The ERC Blog

The Importance of Agricultural Education in Schools

          Kate Ziehm, publisher of ‘Morning Ag Clips’, wrote an article for her publication on December 8th entitled “It is our Responsibility”. Kate received a note from a teacher who said that he shares the Morning Ag Clips with his class and raved about how that helps keep his students current on agriculture issues. She […]

The Status and Statistics of Rural Broadband

It has been reported for years that high speed broadband is lacking in the rural areas of our country compared to urban and suburban areas.  People living in rural America do not have to be told they need broadband – they are well aware of the disadvantages they face living with lack of high speed […]

Ag Organizations Send Letter to Governors on NAFTA

Last week, 22 agricultural associations submitted a letter to the governors of each state expressing concern about the potential of a withdrawal from the important trade agreement.  Among these organizations are ones very familiar to our region:  Agrimark, American Farm Bureau Federation, Coalition of New England Companies for Trade (CONECT), IDFA, National Council of Farmer […]

House Holds Northeast Listening Session on 2018 Farm Bill

House Agriculture Panel (l to r) Ranking Member Peterson (TX), Chairman Conaway (MN), Vice Chairman Robertson (PA), and Rep. Fosse (NY) In order to gather as much information as possible from the public, the Committee has, since June 24, also been holding listening sessions throughout the country (Florida, Texas, Minnesota, California and Illinois).  And, thanks to some […]

Commissioner Steve Reviczky Elected President of NASDA

Connecticut’s Agriculture Commissioner will lead the National Associations of State Departments of Agriculture (NASDA) for 2017 -2018.           One of the ERC member states has a Commissioner leading the prestigious, non-partisan group of Commissioners, Secretaries and Directors of Agriculture. The remaining elected officers of NASDA for this term include State Agriculture Departments’ leaders from New […]

New Brief – Medicaid Buy-in: A State Option to Expand Access to Coverage

Some states have encountered rising premiums, consolidating markets, and the flight of insurers from some counties in their insurance exchanges. In response, some states are considering developing a Medicaid-buy-in plan, which would open their Medicaid managed care programs to consumers shopping for coverage in their exchanges. Under the concept, consumers eligible for insurance exchange subsidies […]

Antibiotic prescribing down but more needs to be done

In the past seven years, per person antibiotic prescriptions have declined 9%, according to a report by the Blue Cross Blue Shield Association. The rate declined even faster for children and infants. Overuse of antibiotics is blamed for contributing to the rise of antibiotic-resistant bacteria or “superbugs”. Every year 2 million Americans become infected with […]

State CHIP programs at risk without federal action

MACPAC estimates that, without federal extension of funding for the CHIP program, all states will run out of funds by July of next year. Three states and the District of Columbia will run out of CHIP funds by the end of this year without federal action. Created by Congress in 1997, the CHIP program has […]

Annual Meeting Recap

  2017 Annual Meeting Agriculture & Rural Affairs Program Recap   The 57th Annual Meeting of the Council of State Governments-Eastern Regional Conference, held August 13 through 16, 2017 at the Mohegan Sun Resort in Uncasville, Connecticut, was the site of much information gathering and relationship building among the attendees. The Agriculture & Rural Affairs […]

New data shows more employees in high deductible plans, rate varies considerably by state

Analysis of new federal data by SHADAC finds that almost half (43%) of people covered by employer-sponsored health plans were in high-deductible plans last year, up from 30% from 2013. For purposes of this study, high-deductible plans are defined as meeting the minimum deductible amount required for Health Savings Account eligibility ($1,300 for an individual […]

CMS finalizes important patient-friendly informed consent payment proposal

CMS has finalized their proposed Medicare rule (regulation) for how hospitals are paid that includes a new measure assessing the quality of hospital informed consent documents given to patients before elective procedures. (The relevant section, Potential Inclusion of the Quality of Informed Consent Documents for Hospital-Performed, Elective Procedures Measure starts here on p. 373 of […]

Survey of state legislators’ values for health reform finds strong differences by party but some encouraging overlap

Both Democratic and Republican state legislators from across the US agree on the need to control health care costs, according to a new survey published in the American Journal of Public Health. However, other top priorities between the parties differ strongly. Republicans prioritized smaller government along with reducing costs while Democrats prioritize improving health equity […]

State policymakers hear how bioscience is generating jobs with health innovation

The growing Bioscience industry holds great potential to improve the region’s economy and health , according to speakers at “Bioscience Initiatives: Improving Health and Growing the Economy” at this week’s CSG-ERC Annual Meeting in CT. Panelists included Mostafa Analoui, PhD, Executive Director, UConn Venture Development, Mike Hyde, Vice President, External Affairs, The Jackson Laboratory, and […]

State health policymakers get the latest from DC and options to respond

At this week’s CSG-ERC Annual Meeting in CT, state policymakers from across the Northeast got updates from experts on the federal health care landscape, state options to adapt. CT’s Lieutenant Governor Nancy Wyman pulled it all together describing CT’s progress toward health reform. Mitchell Stein gave a detailed summary of federal activity including CHIP reauthorization […]

