California's Central Valley is home to about five Kaiser-affiliated hospitals, offering emergency and other medical services 24 hours a day, seven cslifornia a week. West Lancaster, CA Driving directions References Kaiser Permanente: Quick Facts. Written by Max Stirner. Max Stirner is a New York-based writer and editor with over a decade of experience. Richmond, CA 1 0.
Many facets of the program will be examined over the course of the evaluation: Outcomes of care, such as inpatient and outpatient utilization of services will be analyzed using the enrollment, claims, and encounter data for the enrollees of each plan.
Program costs will be evaluated by calculating the PMPM costs for enrollees and conducting cost effectiveness analyses by combining the costs of care with quality and access to care indicators to determine not only potential cost-savings but whether or not the plan provided better value for each dollar spent. Enrollee perceptions of care and satisfaction with their experience in the IHAWP will be evaluated using mailed and online surveys.
Evaluation of the provider network for the IHAWP will be conducted by generating maps to examine geographic variation in provider availability. In addition, provider perceptions of their experience in the IHAWP will be examined using qualitative interviews and focus groups. The report evaluated the work of mental health actors around the state, identifying several areas of achievement in the last two years.
Specifically, the document also highlighted expanding core services for children, and tiered psychiatric care reimbursement rates as areas of positive impact. Behavioral health workforce shortages, red tape between Managed Care Organizations providing health care, and inconsistent treatment costs were among the problems identified.
Regional gaps in mental health care access are another pressing concern. Commission members said fractured provider networks made the problem worse. The biannual report made a six-point list of policy recommendations for legislators, with items including regional flexibility, insurance rules and data infrastructure.
Other points, however, prompted more detailed calls to action. The commission said lawmakers needed to address a workforce shortage in mental health fields for professionals, paraprofessionals and direct support workers. The group recommended incentive programs, both to keep professionals trained in the Hawkeye State, and to attract them from elsewhere.
On another issue, officials said the state needed a more robust system for children with mental health and developmental disabilities. The report said such a system would need to align with Family First legislation, and remain evidence-based. In addition, the Legislature must ensure that the state continues adequate funding for this system. As with most things, the availability and stability of funding were among the most frequently-discussed matters of the MHDS report.
The commission said lawmakers could expect the financial needs of the MHDS system to grow, recommending a 3. Addressing monetary problems would require attention to a variety of issues at once, according to the report.
Another point of contention: carryforward money. The commission said that was insufficient. Comments: Kalen. McCain southeastiowaunion. Kalen McCain News Jan. News Jan. Andy Hallman. AnnaMarie Ward.
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These bills have moved out of subcommittee and into full committees. IHA will provide updates as these bills advance. Legislation Now: Featuring updates on state legislation Bills that moved March 6, Today marks the end of the first funnel, and IHA has been tracking legislation that has survived or failed to pass the first funnel.
Senate File would require hospitals to allow patients to have at least two visitors related to the patient during at least four days in any seven-day period for no less than five hours daily during a public health emergency. The bill also mandates a coordinator to evaluate and maintain the stockpile. Finally, the bill requires the Department of Inspections and Appeals to ensure compliance with these policies by completing an inspection once every two years. This bill did not survive past the first funnel deadline.
IHA will continue to monitor this bill and will provide updates if the issue reemerges. Tort reform : Senate Study Bill was introduced last week by Sen. Brad Zaun. This legislation moved quickly through subcommittee and out of the full committee this week and is now eligible for debate in the Senate. A similar bill, House File , is eligible for debate in the House.
House File also was introduced and passed out of committee. This bill was filed by Rep. Public hospital trustee elections: During the legislative session, a bill contained language that moved up the deadline for public hospital trustee candidates to turn in their candidacy papers to spring.
During the legislative session, IHA successfully advocated a temporary fix that returned the deadline to early fall. This legislation session, Sen. Roby Smith R-Davenport introduced legislation that included a permanent fix. Senate Study Bill moved the deadline for trustee candidates to turn in their candidacy paperwork to at least 69 days before the date of the election. This was another quick-moving bill, being introduced Monday, approved by a subcommittee Wednesday and voted out of a committee Thursday.
