Federal Studies and Reports

• According to a recent Kaiser Family Foundation (KFF) poll approximately 3 in 10 Americans still believe ivermectin is effective for treating COVID-19, with many Americans having low trust in news media and official institutions for accurately providing health information. Though misinformed beliefs are strongly held by only a limited number of people, the prevalence of misinformation across many health issues is alarming. Thirty percent of respondents felt that parents should not be required to vaccinate their children against measles, mumps, and rubella. Additionally, more than a third of respondents thought that using birth control such as intrauterine devices makes it more difficult to conceive once the device is removed. Trust in official health institutions like the CDC and FDA was modest from survey respondents. Though participants used social media frequently for health information, it ranked low for credibility for such information. Similarly, trust in news media was low, though local TV news received slightly higher trust rankings. An individual’s own doctor was the most trusted source of health information across the board (KFF Health News, August 22).
• Researchers analyzed a large database of U.S. veterans’ health records to quantify the long-term health impact of COVID-19. They found COVID-19 significantly increased the risk of various conditions, estimating the public health impact to be over 50% greater than cancer or heart disease. Data from about 140,000 COVID-19 infected individuals in 2020 and 6 million uninfected individuals for that same year were analyzed for the study. In the three months post-infection, patients had higher rates of death and adverse health conditions such as heart failure, diabetes, Alzheimer’s disease, and depression. These risks declined over time but remained significant for about a third of the health problems studied over the course of two years. However, the sample population was primarily older and male, potentially limiting the applicability of the results to other populations. Despite this, researchers agree about the importance of studying COVID-19’s long-term effects for future treatments and disability claims (Science, August 21).

Featured Content

Hospital Nurse-to-Patient Ratios

• Oregon joins California, Massachusetts, and New York to become the fourth state in the country to implement nurse-to-patient ratios in hospitals, aiming to improve patient care and nursing conditions. Hospitals in Oregon must comply with the certified nursing assistant ratios by September 1, and over time adhere to other nurse staffing standards that vary by unit type and patient acuity. Hospitals that repeatedly violate staffing rules could face fines up to $5,000 per offense, enforced by the Oregon Health Authority starting in June 2025. However, Oregon Health & Science University Hospital expressed reservations with the law, suggesting broader solutions for issues with understaffing must be considered, such as increased wages, loan forgiveness and educational scholarships. This is similar nationwide, with staffing ratios facing opposition from other organizations and health systems that cite financial strain and an over-dependence on temporary staff if enforced. Lawmakers in other states are also looking to pass similar measures and several states have policies requiring nurse-led staffing committees at hospitals (Modern Healthcare, August 17).