The Future of Medicine in the Human Genome Genomics — Making a difference in patients’ lives / By Mary Branham

From CSG-ERC’s Annual Meeting in Connecticut Mapping the first human genome in 2000 cost about $4 billion; today, it costs about $1,000. The cost has come down because of investment, and because of the important role genomics is playing in medicine today, according to Dr. Murat Gunel, a professor of neurosurgery, genetics and neuroscience at […]

Prevalence and challenges facing high-need patients vary significantly between states

Understanding high-need adults with complex conditions and their barriers to care are key to developing solutions that improve health and control costs. High-need adults have at least two chronic diseases and a functional limitation in their ability to care for themselves or perform routine daily tasks. A new report from the Commonwealth Fund outlines in […]

ICER seeks comment on Value Framework Changes for Ultra-Rare Condition Treatments

The Institute for Clinical and Economic Review (ICER) has proposed adaptations to its value framework for very rare conditions. ICER is a leader in evidence-based analysis of the effectiveness of drugs and other medical treatments. ICER’s analyses, including benchmark value-based prices for new drugs, are used by a growing list of payers in developing fair […]

North American Free Trade Agreement (NAFTA) Renegotiation

On July 17, the Office of the United States Trade Representative released their report entitled ‘Summary of Objectives for the NAFTA Renegotiation’.  One of the promises made by Candidate Trump was a renegotiation of the North American Free Trade Agreement.  In a tweet from October 2016, Trump said, ‘I will renegotiate NAFTA. If I can’t […]

ERC members attend CSG forum in DC on the future of Medicaid

A few weeks ago, seven legislative and staff members from the CSG-ERC region were in Washington DC attending a three-day CSG Medicaid 101 Policy Academy. ERC attendees represented Connecticut, Maryland, Puerto Rico and Vermont. Medicaid covers one in five residents of the ERC region and funds $140 billion in health care services. The forum included […]

Meet NH State Representative Steve Darrow

Let us introduce Representative Steve Darrow, Vice Chair of the New Hampshire House Committee on Environment and Agriculture, and a first time attendee to the ERC Annual Meeting. Steve is a member of the CSG-ERC Agriculture and Rural Affairs policy committee. Rep. Darrow has been a resident of NH for forty-five years.  Rep. Darrow has […]

Updated: CBO estimates that 22 million more Americans will become uninsured by 2026 under the Senate’s ACA replacement proposal

Thursday morning Senate leaders published their plan to replace the Affordable Care Act and modified it earlier today. The Senate proposal closely follows the bill that passed the House in May. According to today’s Congressional Budget Office’s report, the Senate bill would increase the number of uninsured Americans by 15 million next year and 22 […]

Meet the Legislator – MA Senator Anne Gobi

Senator Anne Gobi lives in Spencer, Massachusetts, the town where she was born and raised. After graduating from Worcester State College, Anne studied law at Massachusetts School of Law at night while teaching high school during the day.  After passing the bar, she went into private practice. A member of the Spencer Democratic Town Committee […]

U.S. to Withdraw from Paris Agreement, but Many CSG/ERC States Committed to Carbon Reductions

President Trump today announced that the United States will exit the historic Paris Agreement, whose 195 signatories agreed to reduce their greenhouse-gas emissions in an effort to combat climate change. Only two other nations in the world are not party to the accord: Syria and Nicaragua. In a memo released by the White House, Trump […]

President’s budget proposal includes large cuts to state Medicaid funding, among other health programs

President Trump’s FY 2018 budget proposal includes $610 billion in mandatory savings over the next decade by instituting state Medicaid block grants or per capita caps starting in FY 2020. This goes beyond cuts included in the American Health Care Act passed by the House of Representatives three weeks ago. According to the proposal, “The […]

2016 uninsured rates remain low in ERC region

Early estimates of health coverage finds that 28.6 million or 9% of Americans were uninsured last year, down 20 million from 2010, according to the CDC’s National Health Interview Survey. At 7.7% uninsured, the Northeast had the lowest rate among four US regions. Among ERC states, Massachusetts still ranks lowest in uninsured rate. All ERC […]

Meet Massachusetts Representative Stephen Kulik

Representative Stephen Kulik hails from Worthington in Western, MA, and represents 16 rural communities to the north and west of Springfield. Steve went to Newton Junior College, and then attended Northeastern University before finishing his studies at the University of Massachusetts Amherst. Representative Kulik started his public service on his hometown’s Planning Board and then […]

New tool allows detailed state health comparisons and analysis across a wealth of metrics

State Health Compare is an important new resource that will help state policymakers get the information they need. The tool, created by SHADAC, provides state-level estimates across 46 measures of health and health care. Through the site, visitors can create customized reported of state-level health estimates. The tool brings together data from six federal agency […]

Trump Signs Executive Order on Agriculture

On April 25, 2017, President Trump signed an Executive Order entitled ‘Promoting Agriculture and Rural Prosperity in America’. The Order establishes an Interagency Task Force on Agriculture and Rural Prosperity, which will be supported and funded by the Department of Agriculture.  (To read the full text of the Executive Order, click here) The Task Force […]

State policymakers urge Congress to preserve successful state-federal Medicaid partnership