This funnel-proof bill is now eligible for debate on the Senate floor. Telehealth: Telehealth has been a popular topic of discussion in the House during the week of first funnel. House File provides for telehealth payment parity for physical health services. This bill is identical to the bill that passed out of the House last legislative session and requires that a patient receive the service inside a health care facility for the provider to receive reimbursement at the same rate as if the service was provided in person.
It excludes audio-only services. HF moved very fast, having been introduced Monday and passed through a subcommittee and committee this week. This legislation is now funnel-proof and is eligible for floor debate in the House. House File would require health insurance carriers to cover health care professionals from out of state as providers serving patients through telehealth. The out-of-state provider must be licensed in Iowa, able to deliver health care services through telehealth per Iowa Code and able to satisfy the same criteria that the carrier uses to qualify in-state professionals who hold the same license.
This week, HF was passed out of a committee, making it funnel-proof, and is now eligible for floor debate. Vaccines: House File requires information to be provided, recorded and reported to health care providers and patients about vaccinations. This bill passed subcommittee and was amended and passed out of the full committee. It is now eligible for floor debate. Senate File provides that an employer cannot discriminate against an employee because of their choice to get vaccinated or not.
It also prevents an employer from requiring an employee get vaccinated as a condition of employment. IHA is registered against this bill. This bill passed out of subcommittee and the full committee with amendment. Days awaiting placement: Senate File formerly SSB would require a study by the Department of Human Services to determine the feasibility of providing Medicaid reimbursement to hospitals for administrative days.
Workforce: House File expands the health care professional recruitment program. It passed out of both committees and is eligible for debate. House File makes significant changes to the admissions policies with the dental and medical schools at the University of Iowa. It was heavily debated in the House. Legislators who supported the bill argued the need to give priority in admissions to students who are residents of Iowa or graduate from an Iowa program.
It passed out of the House with a vote of House File requires the University of Iowa Hospitals and Clinics to offer interviews for available medical residencies to Iowa residents who earned undergraduate degrees from Iowa colleges and universities or attended and earned medical degrees from medical schools in Iowa.
This bill passed out of the House with a vote of This has passed out of both committees and is eligible for debate. A similar bill in the House did not make it past funnel. This bill would update the process for EMS to be deemed an essential service.
This new process would have three distinct differences from what the process currently involves: The ability for county or city EMS districts to levy additional tax funds in a future election if the funds levied in the first vote are insufficient. The petition to begin the process for entire counties would be eliminated. The five-year sunset on the tax levy would be eliminated.
Tort reform: Senate Study Bill was introduced this week by Sen. A similar bill, House File , passed out of the full committee last week and is now eligible for debate in the House.
Telehealth: House File was introduced this week by House Democrats. This bill provides telehealth payment parity for mental health and physical health visits. This bill is similar to the bill put forward last year and is a step further than the bill already passed in the House that only covers telehealth reimbursement for mental health.
Three bills have been introduced and were considered this week, although only one has advanced through committee: Senate File : This bill would require DHS to conduct a study to determine the feasibility of providing Medicaid reimbursement for hospitalized patients who no longer meet medical necessity criteria but an alternative level of care for placement cannot be identified.
This bill has advanced through committee and is now eligible for floor debate. Although this bill is advancing in study form, IHA continues to work to identify a reimbursement rate that can be used in lieu of a study process.
IHA wants to thank Sen. Jeff Edler for bringing this bill forward and Sens. Liz Mathis and Mark Costello for their continued dedication to resolving this issue. Senate Study Bill : This bill has two divisions that would create more rigorous requirements for managed care companies.
The first division concerns claims. It would establish more-stringent timelines to pay or deny claims and a better system for tracking. The second division would require DHS to issue a request for proposal for a single-credentialing verification organization.
This bill passed subcommittee but has yet to pass full committee. The bill must pass through committee next week to survive first funnel. A companion bill has been introduced in the House and has not advanced. House Study Bill : This bill would prohibit managed care companies from seeking repayment of overpayments incurred after 12 months. This bill had broad support from providers but did not pass subcommittee and will not advance.
