Policy Updates

Idaho’s 2018 State of the State Address – Healthcare Recap

Governor C.L. “Butch” Otter gave his final State of the State and Budget Address on Monday, January 8, 2018. Below is a recap of the healthcare portion of his address which focused in large part on affordability and accessibility:

The governor opened his healthcare remarks by declaring that Idaho’s healthcare sector has led the state’s employment growth during his 12 years in office, adding more than 26,300 jobs since 2007. Healthcare accounted for 46 percent of the state’s overall job growth and 13 percent of total employment. He said that this raises two public policy debates for the coming decades: how do we make healthcare more accessible and affordable, and how do we ensure employers have enough skilled workers to meet Idaho’s needs, especially in healthcare and other STEM (Science, Technology, Engineering, Mathematics) fields.

The governor also talked about the need for predictability in planning. But, he said, “When it comes to healthcare, the federal government seems to be going the extra mile to ensure that Idaho and other states have no certainty at all about what the future holds.” After many proposals for making healthcare in Idaho more accessible and coverage more affordable, the governor said he was making one last try.

The Idaho Health Care Plan

The governor will be putting forth for the legislature’s consideration, the Idaho Health Care Plan – a proposal that he said, “Would stabilize Idaho’s healthcare insurance market and give more working Idaho families the ability to purchase affordable coverage.” The plan enables people with the more costly and complex medical conditions to move their coverage to Medicaid. This will allow insurance companies to reduce premium rates for most people who remain in the individual marketplace. The governor was quick to point out that this plan is not an expansion of Medicaid. Rather, it’s a way to provide Idaho’s working families who have modest incomes a more affordable way to get the coverage they need. The plan calls for $17.4 million from the General Fund and another $11.4 million from the Millennium Fund.

Seeing affordability and accessibility as among the central public policy challenges of our time, the governor also addressed Idaho’s last-in-the-nation ranking in the number of primary care physicians per capita, especially in the rural parts of our state. He addressed the opening of Idaho’s first medical school – the Idaho College of Osteopathic Medicine (ICOM). The school, which is working with Idaho State University and other stakeholders, is committed to bringing more physician-residency opportunities to Idaho. His budget also contains a request for funding for 11 new residencies at Eastern Idaho Regional Medical Center in Idaho Falls and Bingham Memorial Hospital in Blackfoot. This is in addition to efforts since 2013 to fund medical school seats for Idaho students through the regional WWAMI program where there are currently 40 seats dedicated to Idaho students – twice as many as when the governor took office.

Behavioral Health

The governor thanked the legislature for their support of the creation of behavioral health crisis centers in Coeur d’Alene, Idaho Falls, Twin Falls, and Boise. His budget asks for $2.6 million to create additional crisis centers in Lewiston, Nampa-Caldwell, and Pocatello that will help alleviate the costly use of emergency rooms and jail cells to address behavioral health challenges.

The governor concluded the healthcare portion of his address by affirming that having healthcare professionals in a community is “one of the factors that can determine a community’s success in developing its local economy by attracting and growing businesses that provide good-paying jobs.”

A complete transcript of the governor’s 2018 State of the State and Budget Address can be found here.

A New Take on Payment Reform – Idaho Medicaid’s Regional Care Organizations

Idaho’s Division of Medicaid has been hard at work on a plan for payment reform for Idaho Medicaid. The plan involves bringing together primary care providers, hospitals, specialists, and other providers to improve care for patients. The new endeavor builds on Medicaid’s existing Healthy Connections program, supports national reform efforts, and builds on Idaho’s successful medical home program. The new plan is called “Healthy Connections Value Care.” An initial rollout of the plan is scheduled for the summer of 2018 in the Treasure Valley.

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The Opioid Crisis: Hitting Home in Idaho – Part 2


Idaho’s Response to an Opioid Epidemic

[Last week’s post talked about the growth of opioid abuse in the United States and in Idaho specifically. This article looks at what Idaho is doing to fight its opioid epidemic.]

Many people believe that what’s needed to help put a stop to the problem of opioid addiction and its parallel problem of illicit heroin use in Idaho and elsewhere is a determined effort by physicians to restrict opioid prescribing. They feel that addressing the problem with practitioners is the starting point to a multi-pronged approach.

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The Opioid Crisis: Hitting Home in Idaho – Part 1

Fifteen years ago, the leading cause of accidental death in the United States for those under 40 was accidental trauma. Today the leading cause of death for that same population is drug overdose. According to the Centers for Disease Control and Prevention (CDC), in 2014, deaths from drug overdoses were higher than ever recorded – and six out of 10 involved an opioid. That meant 78 opioid overdose deaths every single day in the U.S. (28,470). By 2015, that total number had grown to more than 33,000 opioid overdose-related deaths.

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The Better Care Playbook…For Treating High-Need Populations

Researchers estimate that people with complex needs, generally high-need, high-cost patients, account for five percent of the population, but 50 percent of health care spending. That’s why five health care foundations* got together in support of the Institute for Healthcare Improvement to create The Playbook. It’s a compilation of information and resources on developing better care for patients with complex health and social needs. The Playbook addresses the needs of these patients who often encounter a healthcare system they find to be expensive, inefficient, and poorly coordinated. The Playbook outlines a strategy for achieving better patient outcomes and lowering overall costs of care.

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Can a Bipartisan Effort be the Answer to Healthcare Legislation?

When the Senate failed last week, by a single vote, to pass a “skinny repeal” of the Affordable Care Act (ACA), some people thought efforts to transform healthcare legislation were finally done. Think again!

Now a whole new kind of effort is taking shape. There’s word of a bipartisan group that has been meeting for months in anticipation of the repeal effort failing. The roughly 40-member group, made up of nearly equal numbers of Democrats and Republicans is called the Problem Solvers Caucus. It’s led by Congressman Josh Gottheimer (D-NJ) and Congressman Tom Reed (R-NY). Gottheimer said the group “knows how to find common ground to move the ball forward on the issues that matter to the American people.” That includes healthcare legislation.

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The New 2017 NCQA Standards

Based on feedback from practices, policy makers, payers, and other key stakeholders, the National Committee for Quality Assurance (NCQA) has revised its PCMH Recognition program to make it more manageable, reduce paperwork, and increase practice interaction with NCQA. It also supports ongoing, sustained recognition status with annual check-in instead of the current program’s three-year recognition cycle.

The new recognition process was released to the public on April 3rd, 2017 and has three parts:

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Five Ways for Healthcare Providers to Get Ready for New Medicare Cards

Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft, and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.

CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems we use now. We’ll start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.

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