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May 23, 2016

Maine isn't the only state with new health care laws

Amid all the changes in health care, it might be useful to take a brief look at laws and initiatives underway in other states around the country.

  • The Vermont Legislature this year enacted a bill requiring all businesses to provide paid sick leave. Up to now, about half of all private sector employers have been providing some form of paid leave to their employees, leaving more than 60,000 Vermonters without paid leave. “An act relating to absence from work for health care and safety” allows employees to use sick time for themselves or to care for a child, parent, grandparent, spouse, sibling or parent-in-law.

The state's Green Mountain Care Board also continues to review hospital budgets, health insurance rates, and other matters toward its mission to contain health care costs and promote and supervise collaboration between organizations testing new ways to pay for and deliver health care.

  • Connecticut's Department of Health and Human Services has $157 million in new funding to promote community health. A five-year program, the Accountable Health Communities Model, is a Centers for Medicare & Medicaid Services Innovation Center initiative that will deploy screening assessments for health-related social needs among Medicare and Medicaid beneficiaries accessing care at participating clinical delivery sites, including community-based organizations, healthcare provider practices, hospitals and health systems, institutions of higher education, local government entities, tribal organizations and for-profit and not-for-profit organizations.

Business initiatives include the Connecticut Business & Industry Association's recommendations for 2016 to address the problem of government costs pushing healthcare beyond the means of many employers, employees and families. The recommendations include stopping the practice of shifting or hiding healthcare costs in non-related government accounts; opposing new healthcare mandates, taxes and fees that can't show a comparative return on investment; reducing cost-shifting to the private sector by making sure doctors and hospitals are appropriately reimbursed by Medicaid; and supporting healthcare initiatives that promote quality and reduce cost.

  • MassHealth continues to evaluate its program, and recently produced a restructuring summary for 2016. With 1.8 million members, MassHealth has grown unsustainably and is now almost 40% of the state's budget of over $15 billion, according to its report. The fee-for-service payment model for providers results in fragmented care. Restructuring could involve bringing in significant levels of federal investment to support delivery system reforms, state-legislated alternative payment methodologies for promotion of more coordinated and efficient care, and transitioning from fee-for-service care into integrated, accountable care models, where provider-led organizations are accountable for the cost and quality of care.
  • In Wisconsin, the Security Health Plan's Community Benefits program, which focuses on improving the health of children, older adults and those with behavioral health problems, reached more than 40,000 individuals in 2015, according to a recent report. Last year, the program partnered with 86 organizations to produce local events, including“Let's Talk About Medicine” workshops. Programs educate people about things like how to read a drug label.
  • California's Right Care Initiative continues to apply scientific evidence and outcomes improvement strategies to reduce patient morbidity and mortality, through a collaborative focus, related to cardiovascular disease and diabetes. Studies show about 81,000 Californians die yearly from these diseases. According to the Centers for Disease Control, many of those deaths are preventable. Current activities include the Right Care University of Best Practices, in three metropolitan areas, that share learning and encourage adoption of evidence-based interventions, along with presentations geared toward medical, pharmacy and quality improvement directors, coupled with Continuing Medical Education in Sacramento and Los Angeles.

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