Senate Study Bill would create more stringent timeframes for them to pay or deny claims and require them to develop a system to better track claims, claim disputes, claim reconsiderations and appeals. The legislation also would require the Department of Human Services to use a request-for-proposal process for services of a single-credentialing verification organization to be use in credentialing and re-credentialing providers for both Medicaid managed care and fee for service.
Further, the managed care organizations would be contractually required to accept verified information from the single-credentialing organization and approve any provider approved and enrolled by the Department of Human Services as an Iowa Medicaid provider. SSB now will be reviewed by a full committee. Emergency medical services: House Study Bill , legislation updating the process for emergency medical services to be deemed an essential service, passed out of the House Ways and Means Committee this week.
This new process would have three distinct differences from what the process currently involves: The ability for county or city emergency medical services districts to request to levy additional funds in a future election if the funds originally levied are insufficient. The bill was reviewed by a House subcommittee and advanced out of the House Human Resources Committee this week.
HF is now eligible for floor debate. A bill allowing residents of medical programs statewide to be covered by the Iowa Tort Claims Act, House File , was approved by a House subcommittee.
HF will now be reviewed by a full House committee. Days awaiting placement : Senate Study Bill was introduced early this week and has already passed through a Senate subcommittee.
This bill would require a study by the Department of Human Services to determine the feasibility of providing Medicaid reimbursement to hospitals for administrative days. Administrative days under the bill means an inpatient stay during which a Medicaid eligible patient no longer meets medical necessity criteria for acute hospital care and is awaiting placement in a nursing facility or other subacute or post-acute care facility.
Workforce: House File , a bill expanding those who qualify to have direct care agreements with patients beyond primary care health professionals, was approved by a House subcommittee and passed by the House Human Resources Committee this week. This legislation is now eligible for debate on the House floor.
Public improvement contracts: Monday, Feb. Senate File is a construction-manager-at-risk bill that provides for alternative bidding methods and prohibits design build projects. The subcommittee approved the bill, and now a full committee will review the bill.
Other bills: House File — Nonmedical switching HF prohibits insurance companies from switching patients to other drugs without their consent. This bill passed out of subcommittee and full committee unanimously. The full House now will review the legislation. A similar bill, Senate File , was set for subcommittee and postponed in the Senate. Senate File — Employee vaccinations SF provides that a hospital cannot discriminate against an employee or health care provider for their refusal to be vaccinated.
It also prevents a hospital from requiring an employee get vaccinated as a condition of employment. A Senate subcommittee reviewed and approved the bill this week. SF will now be reviewed by a full committee. House Study Bill has been moving quickly, having passed through a subcommittee Wednesday morning and scheduled for review by the full Ways and Means Committee Monday afternoon.
HSB is divided into two parts with the first pertaining to county or city districts declaring EMS an essential service and the second pertaining to the entire county declaring EMS an essential service. Further, the bill directs that after city or county EMS district trustees or county boards of supervisors adopt a resolution declaring EMS an essential service, the issue would go up for a vote of the people.
If approved, the district or county would coordinate with local EMS agencies to develop an EMS system advisory council responsible for making recommendations about needed funding and submitting an annual report.
Tax funds would continue to be used to support EMS until an effort to discontinue the practice is approved through another vote of the people. This new process would have three distinct differences from what the process currently involves: The ability for county or city EMS districts to levy additional tax funds in a future election if the funds levied in the initial vote are insufficient.
The petition process to begin the process for entire counties would be eliminated. This bill passed unanimously out of the full committee. House File is legislation expanding the professional recruitment program to students who graduate from an academic program at an eligible institution that leads to licensure in a health care profession. This bill passed out of subcommittee. This passed out of subcommittee and the full committee, and it was renumbered House File House File is legislation requiring interviews be offered to medical residency applicants from Iowa or graduates from an Iowa program.
In , there were , individuals in Iowa enrolled in Medicare, or Aged beneficiaries made up 85 percent of the total number, while 15 percent were disabled. Some individuals, such as low-income seniors, are eligible for both Medicare and Medicaid; these individuals are known as dual-eligible beneficiaries.
