Healthcare News of Note: Which states offer their residents the best hospital-based healthcare?

• Pennsylvania was ranked the best state for healthcare in the United States, according to a NiceRx report.
• Fewer than half of 180 public health officials were confident that their jurisdiction was prepared for the launch of the nation’s new mental health hotline.
• A newly proposed rule change by the Biden administration could bring relief in 2023 for some Americans who find themselves ineligible for Affordable Care Act subsidies due to the “family glitch.”

Over the last few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.  

1. Pennsylvania ranks as the state offering the best healthcare, according to NiceRx rankings

Pennsylvania led the states offering the finest hospital-based healthcare in the country as computed by NiceRx using five factors to determine state healthcare scores. Illinois, Ohio, Michigan and Massachusetts rounded out the top states for healthcare, per the report.

Criteria included number of hospitals on the U.S. News Honor Roll, number of hospitals in Healthgrades’ “America’s 50 Best Hospitals,” percentage of hospitals with an “A” safety grade from Leapfrog, and numbers of hospitals and staffed beds per million residents.

Pennsylvania was listed as the “best state for healthcare in the United States, with a state healthcare score of 8.04,” wrote the report authors. “Pennsylvania has some of the best hospitals in the US, with 1 hospital on the honor roll and 4 within America’s Top 50. Pennsylvania also has an impressive 2671.5 staffed beds and 13.8 hospitals per 1 million residents.”

Illinois placed second, with two hospitals on the honor roll and four in the top 50, earning a state score of 7.76. “Despite its somewhat lacking safety standard of just 28.5% of Illinois hospitals achieving an ‘A’ grade, where Illinois stands out is its massive 13,515.5 staffed beds per million residents, the highest on our list,” wrote the authors.

Ohio earned a 7.16 score, Michigan a 6.88 and Massachusetts a 6.48.

States with the lowest healthcare rankings

The state with the lowest healthcare ranking according to the NiceRx report is Vermont, with a score of 1.28. The other lowest-ranked states are Nevada with a 1.52, Delaware with a 1.92, New Hampshire with a 1.96 and Alaska with a 2.00.

2. Preparedness by state and local agencies is low as the debut of a national mental health emergency hotline looms

Many agencies at state and local levels are not prepared to meet an increased need for mental health services, “and policymakers and administrators will need to work quickly” to be ready before the 988 hotline number goes live July 16, according to authors of a new working paper released in June by the RAND Corporation.

A survey of 180 public health officials “responsible for helping to roll out the nation’s new 988 service” showed fewer than half were confident that “their jurisdiction was prepared in terms of financing, staffing, or infrastructure,” according to a RAND Corporation news release.

In the release, Ryan McBain, co-lead on the research project and a policy researcher at RAND, said, “Our findings have confirmed what many advocates and experts feared: communities throughout the United States have not had the time or resources to adequately prepare for the debut of the 988 hotline number.”

In conclusion, the paper’s authors wrote, “Although many reported a lack of preparedness for 988, these findings underscore specific areas for greater investment, such as infrastructure that would allow callers to connect with local services in a timely manner. The findings also highlight strengths that could be built on, such as existing mental health emergency hotlines that could be integrated as part of the Lifeline network,” which will field 988 calls.

Survey highlights

Results of the RAND Corporation survey of public health officials regarding preparedness for the 988 hotline include:

• 51% of respondents reported that they were not involved with the development of a strategic plan related to the launch of 988.
• Around 16% reported that they had a budget to support 988 operations.
• Approximately 85% reported that there was a mental health emergency response hotline or call center operating in their jurisdiction, but fewer than 50% of those hotlines were reported as being part of the Lifeline (988) network.

3. A proposed new rule could bring relief to some Americans affected by the ‘family glitch’

An April 5 healthinsurance.org article states, “The ‘family glitch’ has left several million Americans ineligible for the ACA’s [Affordable Care Act’s] subsidies. But a newly proposed rule change [by the Biden administration] could bring relief for some as of 2023.”

The article goes on to state, “The White House published a statement [April 5] indicating that they expect about 200,000 uninsured people to gain coverage as a result of the proposed family glitch fix.” In addition, coverage is projected to become more affordable under the new rules for nearly 1 million Americans who have insurance.

“Fixing the family glitch will not result in subsidies for everyone who is currently caught by the family glitch; some will still find coverage to be unaffordable,” the article states.

According to the Federal Register,  a public hearing on the rule is scheduled for 10 a.m. ET on June 27.

Family glitch background

A Kaiser Family Foundation brief from April 2021 estimates that 5.1 million people — 2.8 million of whom are children under age 18 who do not qualify for the Children’s Health Insurance Program — fall into the “family glitch.” 

“The so-called glitch occurs because the ACA prohibits people with an offer of affordable employer coverage from purchasing subsidized coverage through the ACA marketplace,” stated a KFF news release. “Under current rules, the affordability of employer coverage is based on what it would cost just to cover the worker and not their families.

“Worker-only coverage with an out-of-pocket premium up to 9.83% of the worker’s household income is considered affordable, even if the additional cost of covering their dependents would push them above that threshold.”

HFMA bonus content

Read “State of Medicare: Trustees push back projected date of Part A insolvency, but issues must be addressed,” by Nick Hut, HFMA senior editor.

Listen to a discussion about women in the workplace in this episode of HFMA’s Voices in Healthcare Finance hosted by Erika Grotto.