Yesterday, CSG-ERC sent a letter calling on Congressional leaders to protect and support the 50-year, successful state-federal Medicaid partnership. Signed by ERC Co-Chairs Sen. Terry Gerratana and Rep. Kevin Ryan (CT) the letter notes that state legislators represent the same constituents as members of Congress. As the letter points out, “For over fifty years, Medicaid […]

Meet Delaware Senator Gary Simpson

Senator Gary F. Simpson, representing the 18th Senate District of Delaware, has been in the legislature since 1998. The Minority Leader in the Senate, Gary also sits on the Agriculture, Executive, Rules & Ethics committees, and is a member of the Legislative Council. He retired from twenty years with the University of Delaware in 2011, […]

Milbank publishes study of state health policy capacity resources and needs

State policymakers are responding to an unprecedented set of very complex policy changes that can shift quickly including Medicaid expansion and options, insurance standards and exchanges, public health changes and more. These policies represent a significant piece of state budgets, must engage many stakeholders, and are central to the health and quality of state residents. […]

Amid a Spate of Nuclear Plant Closings, State Officials Mull Economic, Environmental Impacts

Nuclear power has long been a mainstay of the Northeast’s energy mix, but a wave of planned retirements has fueled a debate about the fate of aging reactors, and their value to the region’s economy as states work to achieve a variety of energy and climate goals. In New York and Connecticut, independent analyses have […]

Canadian lessons for the US about health reform

With Congressional and White House leaders’ decision to drop the American Health Care Act, the future of health reform in the US is unclear. Reflecting on the AHCA “drama”, two Canadian physicians have authored an article with lessons for the US. Unlike the US, health care for everyone is a core Canadian value. In 2004 […]

What are the President’s Funding Priorities for Education?

Looking at the President’s 2018 Budget, we are able to see the Administration’s priorities in education.  Note the newly proposed funding for school choice and charter schools and the elimination or reduction of funding for several other education programs and initiatives. The President’s 2018 Budget provides $59 billion in discretionary funding for the U.S. Department […]

CT, NY outline state impact of House ACA replacement plan

Governors of Connecticut and New York have published estimates of the impact on residents and budgets in their states of the American Health Care Act (AHCA) that passed the House Budget Committee today. Connecticut estimates that the AHCA could cost the state $1 billion per year after full implementation in 2020 and would cost seniors […]

Hospitals must now notify “observation” status Medicare patients, implications for state Medicaid programs

Under federal law, hospitals must now notify Medicare patients if they are on “observation status” rather than an admitted patient. According to Kaiser Health News, patients were often not aware they were considered outpatients, as they were in identical hospital beds and receiving the same care as other admitted patients. Many learned that they were […]

Meet Representative Carolyn Partridge

 Representative Partridge,  Chair of the Vermont House Committee on Agriculture and Forestry,is an 18-year member of the Vermont House of Representatives and the Chair of the Committee on Agriculture and Forestry. She is better known to the regular participants of the ERC as one of the two Co-Chairs of the ERC Agriculture and Rural Affairs […]

Wind Generation Surpassed Hydroelectric Power in 2016 – U.S. EIA

Last year, wind energy generation in the United States edged out conventional hydroelectric output, which has historically been the nation’s largest source of renewable energy, the U.S. Energy Information Administration said in a brief published March 6. Wind power now generates 5.5% of the nation’s electricity, four times more than solar power, and enough to […]

Workforce Development: 5 Things to Know

Workforce Development: 5 Things to Know 1.   Employment and Training Administration (ETA) Publishes Guidance on Registered Apprenticeship Provisions and Opportunities in the Workforce Innovation and Opportunity Act (WIOA) for States Registered Apprenticeship is an important workforce development strategy that the workforce system provides to its customers, both job seekers and employers. It is an […]

Report Finds Efficiency Could Replace Power from Indian Point Nuclear Plant in New York

Last month, when New York Gov. Andrew Cuomo announced a deal to close the Indian Point Nuclear Power plant by 2021, some experts questioned whether the plant’s output could be replaced without relying on large quantities of natural gas. Indian Point supplies one quarter of the electricity consumed by New York City and Westchester County. […]

New report finds adults in Medicaid expansion states have better access to care, fewer financial barriers

A new report from the CDC provides the first analysis of the population-based impact of the Affordable Care Act. The analysis used data from the 2014 Behavioral Risk Factor Surveillance System, a state-based ongoing survey of adult Americans about health risk behaviors, chronic conditions, health care access and use of preventive care. As for previous […]

Employer sponsored coverage stable but states vary

Between 2014 and 2015, overall US rates of private employers offering health coverage did not change, but rates decreased among small firms and rose among large firms, according to a new analysis by SHADAC. States continued to vary considerably in private sector offer rates. Nationally 47.5% of all private sector workers are enrolled in employer-sponsored […]

Meet the Legislator – PA Senator Judy Schwank

This month’s featured CSG-ERC Agriculture and Rural Affairs legislator is Senator Judy Schwank of Pennsylvania. Senator Schwank was first elected to the senate in 2011. The long-serving and well-loved senator from Judy’s district unexpectedly passed away, and the seat needed to be filled. Judy was on vacation with her husband when she got the call […]

