance break at work as a wood finisher, Trost’s wife brought him to an emergency room near where they live at the edge of the Poconos in Dingmans Ferry, Pa.

“They’ll give me a chest x-ray and antibiotics and I’ll be on my way,” Trost thought.

Michael Trost of Dingmans Ferry, Pa. (seen here with his wife, Susan Rosalsky) was billed $32,325 for a surgery with an out-of-network doctor in an in-network hospital. (Elana Gordon/WHYY)

Michael Trost of Dingmans Ferry, Pa. (seen here with his wife, Susan Rosalsky) was billed $32,325 for a surgery with an out-of-network doctor in an in-network hospital. (Elana Gordon/WHYY)

Trost left in April with much more than that: six weeks at home, recovering from open-heart surgery.

Even though they made a point of going to hospitals covered by their insurance, the doctor who performed the surgery was out-of-network.

Doctors had learned that Trost’s heart was “pumping really hard, and it’s not working,” he recalls, so they transferred him to a bigger hospital for a mitral valve repair. He was discharged a few days later.

But a few weeks after the unanticipated surgery, the bills started rolling in, including one for $32,325.

Turns out, even though the two had made a point of going to hospitals that were covered by their insurance, the doctor who performed the heart surgery was out-of-network. Continue reading

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