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Report: Montana Medicaid reduced ER visits, charity care, leaned into telehealth

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A groundbreaking examine launched Thursday confirmed that a lot of Montana’s best hopes about how Medicaid growth may benefit the state have turned out to be true, and in some circumstances, higher than anticipated.

The report, commissioned by the Montana Healthcare Basis, performed by Manatt Well being, demonstrated that reliance on emergency room for medical care fell considerably, hospitals and healthcare techniques noticed the quantity of uncompensated charity care drop, and the state spent much less of its funds than neighboring or comparable states on healthcare.

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“Enhancing well being is a sophisticated, expensive activity, however the findings are actually important,” stated Dr. Aaron Wernham, the CEO of the Montana Healthcare Basis.

Among the many most notable discovering was that after a 12 months of being lined by the Medicaid growth, ER visits fell by 14 %. That’s necessary as a result of one of many key promoting factors to lawmakers and the general public has been to lower journeys to the emergency room, the place it’s typically extra expensive and resource-intensive to deal with sufferers. The speculation went that by increasing Medicaid and medical health insurance typically that sufferers would go to healthcare suppliers earlier than sickness or continual circumstances developed right into a disaster or emergency medical state of affairs.

Wernham advised the Each day Montana that the examine is likely one of the first of its form to precise present arduous information to recommend that’s the case. The report, “Medicaid in Montana,” is the group’s second annual report on the subject.

Nevertheless, Wernham stated it’s necessary for his group to trace the impression of the growth in order that each leaders and residents understand how the expensive, complicated program could also be working or what different options could also be wanted.

Not an emergency

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Greater than 278,000 Montanans are insured by Medicaid. And the info collected via the Basis, Manatt and the Division of Well being and Human Providers reveals that “enrollee use of the emergency division decline annually they have been enrolled.”

“These outcomes provide a robust validation of the Legislature’s core causes for increasing Medicaid,” Wernham stated. “They didn’t need individuals going to the emergency room when there was one other division.”

Largely, the pattern strains proves that Medicaid growth enrollees are going to different departments because the variety of journeys to the emergency room falls. The report reveals a continued pattern line of fewer visits the longer a affected person has entry to different companies.

Montana pioneering telehealth

Wernham credited Montana leaders for pioneering and main the cost to embrace telehealth and telemedicine, particularly through the COVID-19 pandemic. He stated that by writing into legislation the reimbursement for telehealth, lawmakers gave the added nudge to healthcare suppliers who have been considering including it.

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“We’ve talked loads about this as an answer for a very long time, however due to the pandemic, suppliers jumped into it and other people used it,” Wernham stated.

Telehealth’s success, as captured by the report, produced numbers which might be nearly arduous to fathom. Behavioral telehealth visits since 2019 have risen by 2,817 %.

“In 2021, the Montana Legislature handed and the governor indicators a invoice to make these momentary telehealth measures everlasting, institutionalizing new entry to service for rural Montanans,” the report stated.

Montana Gov. Greg Gianforte, the previous tech business developer, praised the choice.

“Telehealth companies are remodeling how care is delivered in Montana, notably in our frontier and rural communities,” Gianforte stated.

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Montana spends lower than most different states

The proportion of Montana’s general state common fund spending on healthcare dropped and was considerably decrease than that of neighboring states. Notable is that different states like Wyoming and South Dakota, which haven’t accepted Medicaid growth, are spending much more state cash on healthcare than Montana.

Montana solely spends 12 % of its state common fund.

By comparability, the U.S. spends 18 % on common, whereas South Dakota spends 20 % and Wyoming doles out 17 % %.

“Montana had the ninth lowest price of state common fund spending on Medicaid,” the report stated.

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In its comparisons, solely Oregon had much less at 9 %.

When Medicaid growth was handed in Montana, some lawmakers frightened that by providing this system at no cost, or enormously diminished, would merely encourage residents to make use of this system excessively or present an incentive for staying on it.

Nevertheless, statistics collected by the muse present that as of July 2021, enrollees have been contributing greater than $430,000 per thirty days towards premiums, and most stayed on this system for lower than 24 months.

“(The) protection was typically not accessible to them via their employers,” the report stated. “Half of the state’s Medicaid growth inhabitants (able-bodied adults) was enrolled for lower than two years between 2016 and 2020.”

Medicaid growth enrollees contribute premium funds equal to 2 % of their family incomes, and people funds proceed to extend, the report discovered.

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Substance abuse programming

Wernham stated one other key discovering was that for the reason that growth, the variety of substance abuse applications has greater than doubled, and funding has elevated much more.

He stated that suppliers usually tend to spend money on programming as a result of there’s a steady funding stream. That change has meant extra programming, and extra alternatives in rural elements of the state.