ICER revises value assessment methodology, public comments open

The non-profit Institute for Clinical and Economic Review has posted for comment their updated Value Assessment Framework. ICER is an independent research institute that analyzes evidence on the effectiveness and value of drugs and other treatments, including evidence-based calculations of prices for new drugs that accurately reflect their value in long-term patient outcomes and highlighting […]

Meet Maine Representative Michelle Dunphy

  Meet Representative Michelle Dunphy, House Chair of the Maine Agriculture, Conservation and Forestry Committee Representative Dunphy is in her second term in the Maine House of Representatives and is the House Chair of the Agriculture, Conservation and Forestry Committee. Maine is one of the few states in the northeast that has joint House and […]

Maryland explores state options to control pharmacy costs

Like many states, Maryland is considering state policy options to control rising prescription costs. Tuesday, the state’s Senate Finance Committee heard from 13 invited experts about possibilities. Committee Chair, Sen. Thomas “Mac” Middleton, opened the briefing stating that controlling prescription drug costs is “one of the biggest issues that we’ll deal with this year.” Ellen […]

Non-medical vaccine opt-outs for children dropping in most of US, but some ERC states still rising

New analysis by the CDC finds that while the percentage of families opting out of school-required vaccines for kindergartners for non-medical reasons is dropping nationally, the rate continues to rise in a handful of states. Among the eleven states with rising non-medical vaccine exemption rates are Connecticut, Maryland and New York. All but three states […]

ERC states remain among the most healthy, but lots of room for improvement

The latest America’s Health Rankings finds that overall residents of the CSG-ERC region are generally healthier than other states. While Hawaii was the healthiest state, Massachusetts and Connecticut were numbers 2 and 3, respectively. Among ERC states, only Delaware (#31) and Pennsylvania (#28) were below the US overall average. The rankings are based on 34 […]

Benefits of State Clean Energy Mandates Outweigh Costs, Federal Report Finds

The costs associated with implementing state renewable-energy standards between now and mid-century will be far outweighed by the benefits to public health and the environment, a new federal report finds. The report was released jointly by the Lawrence Berkeley National Laboratory and the National Renewable Energy Laboratory, and is the third in a series of […]

First-in-the-Nation Offshore Wind Farm Comes Online in Rhode Island

Last week, America’s first offshore wind farm, a 30-megawatt project situated off the coast of Block Island, Rhode Island, began to deliver electricity into the New England Power grid. Proponents of the industry hope the pilot will jump-start a thriving U.S. industry in the coming years. The $300-million, five-turbine wind farm, developed by Deepwater Wind, […]

States sue generic drug companies for price fixing

Last Wednesday twenty state Attorneys General filed suit against six drug companies for fixing prices of generic drugs. Seven ERC states are included in the lawsuit including Connecticut, Delaware, Maine, Maryland, Maine, New York and Pennsylvania. The six drug companies include Mylan Pharmaceuticals, Aurobindo, Citron Pharma, Heritage Pharmaceuticals, Mayne Pharma and Teva Pharmaceutical. The suit […]

CSG, ERC pass resolutions to preserve Medicaid state-federal partnership

At our meetings in Virginia last week, both the National and Eastern Region Council of State Governments passed resolutions urging federal policymakers to support and continue the successful Medicaid state-federal partnership and “avoid the imposition of new burdens on state budgets.” The resolutions are in response to signals from the incoming federal administration and Congress […]

Allow us to introduce ourselves.

We are Bob Haefner and Tara Sad, former State Representatives from the beautiful state of New Hampshire, and now your Agricultural Policy Consultants for the Council of State Governments/Eastern Regional Conference. We are delighted to join the great CSG/ERC Team! So, a little bit about us.   We were both elected to the NH House […]

ERC region and individual state Medicaid fact sheets online

The new administration has signaled interest in reforming Medicaid by giving states more flexibility but with fewer resources. Both CSG/ERC and CSG nationally are considering resolutions urging “that the federal Executive and Legislative Branches maintain the integrity of the strong state-federal partnership that has been the hallmark of the Medicaid program since its inception more […]

Nominations open for New England comparative effectiveness council

The Institute for Clinical and Economic Review is seeking new members for the New England Comparative Effectiveness Public Advisory Council, in addition to two other councils in California and the Midwest. Many health policy experts blame new technologies for drugs, devices and other innovations with driving health costs up without necessarily improving the quality of […]

Regulation of fast growing freestanding EDs varies among states

Freestanding EDs (FSEDs) are a growing alternative to traditional hospital-based emergency care but come with controversy. FSEDs began in the 1970s as a critical care option for rural areas, but have recently grown across the nation. FSEDs can be independent or affiliated with a hospital. A new study published in this month’s Health Affairs finds […]

Northeast ranks best for health of women and children

The newest report by America’s Health Rankings finds that Massachusetts leads the nation in the health of women and children and residents of CSG-ERC states are generally healthier than average American women and children. The report examines 60 measures important to the health of women and children from health care services such as vaccines and […]

Where are the marketplaces offering bargains? Insurance premiums vary inside and outside ACA marketplaces

