News from the States
- Governor Ricketts announces Sheri Dawson as Director for Nebraska’s Division of Behavioral Health
- Illinois Consortium on Drug Policy publishes study on State’s heroin crisis
Around the Agencies
- AHRQ releases brief on newborn and maternal hospitalizations related to substance abuse
- GAO report recommends that additional State reporting may help CMS oversee prescription drug fraud
- NIH report finds that most American adults have experienced some level of pain
- NIH-funded study shows possible link between e-cigarettes and initiation of tobacco use
- CDC report finds 7 million fewer uninsured this year than in 2014
- CMS releases 2015 Health Insurance Marketplace Special Enrollment Period Report
- AHRQ releases Medical Expenditure Panel Survey Insurance Component Chartbook
- CMS report shows cost savings among Accountable Care Organizations
- CBO report finds that eliminating sequestration could result in 1.4 million more jobs
In the News
- States collected $32 billion from “sin taxes” in fiscal year 2014
- Largest insurers in the Health Insurance Marketplace raised premiums an average 75% more than smaller insurers in past year
News from the States
Governor Ricketts announces Sheri Dawson as Director for Nebraska’s Division of Behavioral Health
Governor Pete Ricketts announced the appointment of Sheri Dawson, R.N. as Director for the Division of Behavioral Health for the Nebraska Department of Health and Human Services (DHHS). Ms. Dawson has served as the acting director of the Division of Behavioral Health since earlier this year. Prior to serving as acting director, she held different roles within the department including Deputy Director of Community-Based Services, QI and Managed Care Administrator, Program Specialist, and Nurse Surveyor/Consultant. Additionally, Ms. Dawson served as Associate Director of Nursing for the Nebraska Department of Public Institutions.
Illinois Consortium on Drug Policy publishes study on heroin crisis
The Illinois Consortium on Drug Policy at Roosevelt University released a report on the State’s continuing heroin problem. The study found that 25 percent of State-funded treatment admissions were for heroin, significantly higher than the 16 percent of heroin admissions for the nation. The report suggests improving treatment for prescription opioid drugs, increasing access to naloxone, implementing medication-assisted treatment programs in jails and prisons, and ensuring that drug courts follow evidence-based practices.
Around the Agencies
AHRQ releases brief on newborn and maternal hospitalizations related to substance abuse
The Agency for Healthcare Research and Quality released a brief on Neonatal and Maternal Hospital Stays Related to Substance Use. From 2006 to 2012, the rate of neonatal hospitalizations related to substance use increased by 71 percent, and the rate of maternal hospitalizations related to substance use increased by 33 percent. The costs for neonatal hospitalizations rose by 135 percent, from $253 to $595 million, from 2006 to 2012. For maternal hospitalizations, costs rose by 35 percent, from $258 to $349 million. The rate of maternal hospital stays for opioid use rose by 134.7 percent. Of the newborns hospitalized because of substance use-related issues, 20 percent had low birth weight, compared with 7 percent of all other neonatal stays. There was a rise in hospital stays for neonatal abstinence syndrome, from 7,240 in 2006 to 18,968 in 2012.
GAO report recommends that additional State reporting may help CMS oversee prescription drug fraud
A new Government Accountability Office (GAO) report has recommended that the Centers for Medicare & Medicaid Services (CMS) require States to report on two controls that are not currently included in CMS’s reporting requirements: lock-in programs for abusers of non-controlled substances, and prohibitions on automatic refills.
Currently, lock-in programs address doctor shopping by restricting beneficiaries who have abused the Medicaid program to only receiving controlled substance prescriptions from a single provider and pharmacy. A lock-in program for those with non-controlled substance prescriptions could also help address potential fraud and abuse. However, CMS does not currently collect information about lock-in programs for non-controlled substances. Similarly, CMS does not collect data on automatic refill prohibitions, even though such data could reduce the potential for medication stockpiling, continued fill of discontinued medications, and waste of prescription medications. According to the report, requiring States to report on these controls could help CMS oversee prescription drug fraud, and CMS has stated that it will consider the GAO’s recommendations.
NIH report finds that most American adults have experienced some level of pain
The National Center for Complementary and Integrative Health, a branch of the National Institutes of Health, recently analyzed data from the 2012 National Health Interview Survey (NHIS) and found that most American adults have experienced some level of pain. The severity of pain varied among survey respondents, with an estimated 25.3 million adults (11.2 percent) experiencing some level of pain every day for the preceding 3 months. There were associations between pain severity and race, ethnicity, language preference, gender, and age. Those with high levels of pain were more likely to have worse health status, use healthcare services, and suffer from disability.
NIH-funded study shows possible link between e-cigarettes and initiation of tobacco use
A study on electronic cigarette use and subsequent tobacco use by adolescents, published in the Journal of the American Medical Association, found that students who have used e-cigarettes by the time they start ninth grade are more likely than others to start smoking traditional cigarettes and other combustible tobacco products within the next year. E-cigarettes could increase tobacco initiation rates among youth who would not have otherwise smoked cigarettes; youth who try e-cigarettes and subsequently become addicted to nicotine might transition to conventional cigarettes. While the study authors cannot conclude that e-cigarette use directly leads to smoking, this study raises concerns that increases in youth e-cigarette use could increase the prevalence of smoking-related illness.