“Federal and state Medicaid funds accessible to assist substance use dysfunction prevention and remedy have quadrupled since Montana’s Medicaid Growth,” the report stated.

The report discovered that lots of the applications helped to determine a stronger framework of community-based care.

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“This was a lifeline for sufferers as an entire,” Wernham stated.

Detecting severe circumstances

Lastly, Medicaid growth additionally performed a key function in detecting severe well being circumstances, like breast most cancers and colon most cancers, earlier due to pre-screening.

Although pre-screening decreased in 2021, possible because of issues about COVID in healthcare settings, in 2020, the screenings lined by Medicaid discovered 65 circumstances of breast most cancers and 770 doubtlessly averted circumstances of colon most cancers.

From uncompensated to compensated

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In its first 12 months, hospitals all through the state had reported a drop within the uncompensated charity care. Due to federal legislation, hospitals could not flip away sure sufferers in want of care. But, due to the dearth of insurance coverage, many hospitals and healthcare facilities have been compelled to jot down off the care as “uncompensated charity care.” This created a monetary disaster for a lot of smaller, rural healthcare facilities, which couldn’t make up the distinction.

Nevertheless, nearly as quickly as Medicaid expanded, the quantity of uncompensated charity care began dropping, being changed by Medicaid reimbursement charges. Whereas many suppliers and healthcare techniques stay involved concerning the quantity of reimbursements masking the price of offering healthcare, the issue has enormously improved, Wernham stated.

The state can also be in the midst of a reimbursement price examine that may look at the function charges are enjoying within the healthcare subject.

“Hopefully, it will assist the state work out if charges are sufficient to recruit suppliers and retain them in state,” Wernham stated.

In 2015, Montana’s uncompensated healthcare prices approached $400 million. By 2020, that quantity had dropped to $180 million.

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In that point, not one rural hospital in Montana has closed, Wernham famous, whereas many different rural hospitals in different states have closed.

That’s much more vital in rural Montana, the place not solely hospitals however cities may be miles and miles away.

Uncompensated charity care dropped from $64 million amongst Montana’s rural hospitals in 2016 to $35 million in 2020, a lower of greater than 40 %.



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Montana

University of Montana graduate students from new union, one of largest in state • Daily Montanan

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University of Montana graduate students from new union, one of largest in state • Daily Montanan


Graduate students at the University of Montana in Missoula have formed a union after two years of organizing, and with more than 400 eligible members, it will be one of the largest in the state.

The Department of Labor and Industry certified the UM Graduate Employees Union last week, according to the Montana Federation of Public Employees.

“Our organizing message was simple,” said Colette Berg, an organizing lead and UM graduate employee, in a statement from MFPE. “Graduate employees’ wages, benefits, and working conditions aren’t keeping up with Missoula’s cost of living or honoring our roles in research, teaching, and learning. Everyone realizes we’re a lynchpin for UM, and we look forward to bargaining collectively with UM’s leadership to collaboratively address the challenges GEU members face.”

The labor movement has been active in the U.S. in recent years, including in Missoula, where the cost of housing has far outpaced wages. However, the proportion of workers who belong to a union has generally declined in the country during the last couple of decades.

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Graduate students are especially difficult to organize because they are spread across a campus and work on different contracts that can range from two to five years, according to the Montana Federation of Public Employees.

According to the Montana State University Graduate Employee Organization in Bozeman, they’re also not easy to sustain. The Graduate Employee Organization counts 169 members.

MSU Graduate Employee Organization President M Wittkop said a graduate student union has challenges that are different from other locals. That’s because a campus union is made up of students — whose members by definition are constantly graduating and moving on.

MSU graduates formed their student union in 2015, according to the Office of the Commissioner of Higher Education. Bozeman also has notoriously high housing costs.

A report from an April 2024 graduate union assembly in Bozeman said the local will need new members in order to avoid dissolution. However, Wittkop also said the union has driven significant wins for its members, including in 2023.

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“We got one of the biggest raises across the board for all graduates,” Wittkop said.

The increase amounts to roughly $100 more a month for the minimum allowable stipend a graduate student can be paid, or currently $760 a month, they said. The minimum will go up another $100 on Aug. 1.

“We also put in more strict limits on how many classes a TA (teaching assistant) can be assigned and changed language around work environment to protect students against ‘PI abuse,’” Wittkop said.

(That’s the potential abuse of power a thesis advisor or PI, a principal investigator, might enact over a student, they said.)

The graduate union also completed a cost of living survey, which among other things, showed 45% of respondents had skipped “necessary medical care” to save money, and 46% had skipped meals or eaten less to save money.