A new study by the Urban Institute finds health insurance premiums in the ACA marketplaces average 10% lower than employer-sponsored coverage but that ratio varies considerably by state. The study looked at unsubsidized premiums adjusted for actuarial value, as most employer coverage is more generous than marketplace plans, as well as utilization and age distribution. […]

GAO finds individual insurance markets concentrated in most states in 2014

Recent news about insurers leaving health insurance exchanges have raised concerns about lowering competition and rising prices for health insurance. Prior to 2014 health insurance markets in most states were highly concentrated, according to the US General Accounting Office. It was hoped that the Affordable Care Act’s insurance exchanges would reverse that trend expand options […]

Annual meeting slides are posted online

Presentation slides from this month’s annual meeting have been posted. Slides from the Health Policy Committee panel on State Options to Control Drug costs include the MA Health Policy Commission, ICER, and Melanie Forcier. The handout Summary of VT’s drug price transparency law is also posted. Coming soon – a brief answering questions about how […]

ICER seeks input on value methodology update

There is a growing concern that untested new treatments and drugs are driving up the cost of health care. Consumers and payers don’t have enough trusted sources to evaluate the value of costly, new interventions – whether they are worth what they charge. The Institute for Clinical and Economic Research (ICER), a leading and trusted […]

Court affirms Canadian drug price control authority

In a ruling released last week, Canada’s Federal Court upheld the constitutionality of the Canadian Patented Medicines Prices Review Board to ensure drug prices are not excessive. The Board uses scientific reviews of drug effectiveness along with economic and market analysis to define a fair price for each medication. Drug prices cannot be higher than […]

State policymakers hear about successes and challenges in Medicaid reform

Wednesday’s Medicaid Reform meeting hosted by CSG-ERC Health Policy Committee highlighted the variety of approaches states are taking to address their unique challenges. All states are committed to move away from volume-based payment models toward building value. All states were also committed, and have devoted significant resources, to quality improvement and delivery reform to build […]

solar panels

In New York’s Fast-Growing Solar Market, A Focus on Assessing “Value”

As New York proceeds with its energy-system overhaul, solar power is booming, and regulators and industry sources say that finding a way to accurately value solar’s contribution to the grid will be key to sustaining that growth. Gov. Cuomo’s Reforming the Energy Vision, or REV, aims to incentivize utilities to incorporate solar, wind and other […]

Brief: Preventing Underservice in Medicaid Reform

Medicaid is unique in the American health system for a number of reasons. As an income-based, entitlement program run by states with federal support that serves members at risk for poor health due to social determinants, it carries both unique strengths and challenges. Unnecessary over-treatment has received a great deal of attention as a driver […]

Health Committee Forum on State Medicaid Reforms — June 29, Boston

Medicaid is now the largest coverage plan in the US, consuming almost 20% of state budgets and straining health systems. CSG-ERC states are leading the nation in driving innovative Medicaid reforms. Later this month, CSG-ERC’s Health Committee will host State Medicaid Reforms: Different Models, Common Goals. The meeting of Northeastern health policymakers will allow in-depth […]

Insurance exchange premium growth in ERC region averaged 6.7% this year with wide variation; same variation but higher prices expected for 2017

A new analysis finds that insurance exchange premium growth over the last two years varied considerably between states. According to the Urban Institute, the average annual premium increase for the lowest cost Silver plan from 2014 to this year was 5.5% nationally and 4.2% for the ERC region. However individual ERC state annual rates varied […]

Awaiting Governor’s signature, VT bill requires drug companies to justify prices

A Vermont bill that would make drug companies justify their prices has passed both houses and awaits the Governor’s signature. S.216 requires drug companies to submit detailed information explaining price increases for the most common drugs with sharply rising prices. The information would be reported publicly online. It is unclear what the state will do […]

CSG/ERC Seminar at Penn Addresses Carbon Policies, Sustainable Water Infrastructure and Renewables

On May 6, CSG/ERC brought together legislators from around the Northeast and eastern Canada to discuss policies to reduce carbon emissions, expand access to renewable energy and electric vehicles and promote sustainable practices for managing urban water resources. The meeting was hosted by the Kleinman Center for Energy Policy at the University of Pennsylvania, and […]

New report finds higher access to care in ERC states

Despite wide state-to-state variation, a new CDC report finds that in 2014 residents of all ERC states are more likely to have a usual source of medical care than most Americans. Vermont led the country with only 2.8% of residents that report they do not have a regular care site. Vermont also leads the country […]

Wide variation in health care prices by state

A new report finds that health care prices are higher across most of the CSG-ERC region than the rest of the US. Only New York and Maryland’s prices were below the national average. The report by the Health Care Cost Institute averaged prices for common treatments across and within 41 states and the District of […]

As New York Moves to Reshape its Electricity System, a Focus on Renewables, and Jobs

Two years ago, New York Gov. Andrew Cuomo launched Reforming the Energy Vision (REV), a bold plan to restructure the electricity system to accelerate the development of cleaner forms of power, enhance the grid’s resiliency to severe weather and improve affordability for residents throughout the state. At a recent energy conference in New York City, […]

