State Highlights: Medicaid Rule Could Hurt Nursing Home Alternatives; Tenn. Lowers Uninsured Rate

Stateline: New Medicaid Rule Could Challenge State Shift Away From Nursing Homes
Starting this year, a new federal rule will require states to ensure that long-term care alternatives to nursing homes—such as assisted living facilities, continuing care retirement communities, group homes and adult day care—work with residents and their families to develop individual care plans specifying the services and setting each resident wants. The overarching goal is to create a “home-like” atmosphere, rather than an institutional one and to give residents choices about their care. While nearly everyone supports the concept, states, providers and even some consumer advocates are complaining that the rule could make it difficult for health care providers to fulfill increasing demand for long-term care outside of nursing homes. (Vestal, 11/18)

The Associated Press: Tenn. Has Lowest Number Of Uninsured In Decade
A new University of Tennessee report says the number of uninsured people in Tennessee has hit a 10-year low. Media cited the study in reporting that the number of people without health insurance shrunk about 25 percent in the first year of the health insurance marketplace, which was implemented under the federal Affordable Care Act. It was the biggest drop since the university began collecting data 20 years ago. (11/18)

U.S. News & World Report: Seeking The Right To Try
Some states are making this process easier, passing laws that allow terminally ill patients access to drugs that have not been approved by the government. In Arizona, such a provision quietly won approval during the midterm elections. This type of measure – passed also in Colorado, Louisiana, Michigan and Missouri – is known as a "right to try" statute. It allows dying patients to request access to treatment that has not been approved by the Food and Drug Administration, the federal agency that reviews testing by drug companies to decide whether medications are safe and effective. The laws allow doctors, hospitals and manufacturers to bypass the FDA and protect them from prosecution, even if they request medication from a drugmaker in another state. (Leonard, 11/18)

Kaiser Health News: California’s Managed Care Project For Poor Seniors Faces Backlash
California’s experiment aimed at moving almost 500,000 low-income seniors and disabled people automatically into managed care has been rife with problems in its first six months, leading to widespread confusion, frustration and resistance. Many beneficiaries have received stacks of paperwork they don’t understand. Some have been mistakenly shifted to the new insurance coverage or are unaware they were enrolled. And 44 percent of those targeted for enrollment through Oct. 1 opted out. (Gorman, 11/19)

California Healthline: One-Quarter of Possible Participants Have Opted Out of the Duals Project
About 50,000 Californians so far have enrolled in Cal MediConnect, according to figures released Monday by the Department of Health Care Services, which oversees the program. However, about twice that number -- a little more than 100,000 duals -- have chosen to opt out of the program. (Gorn, 11/18)

The Associated Press: Hawaii To Use Federal Funds For Migrants' Health
Hawaii will save about $21.5 million by tapping into federal funding to pay for health care for people living in the state under the Compact of Free Association, a newspaper reported Tuesday. Roughly 7,500 adult migrants from the Federated States of Micronesia, Palau and the Marshall Islands will be able to sign up for medical coverage under the Affordable Care Act. Under the compact, Pacific Island citizens freely live and work in the U.S. with no time constraints in exchange for allowing the U.S. military to control strategic land and water areas in the region. (11/18)

The Associated Press: NC Medicaid Forecasting Small Surplus This Year
North Carolina's Medicaid office predicted Tuesday it would have a small surplus for this fiscal year despite a spike in prescription drug spending and continued enrollment growth for the health insurance program that serves more than one in six state residents. The forecast is another sign the beleaguered program is in a better financial position compared to recent years, when shortfalls reached hundreds of millions of dollars. Acting state Medicaid finance director Rudy Dimmling said the agency's forecast of spending $68 million less than state appropriations and receipts taken in by the end of June comes with many caveats. (Robertson, 11/18)

The Denver Post: Colorado Employers' Health Insurance Rates Rise 8 Percent
Colorado employers face an 8 percent increase in the cost of renewing employee health insurance plans for 2015, the latest in a decade of steep increases, according to a survey released Tuesday. If there's good news in the survey's findings, it's that the hike will be lower than the double-digit increases that have occurred nearly every year since at least 2004. (Draper, 11/18)

The Baltimore Sun: Harford's Hospitals Won't Hire Tobacco Users Come 2015
Starting Jan. 1, 2015, a tobacco product ban in effect at both University of Maryland Upper Chesapeake Health hospital campuses in Harford County will become even more stringent, and as of July 1, 2015, Upper Chesapeake will not hire anyone who uses tobacco, the health care company said this week. Upper Chesapeake is Harford County's largest private employer, with more 3,100 employees, according to the most recent fact sheet posted on the organization's website. Hospital admissions, emergency room and outpatient visits to the two campuses exceed 285,000 annually. (Anderson, 11/18)

WDIO: Nine Regional Medical Providers Join Forces In New Collaborative: Wilderness Health
Nine regional hospitals and clinics [in northern Minnesota] came together on Monday, not in a merger, but rather a collaboration with the goal to improve patient health care. The group, Wilderness Health, connects these health care providers spanning in a triangle from Grand Marais down to Moose Lake and back up to International Falls. The Executive Director of Wilderness Health, Cassandra Beardsley, said data integration is just one example of how they'll work together. (Kruse, 11/18)

Kansas Health Institute News Service: Medicare Termination Looms At Kansas Hospital
A federal agency has sent notice that Medicare payments to overcrowded Osawatomie State Hospital will be terminated, but state officials say they will address concerns before the deadline and avoid the termination. Kari Bruffett, secretary of the Kansas Department for Aging and Disability Services, said Tuesday that she is aware of the termination notice from the federal Centers for Medicare and Medicaid Services. But she said the state has until Dec. 8 to correct deficiencies and will do so. (Marso, 11/18)