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Additionally, the survey found 57% of graduate students needed second jobs, such as pet sitting, while in school. Of 826 graduate assistants, 184 responded to the 2024 survey, according to the union.

Wittkop said they believe the union has the potential for longevity if it can find new members, but the current challenge is broadcasting its existence.

“We’re going to have to really put in the work to find these people,” Wittkop said.

The Montana University System already counts 23 collective bargaining agreements covering roughly 2,374 people of an estimated 9,000 total employees, according to the Office of the Commissioner of Higher Education. That doesn’t include the new union at UM.

Faculty at the Bozeman campus formed a union that was approved in 2011 but then decertified in April 2013, according to the Commissioner’s Office.

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At UM, a faculty union and classified staff union have long been active, and MFPE President Amanda Curtis said the organization looks forward to supporting the new graduate student union as well. Berg could not be reached for additional comment.

“We are so proud of the graduate employees at UM who have now organized and certified Montana’s largest new union in years,” Curtis said in a statement. “Their commitment to ensuring graduate employees have a strong voice in their working conditions and wages is what unionism is all about.”

A couple of years ago, the Missoula Tenants Union formed in the Garden City, and nurses at Providence St. Patrick Hospital recently — and visibly — renegotiated their contract; signs advocating support for the nurses popped up across the community.

The Montana Federation of Public Employees said collective bargaining at UM has been marked by a respectful and fair relationship between union members and university leadership for decades.

In an email, UM spokesperson Dave Kuntz said the university worked with the Department of Labor and Industry and the Commissioner’s Office throughout the process — clearly defined in statute — with graduate students.

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“Graduate students are critical to UM,” Kuntz said in an email. “Their scholarship, research, and teaching help to advance our entire state and address many of the most pressing issues facing society.”

The labor movement has been historically strong in Montana. Last year, roughly 13% of workers were represented by a union compared to roughly 10% of those in the U.S., according to U.S. Bureau of Labor Statistics.

The news release from Montana Federation of Public Employees said the state certified the new Graduate Employees Union at UM on June 25, and it is MFPE’s newest local with “full collective bargaining rights to secure a fair contract.”



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Top stories from today's Montana This Morning, July 3, 2024

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Top stories from today's Montana This Morning, July 3, 2024


Top stories from today’s Montana This Morning, Wednesday, July 3, 2024 – Latest local news and headlines from across the world.

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How Trump works with the RNC to fit his MAGA agenda

How Trump has molded the RNC to fit his MAGA agenda

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Visiting state lands on the 4th? Here’s what you need to know before you celebrate

Visiting state lands for the 4th of July? Here are some simple rules to remember

Gas prices lower this July 4th

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Gas prices lower this July 4





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New Montana law requires government boards to record public meetings

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New Montana law requires government boards to record public meetings


A new law went into effect on July 1, requiring government boards to record public meetings by video or audio.

The goal is to encourage public participation and provide greater transparency.

House Bill 890 drew some opposition at the state legislature last year, but it looks like boards around Montana have found reasonably priced equipment and are ready to post those meetings online.

Some boards such as the Yellowstone County Commission have already been posting recordings of regular meetings and discussions.

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“It’s a right for everybody to be able to see what happened,” said Commissioner Don Jones, R- Yellowstone County. “And you know what we were talking about and our thought process.”

Jones supports the idea of HB 890 which states in its title that it provides for increased transparency and accountability.

“Our constitution has made it very clear that the Sunshine Laws need to be there to let the public have that opportunity, see what we’re doing,” Jones said.

The Montana Association of Counties (MACO) wanted the requirement to be optional.

“We want to follow the law,” said Commissioner Ross Butcher, Fergus County. “We want to do it appropriately. But when it’s ambiguous, that’s difficult.

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Butcher is the MACO president and says it’s not clear what constitutes a meeting.

As chair in Fergus County, he says commissioners have figured out what meetings to record.

“I do think it’s easy enough to just look at it and say, listen, any meeting that you’re going to agenda-dize and follow the steps of an open meeting, then you probably should record it,” Butcher said.

The law applies to the Board of Investments, the public employees retirement board, teachers retirement board, the board of Regents, county commissions, city councils, school boards and county boards of health.

“Concern about the level of distrust and the lack of civility in our public discourse, first off,” said Rep. Brad Barker, R-Carbon County. “Second thing is it supports Montana’s constitutional right to know. And the third is we have the technological means.”

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The Canyon Creek school board and the County Water Board of Billings Heights board are among those ready to record meetings.

“I don’t think any of us have a problem with transparency,” Butcher said. “I think it’s a good thing.”

“It should be beneficial if people want to get engaged and I encourage everybody to get engaged in their local government,” Jones said.





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