Rich/Poor Life Expectancy Gap Depends on Where You Live

The richest 1% of Americans live 14.6 years longer, on average, than those with the lowest 1% of incomes and that gap is growing. While this disparity is well-known, the reasons are not well-understood. The Health Inequity Project is working to change that. Publishing their results in JAMA, researchers from across academia joined forces to […]

Update – Palliative Care Webinar time change

Due to an unavoidable conflict, the time for the webinar: The Potential of Palliative Care for People with Serious Illness by the MAPOC Complex Care Committee will be an hour later than originally scheduled. The webinar will still be on May 9th but will be at 10:30 am. All registered participants should have received an […]

Northeastern physicians lowest paid in US

According to Medscape’s 2016 Physician Compensation Survey, at $266,000 physicians from Northeastern states have the lowest incomes in the US, closely followed by their colleagues from Mid-Atlantic states at $286,000. Among ERC states, only New Hampshire (2nd highest) was in the top ten states for physician compensation, while Rhode Island (lowest), Maryland, Massachusetts, New York […]

CEPAC meeting affirms the value of outpatient palliative care, but more research is needed

At yesterday’s meeting in Hartford, CEPAC took a deep dive into the clinical and cost effectiveness of palliative care delivered in outpatient settings. From CEPAC’s report, “Palliative care is a management approach that provides symptom relief and comfort care to patients with serious or life-threatening illnesses, with the goal of improving quality of life for both patients […]

CSG/ERC region scores well in health care quality, but significant disparity challenges

The latest National Healthcare Quality and Disparities Report from HHS finds significant improvement in access to health care across groups in 2014, likely due to the Affordable Care Act. Released earlier this month, the annual report tracks over 250 measures of quality and disparities in health care. ERC states generally performed better than the nation […]

Supreme Court rules against VT health price database

For many years, health care prices paid by US insurers and employers have been protected as trade secrets. Those prices and the lack of transparency are widely blamed for the high costs of health care in the US. To address this problem most states, including all ERC states, are creating all-payer claims databases (APCDs) as […]

Canada Pushes Airport Preclearance

Canada – U.S. Border Update                                                March 2016 Canada Pushes Airport Preclearance The new Liberal government in Ottawa is making a renewed effort to increase customs preclearance capabilities for persons traveling by air to […]

Transportation Report — March 14

Week of March 14, 2016 “Orphaned” Funds Available Recent new guidance from the Federal Highway Administration (FHWA) announced that roughly $2 billion in previously unused earmarks can be put back to work to support infrastructure projects across the country. As previously reported, the guidance implements a provision in the Consolidated Appropriations Act 2016, which gave […]

Transportation Funding

On February 23, The Council of State Governments hosted a webinar on transportation funding, moderated by Sean Sloan, director of transportation and infrastructure policy for CSG.  The speakers included Joe McAndrew, policy director of Transportation for America, Alison Primo Black, Senior Vice President and Chief Economist of the American Road and Transportation Builders Association, and […]

Important Developments in Puerto Rico’s Transportation System

On February 25th US DOT Secretary Foxx made an historic trip to San Juan, Puerto Rico with Federal Highway Administrator Gregory Nadeau to join Governor Alejandro Javier García Padilla and Puerto Rico Secretary of Transportation and Public Works Miguel Torres Díaz in signing an agreement that further strengthens the development of transportation infrastructure and promotes […]

EPA’s Clean Power Plan: A Brief Overview for the ERC Region

On August 3, the Obama administration finalized the Clean Power Plan, the first-ever national rule to cut carbon pollution from existing power plants. The U.S. Environmental Protection Agency (EPA) also issued final carbon pollution standards for new, modified, and reconstructed power plants, and proposed a federal plan and model trading rules to assist states in […]

2016 State of the States

ERC governors talk about jobs, infrastructure, pension reform, opioid addiction and more… The economy and jobs were the central focus of the 2016 State of the State speeches delivered by the governors of 11 ERC member states (from Maine to Maryland). While there was much talk about budget deficits, fiscal restraint and pension reform, jobs […]

Motor vehicle deaths up 8% in 2015

2015 was the deadliest year on US highways since 2008, with 38,300 deaths and 4.4 million serious injuries, according to preliminary numbers from the National Safety Council. That number is 8% higher than the 2014, compared to an increase of less than 0.5% from 2013 to 2014. The NSC blamed lower gas prices, resulting in […]

Medicare members from ERC states have saved $5.6 billion on prescription drugs under the ACA; over 8.8 million received free preventive care in 2015

Thanks to the Affordable Care Act (ACA) enacted into law in 2010, millions of elderly and disabled Medicare beneficiaries in CSG-ERC states have saved billions of dollars on prescription drugs and free preventive care, according to new numbers from the Centers for Medicare and Medicaid Services. The ACA includes increasing discounts for Medicare Part D […]

Benefits of sponsoring out of state trips for policymakers

A new Health Affairs blog highlights the benefits of learning trips for state health policymakers working on systemic change. The author, President of New Jersey’s Nicholson Foundation, notes that out-of-state trips are very effective in fostering new perspectives on problems and finding innovative solutions. “The Nicholson Foundation is dedicated to addressing the complex needs of […]

