HARTFORD, Conn. - The Connecticut Department of Public Health is hard at work trying to secure up to $70 million in Affordable Care Act money to help the state revolutionize the way health providers get paid.

The big idea behind the Affordable Care Act funding is to devise a payment system that makes quality the priority, says Jill Zorn, senior program officer at the Universal Health Care Foundation. That represents a major shift from the current payment system for most health-care providers in Connecticut and the nation, she says, in which their fees are based on volume.

"Hospitals get paid per test, per admission, and many experts agree that we need to transition to a system that pays for outcomes - and pays for quality."

It's a big job. That's why the Affordable Care Act will award the state $70 million if it comes up with a winning application. Zorn says the Universal Health Care Foundation and the Connecticut Health Foundation matched a grant from Grantmakers in Health to give the state $45,000 to hire a team of specialists to apply for the federal dollars.

Jeanette DeJesus, who advises Gov. Dannel Malloy on health issues as director of the state Office of Health Reform and Innovation, says a winning application needs to reflect the views of all of the players in the health-care system.

"You're basically looking at completely revolutionizing the way that the health system currently functions. So, you need the insurers in the room at the table, you need the providers - the doctors, the nurses, the assistants."

DeJesus says the tricky part is devising a payment system that incorporates the various roles of doctors, nurses, hospitals, insurers and nonprofits.

"Where you can integrate the type of work they do in order to keep you really healthy, or improve your health; and then for the doctor and the practice to be reimbursed for keeping you well, and for eliminating waste in the system."

Dejesus says the state should learn the fate of ACA funding by early December.

More information is online at healthreform.ct.gov.


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Many Mississippians could see higher credit scores if a rule proposed by the Consumer Financial Protection Bureau goes into effect.

The proposal would effectively remove medical bills from credit reports, potentially improving credit scores for millions of people. Mississippi is among the states with the highest share of adults with medical debt, at just over 15% of the population.

Kiren Gopal, senior counsel for the Consumer Financial Protection Bureau, said the rule would prohibit lenders from considering medical bills when making credit decisions, such as for car loans or small business loans.

"Right now, 15 million Americans still have almost $50 billion worth of outstanding medical bills on their credit reports," Gopal explained. "It's punishing them by blocking them from really important life opportunities like buying a home, for example."

The Consumer Financial Protection Bureau is taking public comments on the proposal through Aug. 12, online at regulations.gov. Gopal added they are working toward a final rule to take effect in 2025.

Gopal pointed out the bureau published research last year showing people in Mississippi are considerably more likely to have a medical collection listed on their credit report, compared to consumers nationally.

"Nationally, we see about 17% of consumers have a medical collection on their credit report, whereas in Mississippi, it's 22% respectively," Gopal reported.

He added if the new rule is enacted, people with medical debt on their credit reports would see their credit scores rise by 20 points, on average. Overall, it could lead to about 22,000 additional home mortgage applications being approved each year.


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Virtual healthcare gained steam during the pandemic, by allowing doctors to reduce in-person contact and still render services to patients.

And while social restrictions have eased, the convenience of remote visits remains popular.

Family Physician and Community Health Network Medical Director for Telehealth, Dr. Stephanie Russ, said there are three different types of appointments.

Electronic questionnaires - or e-visits - communicate health concerns to a medical provider, telehealth services are phone-only visits, and video visits are face-to-face appointments.

"It's really been nice for patients because of the convenience," said Russ. "They don't have to take off a day of work. They don't have to wait in the doctor's office. Usually, the wait times are much less for telehealth than what it is in person."

Russ said while the pandemic drove utilization, doctors continue to see increased usage.

Another benefit is the availability of health services for rural areas that lack access to an in-office physician.

A 2020 Indiana University Center for Rural Engagement report finds that 29 Indiana counties had a shortage of primary healthcare services.

Most insurance companies cover virtual visits. Patients with common summertime infections - such as swimmer's ear, pink eye, and allergies - can download pictures for their virtual appointments.

Despite the convenience and time saved with remote visits, Russ cautioned that specific conditions require an in-office visit.

"Acute abdominal pain, chest pain, shortness of breath," said Russ, "anything that would be considered more emergent would not be appropriate, or anything where the provider needs to be able to listen to your heart and lungs or do a physical exam. "

Russ said medical providers can only practice in the state that they're licensed in and most telehealth options offer multi-state providers to assist patients who are traveling or in different locations.

According to the site Market USA, in 2022, the usage of telemedicine increased from 64% to 76% among people who are 55 years old or older.






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World Hepatitis Day is this Sunday, and for the Oregon Health Authority, it's an opportunity to promote its plan to eliminate hepatitis across the state.

Released in March, the plan includes major goals and strategies to limit the spread of hepatitis A, B and C over the next six years. It's gotten new attention after 2,400 patients in Oregon hospitals were potentially exposed to hepatitis and HIV earlier this month.

Concerns are high, but epidemiologist Dr. Dean Sidelinger, Oregon's state health officer, said people should be aware of the threats of hepatitis, but not anxious.

"In day-to-day times, people should feel safe and confident in going to the doctor," he said. "The risk of exposure to these viruses is extremely low in most cases."

Hepatitis is inflammation of the liver, and contagious viruses are among the causes. Sidelinger said he's confident Oregon has the technology and resources to fully eliminate the threat.

While many people may have heard of hepatitis, they may not fully understand how prevalent it is in their communities. According to OHA data, the proportion of chronic hepatitis C cases among people in their 20s tripled between 2010 and 2019.

Sidelinger said there's a good chance most Oregonians know someone who is affected by chronic hepatitis.

"It can seem out of the blue to be talking about hepatitis and [a] hepatitis awareness day, but this is a disease that affects many individuals," he said. "But the good news is, everyone can take steps to protect themselves."

The OHA says you can help prevent the spread of hepatitis by washing hands and fresh produce, staying current on vaccinations, avoiding sharing needles, and getting tested regularly. These tips and more are part of the state's plan to eliminate hepatitis by 2030.


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