For those enrolled in Medicare who are eligible, enrolling in Medicaid may provide some benefits not covered by Medicare, such as stays longer than days at nursing facilities, prescription drugs, eyeglasses, and hearing aids. Medicaid may also be used to help pay for Medicare premiums. Most payments were made toward long-term care. In , the United States Supreme Court ruled that adequate healthcare for prisoners is a constitutional right and that the refusal to provide them with such violates the Eighth Amendment prohibiting cruel and unusual punishment.
As such, state budget allocations for correctional facilities, like other healthcare expenditures, have continued to grow, especially as the prison population ages. This was up from , but down from a peak in as the average daily prison population decreased. States have experienced fiscal pressure to manage prison healthcare costs without compromising prisoners' right to quality care. The manner in which states manage prison health care services that meet these legal requirements affects not only inmates' health, but also the public's health and safety and taxpayers' total corrections bill.
Although total spending and per inmate spending grew by about 17 percent and 18 percent respectively, the daily prison population did not change from to Meanwhile, the percentage of inmates age 55 and over in Iowa grew by 42 percent , the largest growth among neighboring states.
State employee health insurance accounts for the second-largest portion of state healthcare spending, behind only Medicaid.
Premium costs varied widely, with higher premiums found in states such as New Hampshire and Vermont compared to those in states like Arkansas and Mississippi. Part of this variation is due to demographic factors and provider prices, and part may be attributed to differences in health plan "richness," or the cost sharing between the insurer and health plan enrollees, such as deductibles and copayments.
By way of context, these plans would be designated "platinum" plans within the new health insurance marketplaces. Several states are experimenting with various cost-containment methods. The idea is to save on administrative costs for insurers and leverage the larger pool to negotiate lower premium rates. Evidence of cost savings is mixed, with the smaller public employers reaping most of the benefits. Programs for pooling public employee health plans have been implemented in 31 states; as of December , Iowa was not one of them.
The majority of states offer at least one self-funded healthcare plan; the state pays health insurance claims with state and employee out-of-pocket insurance contributions, while an insurer administers the benefits. Iowa was one of only four states that did not self-fund any of its health plans. This was about a 12 percent drop from net expenditures in , the largest decline among neighboring states.
Note: Due to such variations as demographics, plan richness and provider rates, "higher spending is not necessarily an indication of waste, and lower spending is not necessarily a sign of efficiency. In Iowa, average state employee health plan premiums for single and family coverage were lowest among neighboring states.
The state paid on average 97 percent of the premiums, a greater percentage than almost every other state in the nation. For private insurance, consumers typically either receive coverage through their employer or buy it on their own through the individual market. As healthcare costs have increased, so have insurance premiums. Between and , insurance premiums for employer-sponsored plans, including state and local government plans, increased percent for single coverage and percent for family coverage.
However, the rate of increase has slowed in more recent years. Between and , premiums grew by 81 percent for single coverage and 88 percent for family coverage. Between and , the rates of increase were Employers have reacted to these costs in a number of ways, one of which has been to shift more responsibility for premium contributions to their employees.
The portion of premiums paid by employees for single coverage has increased by four percentage points, from 14 percent to 18 percent, since , and by three percentage points, from 26 percent to 29 percent, for family coverage.
These figures were below national averages. In , private sector employers in Iowa contributed on average 77 percent to single coverage premiums and Click on the table below to view further details and state comparisons. The Henry J. Kaiser Family Foundation measured the competitiveness of the private health insurance market in , using the Herfindahl-Hirschman Index HHI as an indicator. The HHI takes into account how much of a market is controlled by each of the companies competing within it market share and is expressed in a value between zero and 10, The lower the number, the more competitive the market.
The analysis was divided into individual, small group and large group insurance markets. The data also includes information on the market share of the largest insurer in each state, as well as the number of insurers with a market share of greater than five percent.
The individual, small group and large group health insurance markets were less competitive in Iowa than in its neighboring states.