CDC report finds 7 million fewer uninsured this year than in 2014
According to a report by the CDC’s National Center for Health Statistics, an estimated 29 million U.S. residents of all ages lacked health insurance in the first three months of 2015, which is 7 million fewer than in 2014. The uninsured rate for adults under age 65 fell by 7.8 percent in Medicaid expansion States, compared with 5.9 percent in non-expansion States. Among adults aged 18–64, the percentage of uninsured individuals decreased from 16.3 percent in 2014 to 13.0 percent in 2015, with a corresponding increase in private coverage, from 67.3 percent to 70.4 percent. The report analyzes insurance trends by age, poverty status, and race and ethnicity. It also presents estimates of public and private coverage, coverage through exchanges, and enrollment in high deductible health plans (HDHPs) and consumer directed health plans (CDHPs).
CMS releases 2015 Health Insurance Marketplace Special Enrollment Period Report
Although the next open enrollment period for Health Insurance Marketplace coverage doesn’t begin until November 1st, some individuals qualify for a special early enrollment period. A consumer can qualify for a special enrollment period (SEP) if they have lost health coverage, lost Medicaid eligibility, or had a change in family status.
CMS released a snapshot of information about consumers who selected a plan from the February 23 to June 30, 2015 SEP through the HealthCare.gov platform. Nearly 950,000 new consumers selected a plan through the SEP. Of enrollments during the SEP, 50 percent of plan selections occurred because of health coverage loss, and 19 percent occurred because of Medicaid ineligibility.
AHRQ releases Medical Expenditure Panel Survey Insurance Component Chartbook
The Agency for Healthcare Research and Quality (AHRQ) released its 2014 Medical Expenditure Panel Survey Insurance Component (MEPS-IC). The MEPS-IC is an annual survey of private employers and State and local governments. The MEPS-IC produces national- and State-level estimates of employer-sponsored insurance, including offered plans, costs, employee eligibility, and number of enrollees. The Chartbook, which looks at changes in employer-sponsored insurance before and after ACA implementation, provides both single- and multi-year trend analyses using data from 2003 to 2014.
CMS report shows cost savings among Accountable Care Organizations
The Centers for Medicare & Medicaid Services Medicare released quality and financial performance results showing that Accountable Care Organizations (ACOs) are improving the quality of care that Medicare beneficiaries receive while saving money. ACOs created cost savings amounting $422 million in 2014. Compared to Medicare Shared Shavings Program (MSSP) ACOs, Pioneer ACOs are early adopters of coordinated care and tend to be more experienced. Pioneer ACOs also have an established care coordination infrastructure, and assume greater performance-based financial risk. In 2014 there were 20 Pioneer ACOs and 333 MSSP ACOs. Eleven Pioneer ACOs earned $82 million in shared savings, and 92 MSSP ACOs earned $341 million in shared savings. ACOs with three years of experience in the program were more likely to earn savings than those with only one or two years of experience.
CBO report finds that eliminating sequestration could result in 1.4 million more jobs
In response to a request from Senator Bernie Sanders (VT), the Congressional Budget Office (CBO) released a report on the macroeconomic effects of eliminating automatic reductions to discretionary spending caps. The Budget Control Act of 2011 created caps on discretionary budget authority for each year through 2021, with automatic reductions in those caps that would be triggered under certain conditions. According to the CBO, eliminating the automatic reductions for fiscal years 2016 and 2017 would allow for an increase in appropriations of $90 billion in 2016 and $91 billion in 2017. The changes in spending could increase full-time employment by 0.2 million to 0.8 million in 2016, and 0.1 million to 0.6 million in 2017; 1.4 million jobs could be created over two years without automatic reductions in budget caps.
In the News
States collected $32 billion from “sin taxes” in fiscal year 2014
According to a recent article in Governing Magazine, States collectively took in approximately $32 billion in “sin taxes”—taxes on tobacco, alcohol, and gambling—in fiscal year 2014. The most common sin tax-related practice among State legislatures is passing cigarette tax hikes. Since 2000, States enacted a total of 111 tax increases on tobacco products, and another 23 on alcohol. States rely on sin taxes to varying degrees. Delaware, New Hampshire, Nevada, Rhode Island, and West Virginia accounted for the largest share of total sin tax revenues in 2014.
Largest insurers in the Health Insurance Marketplace raised premiums an average of 75% more than smaller insurers in past year
A new study in the Harvard Journal of Technology Science looks at changes in health insurance premiums made by individual health insurance issuers in 34 federally facilitated and State partnership health insurance exchanges. The study found that the largest insurance issuers in the Health Insurance Marketplace raised premium rates by an average 23.9 percent while the other issuers raised rates by an average 13.7 percent. One suggested reason for this discrepancy is that larger and more broadly recognized issuers are more appealing to older enrollees who have a larger burden of health problems, while younger and healthier individuals may be more receptive to smaller and newer issuers.
Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.