Next CEPAC meeting taking a deep dive into effectiveness of palliative care

The March meeting of CEPAC, New England’s comparative effectiveness council, will be in Hartford, CT on the 31st. CEPAC is an independent council of clinicians, academics and consumer advocates across the region who take a deep dive into research around treatments for specific conditions, sorting out and voting on clinical effectiveness, but also which are […]

Medicaid and free care – Public Health Law Webinar

Join our partners at the Network for Public Health Law for a webinar Jan. 21st at 1pm on how Medicaid can now cover community services that are usually provided for free. The new rule, published by HHS a year ago, replaces guidance that prohibited Medicaid paying for “free care”. This webinar will be helpful for […]

Health care is expensive for American households, but less than housing or transportation

In 2013 Americans of all ages devoted more of total household spending to housing and transportation than health care, according to the Bureau of Labor Statistics. For most age groups that year, health care spending was also behind food and pensions/Social Security. Spending on health care peaked for ages 65 to 74 at $5,188/person; children spent […]

New Health Affairs issue focuses on high-cost, high-need patients, ACA and Medicaid expansion impacts

CSG-ERC policymakers will find a wealth of helpful information in this month’s Health Affairs issue. Several papers address the challenge of caring for high-cost, high-need patients, a significant problem for state budgets that we tackled in an ERC webinar with Clemons Hong last year. Issues and findings in Health Affairs include substance use, supportive housing […]

Medicaid tobacco cessation effectiveness varies between states

An article in this month’s Health Affairs finds that while all state Medicaid programs cover smoking cessation services, there are significant gaps between states. Smoking is the leading preventable cause of disease and Medicaid members are almost twice as likely to smoke as the average American. The Surgeon General estimates that 15% of Medicaid spending […]

Teen birthrates dropped across ERC region last year

New data on births rates from the CDC finds that last year the CSG-ERC region had significantly lower teen birth rates than the rest of the nation, with the exception of Puerto Rico. In both 2013 and 2014, Massachusetts had the lowest teen birth rate both in the region and across all states. Nationally the […]

British medical humor for the holidays

Formerly known as the British Medical Journal, the BMJ Christmas issue is out with critical additions to the scientific literature such as a study of doctors’ coffee purchasing at work (surgeons drink the most, hierarchical position is positively correlated with high consumption and generosity in paying for others’ coffee) and the growing frequency of quotes […]

New England Governors’ letter urges Congressional leaders to expand opioid treatment workforce

All six New England governors signed a letter yesterday to Congress urging passage of the Recovery Enhancement for Addiction Treatment Act, which would expand the types of providers available to deliver important opioid addiction medications. The six states have worked together to address the growing opioid addiction crisis. The bill would help ease long waiting […]

CSG-ERC states lead the nation in health system performance

Health systems in CSG-ERC states perform better than the rest of the US according to the 2015 Commonwealth Fund State Scorecard on State Health System Performance, with Massachusetts leading all states. States are ranked on 42 indicators such as avoidable hospitalizations, health risk behaviors, childhood vaccinations, and hospital patients discharged with information to help recover […]

2016 Medicare rates offer relief for states

Next year’s Medicare Part B premiums announced this week by the Centers for Medicare and Medicaid Services will not increase from this year at $104.90/month for most beneficiaries due to both slow spending growth and federal funding. Medicare Part B funds physician and hospital outpatient care. There will be a modest $28 increase for beneficiaries […]

CSG/ERC joins Network for Public Health Law

Joining seventeen prominent groups such as the National Governor’s Association, NCSL and the American Heart Association, CSG/ERC has joined the Network for Public Health Law as a Friend. Funded by the Robert Wood Johnson Foundation, the Network is a non-profit, non-partisan organization working to improve public health law and policy. Like CSG, the Network is […]

More health insurance options this year than last

An analysis by the US Government Accountability Office of health insurance offerings and premiums, on and off health insurance exchanges, finds more choices for consumers this year than last. Most US consumers had six or more plans to choose from across three metal tiers – bronze, silver and gold. Lowest cost plans are generally found […]

CSG ERC health panel focuses on innovations

Today’s Health Policy panel at CSG/ERC’s Annual Meeting focused on health care innovations that build value and building a workforce to support that transformation. Pam Price, former Delaware House staff, expertly moderated the breakfast session.   We heard from Heidi Louise Behforouz, MD of AnansiHealth and Brigham and Women’s Hospital about the value of including […]

ERC states’ Medicare hospital readmission rates vary

According to Kaiser Health News, two thirds of hospitals in the CSG/ERC region will face Medicare penalties because of high readmission rates. This is the fourth year for the program that penalizes hospitals for the percent of Medicare patients with certain conditions who return to the hospital within 30 days. This year’s penalties will begin […]

Annual Meeting Health Committee Panel — Developing a Health Care Workforce to Reach the Triple Aim

Reaching the Triple Aim of health care – improving population health, improving consumers’ experience of care and satisfaction, and controlling costs—will depend on the strength of the people delivering health care in hospitals, medical homes, doctor’s offices and the community. Join us at CSG/ERC’s annual meeting in Wilmington DE August 16 to 19. At our […]