The least competitive of these was the individual market, with the largest insurer holding a market share of 84 percent. In the United States, there are more than 10, FDA-approved medicines available for doctors to prescribe or individuals to purchase over-the-counter. A major target of state healthcare cost-containment efforts is the price of these medicines. Since generic drugs tend to be significantly less expensive than their brand name equivalents, all states allow pharmacists to dispense generics in place of brand name drugs for prescriptions.
This practice is required in 13 states, except when a brand name drug is specifically ordered by a physician; this group of states does not include Iowa.
Additionally, state Medicaid programs typically take a number of steps to control spending on pharmaceuticals. Most common are establishing preferred drug lists, which are prescription drugs that are automatically covered by the program, and negotiating rebates with manufacturers for both brand name and generic drugs.
Iowa's Medicaid program utilizes both of these strategies, and is also part of a multi-state pool to enhance its buying power. On average, women and individuals over age 65 bought more prescription drugs than men and those under age These totals do not include medications sold over-the-counter. States are also focusing on curbing prescription drug abuse and fraud as a method to contain costs. Between and , there was a documented increase of As an effort to combat the rise in prescription drug abuse and fraud, all but two states have authorized the development of prescription drug databases that can monitor the dispensing of certain controlled substances.
These programs have been bolstered by federal grants encouraging their implementation. Information must be reported weekly by all licensed pharmacies. These requirements exclude drugs directly administered to patients, drugs dispensed to inpatients in hospitals, hospice programs or long-term care facilities, drugs sold by wholesale distributors, and drugs dispensed in a quantity to treat a patient for two days or less.
The law does not require patients to be notified of the monitoring program.. Under the current model, access to experimental drugs by terminally ill patients is controlled by the Food and Drug Administration FDA , which must give its approval after it receives a form from a patient's physician.
What are known as "right to try" laws aim to allow such patients to gain access to experimental drugs without the permission of the FDA. As of March , 27 states in total had adopted right-to-try legislation. At that time, Iowa had considered right-to-try legislation, but no such measure had been passed.
Health information technology IT refers to electronic systems that manage, store and transmit health information, such as patient records. The adoption of modernized health IT has been promoted by the federal government as a way to increase quality while decreasing costs.
For instance, the American Recovery and Reinvestment Act of required most health providers to adopt electronic health records by However, the digitization of health data raises concerns about the privacy of such data, which could be vulnerable to a breach if not properly secured.
Since , health IT privacy and security has been governed by the Health Insurance Portability and Accountability Act HIPAA , which required and set national standards for the confidentiality of patient information "when it is transferred, received, handled, or shared.
All-payer claims databases are one form of health IT that a growing number of states are implementing to track healthcare costs. All-payer claims databases are state systems for collecting data from public and private health insurance claims on demographics, types of services and total charges.
Department of Health and Human Services plans to build a nationwide all-payer claims database consisting of a representative sample of the population. To view the status of such a program in Iowa, click here.
Each year, the United Health Foundation releases a report titled "America's Health Rankings," which measures the overall health of the citizens in each state. The United Health Foundation is a nonprofit organization that "provides helpful information to support decisions that lead to better health outcomes and healthier communities.
In its report, Iowa ranked 24th in the nation , down from 18th in and 20th in According to the report, although the state had a low rate of drug deaths and high immunization coverage among children, there was a high prevalence of binge drinking in the state, as well as increases in the rates of smoking, physical inactivity and Pertussis whooping cough over the previous year.
Compared to neighboring states, Iowa ranked higher than Illinois 30th and Missouri 36th , but lower than Minnesota sixth. To read the full report, click here.
The following is a list of recent healthcare policy bills that have been introduced in or passed by the Iowa state legislature. To learn more about each of these bills, click the bill title. This information is provided by BillTrack50 and LegiScan. Note: Due to the nature of the sorting process used to generate this list, some results may not be relevant to the topic. If no bills are displayed below, then no legislation pertaining to this topic has been introduced in the legislature recently.
The link below is to the most recent stories in a Google news search for the terms Iowa healthcare. These results are automatically generated from Google. Ballotpedia does not curate or endorse these articles.
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