• According to recent data from the KFF’s tracker, New York state is reporting a 72% Medicaid and CHIP renewal rate throughout the redetermination process in comparison to the 59% national rate. The New York rate is the percentage of people who were due to re-apply for Medicaid coverage by June 30. New York has disenrolled 59,000 people, which is a much lower number when compared to other large states in the country. Of those individuals, 47% were determined ineligible (as opposed to being disenrolled for procedural reasons such as failing to provide paperwork). Overall, disenrollment estimates are in constant flux and the renewal percentages are likely to continue to change (Health Payer Specialist, August 14).
• The devastating wildfires in Lahaina, Maui wreaked havoc on the healthcare system last week with AlohaCare, Kaiser Permanente, and UnitedHealth Group providing aid to individuals affected by the disaster. The U.S. Department of Health and Human Services has declared the state of Hawaii a public health emergency as the fires took the lives of over 106 people, destroyed homes, healthcare facilities, and businesses. The state’s Medicaid officials have asked CMS to allow Hawaii to suspend the Medicaid redetermination process and keep all state Medicaid enrollees covered for the time being. CMS has not yet responded to this request (Health Payer Specialist, August 16).
• Nearly five months after North Carolina Governor Roy Cooper passed legislation allowing the state to expand Medicaid, there is uncertainty around whether the program will be expanded at all. The expansion cannot happen until a state budget is passed, and provided Medicaid expansion is not “decoupled” from the state budget, as Governor Cooper requested. Lawmakers are slowing the implementation of the budget bill and if decoupling doesn’t materialize, the state stands to lose up to $60 million in federal funds and its $1.6 billion “bonus” for expansion implementation. For expansion to take place by October 1, the state’s legislature will need to approve it by September 1. Delays could push implementation back as far as 2024 (Fierce Healthcare, August 22).
• The State of Florida has accused five Medicaid managed care plans of violating bans on providing gender-affirming care to minors. The Florida Agency for Health Care Administration (FAHCA), which houses the state’s Medicaid agency, is seeking compensation from the plans for the alleged violations. The plans include Amerigroup’s Simply Healthcare Plan, which is a subsidiary of Elevance Health, Centene’s Sunshine State Health Plan and its Children’s Medical Services Health Plan, Humana, and Molina. Florida banned its Medicaid program from covering gender-affirming procedures in August 2022. Documents reveal the plans authorized prescriptions for medications to address gender dysphoria and one plan was accused of covering an unspecified surgery on a minor. FAHCA is seeking liquidated damages ranging from $2,500 to $15,000 for the violations, apart from the surgery which had no sum listed. The plans have the right to pursue appeals from FAHCA’s actions and payment demands (Health Payer Specialist, August 21).
• CMS has authorized Virginia to become the 19th state-based exchange and officially transition away from healthcare.gov on November 1, 2023 for the 2024 plan year. However, the exchange administrator, the State Corporation Commission (SCC), has suspended the state’s reinsurance program on the exchange, resulting in individual plan rates increasing by an average of 28.4% for 2024. In an actuarial study of the program, it was found that “many people continued to purchase individual coverage in Virginia without federal advance premium tax credits”, which raises the projected state costs for the program. While this is an exciting milestone for the state, the CMS Center for Consumer Information and Oversight (CCIIO) reminded the state that its designation as a state-based exchange is reliant on the completion of the data transfer, which the state successfully accomplished last Thursday (Inside Health Policy, August 17).
• In Oklahoma, Blue Cross Blue Shield is providing support to residents seeking reenrollment in the state’s Medicaid program, SoonerCare. In addition to providing experts at one of its offices in Tulsa and planning other events to assist individuals in Oklahoma City and Lawton, the payer also announced that it can help Oklahomans find plans both online and through a toll-free hotline. At the end of the public health emergency, approximately 300,000 SoonerCare enrollees were notified of their coverage ending because they no longer qualified (Health Payer Specialist, August 16).

News

• CVS Health, parent company of Aetna, has committed $6.6 million in grants through its foundation to enhance maternal health outcomes by supporting three organizations: The March of Dimes, American Heart Association, and the Massachusetts General Hospital. The funding aims to expand the doula workforce, address maternal mortality disparities, and improve prenatal care. Sheryl Burke, CVS Health’s Chief Sustainability Officer, emphasizes that collaboration with local organizations is essential to diversify the doula workforce and provide necessary maternal health services. Aetna and other payers have been working to address maternal care gaps. For example, Aetna Better Health of Maryland partners with maternal digital health provider Mae to reduce mortality rates among Medicaid enrollees, focusing on Black women who experience higher rates of maternal mortality compared to the national average (Health Payer Specialist, August 14).

• GA-STRONG is built upon the premise that a healthy, engaged population is dependent on an abundant and diverse healthcare workforce. The program, created in collaboration with various Georgia health systems and Sellers Dorsey, provides foundational support to Georgia’s teaching hospitals with funds that will allow the institutions to stabilize, develop, and diversify the healthcare workforce. Click here to view the full case study.
• Sellers Dorsey to Moderate HCBS Panel, “Employing APMs to Support Workforce Development.” With provider shortages, inadequate payment structures, and limited training and career paths for home healthcare staff, now, more than ever, it’s crucial to create innovative solutions to strengthen the home health workforce. In an engaging panel discussion moderated by Sellers Dorsey Senior Vice President, Gary Jessee, Texas partners will provide insights on their approach to stabilizing the home health workforce by leveraging alternative payment methodologies (APMs). Click here to learn more.
• What’s ahead for state budgets in Fiscal Year 2024? Sellers Dorsey leads you through each state’s enacted budget for the year, their Medicaid spending plans, and program changes. See where states are looking to allocate funds to best address their most mission-critical challenges and align with the needs of their communities. Click here to download.