Three CSG/ERC states lead nation in heath price transparency

All but five states nationally earned an F grade for public reporting of health prices according to Catalyst for Health Care Reform’s 2015 Report Card on State Price Transparency Laws. However, three of the five states were from CSG’s Eastern region – Maine, New Hampshire, and Vermont. The report assesses state laws, regulations and public […]

Best practices guide on integrating behavioral health into primary care for New England

Up to 70% of physician visits involve a mental health issue and health care costs for people with mental health issues are often up to three times higher than other patients with similar conditions. CEPAC, New England’s comparative effectiveness council, has published their latest guide featuring best practices for integrating behavioral health services into primary […]

ERC states vary in Medicaid enrollment since ACA

Medicaid expansion has had varying effects on enrollment across CSG/ERC states. Under the Affordable Care Act, as of January 1, 2014 states have the option to expand Medicaid eligibility for all low-income Americans, regardless of age or family circumstances. Federal funds will reimburse states for all the costs of care for newly eligible members through […]

Webinar highlighted best practices for state exchanges, power of state-state collaboration

Wednesday’s webinar highlighted just a few of the benefits of the collaboration between CT and MD’s state health insurance exchanges. Peter VanLoon, of AccessHealthCT, and Subramanian Muniasamy of the Maryland Health Benefit Exchange, described how sharing resources and lessons between their states has helped both exchanges improve over the last two years. Well beyond technical assistance, collaboration also touched on […]

Webinar: Health Insurance Exchanges – States Sharing Resources, Solving Problems

Join CSG/ERC’s health policy committee for a webinar May 20th – Health Insurance Exchanges – States Sharing Resources, Solving Problems. We’ll hear from Peter VanLoon, from Connecticut’s health insurance exchange, describe opportunities to assist other states with their exchanges. Depending on how the Supreme Court rules in King v. Burwell this summer, eight million residents of states now using […]

ERC states’ employer coverage eroded since the recession, well before ACA implementation

A new report finds that declines in employer-sponsored coverage across the CSG/ERC region occurred since the 2008/9 recession, well before implementation of the Affordable Care Act. Mirroring national trends, after the recession both employers and workers in the region moved away from coverage in the four years after the recession. ERC states averaged 1.2% gains […]

Survey contrasts wellness plans between US and Canadian businesses

Responding to rising chronic illness rates and poor health habits among workers, 82% of all US and Canadian employers, and 90% of public employers, have embraced workplace wellness initiatives to improve the health of their employees, according to a new survey by the International Foundation of Employee Benefit Plans. Public employers surveyed included state, municipal, county, federal and university workers. […]

Senate HELP Committee Passes No Child Left Behind Rewrite,  Returns More Control to the States and Reaffirms Commitment to Supporting Underserved Students

The Senate Committee on Health, Education, Labor and Pensions passed its draft of the Elementary and Secondary Education Act (“No Child Left Behind” or NCLB) reauthorization as the “Every Child Achieves Act” unanimously on Thursday. Like the House’s version, “Student Success Act” (passed earlier this year by the House Committee on Education and Workforce Development, […]

New report outlines ACA state innovation waiver opportunities

Starting in 2017, under the Affordable Care Act, state policymakers have an opportunity to apply for a State Innovation Waiver allowing small to radical health reforms that are designed for individual state’s context and preferences. Under the Section 1332 waiver, states can modify benefit and eligibility rules, subsidies, state insurance marketplaces, and employer and individual […]

US physicians 16% less likely to accept new Medicaid patients than privately insured; Wide variation across CSG/ERC region

A new analysis by the Centers for Disease Control finds that 68.9% of US office-based physicians accepted new Medicaid patients in 2013, while 84.7% accepted privately insured patients. In CSG/ERC states that gap was lower at 13.4%, but there was wide variation between states. Delaware, Maine, New Hampshire, Pennsylvania and Vermont physicians were significantly more likely to […]

Connecticut, National Groups Issue Reports on English Language Learners

In response to concerns about the performance of Connecticut’s English Language Learners (students whose first language is not English and have limited English proficiency), who earned the lowest rates of proficiency and average scaled score on the NAEP in the country, prompted Speaker of the House Brendan Sharkey (D-Hamden) to appoint the English Language Acquisition […]

HHS creates a Payment Reform Learning and Action Network to support value-based reforms

March 25th President Obama and HHS Secretary Burwell launched the Health Care Payment Learning and Action Network with a live-streamed announcement. In his remarks, the President highlighted Delaware Governor Markell and that state’s commitment to move 80% of state health purchasing into value-based models. The Network is a collaboration of states, providers, payers, consumer groups […]

New regional policymaker guide for choosing most cost effective coverage options for opioid addiction treatments

As we learned in a standing-room only plenary session at last year’s CSG/ERC Annual Meeting in Baltimore, opioid addiction rates have skyrocketed in recent years, taxing the capacity of treatment programs across the ERC region and beyond. We also heard from the New England Comparative Effectiveness Public Advisory Council (CEPAC) about exciting new research comparing […]