Cost and Financing

A new study by the Centers for Disease Control and Prevention show that helmet use decreases fatalities in motorcycle accidents and those riders that wore helmets saved society economic costs. According to the National Highway Traffic Safety Administration, riders killed in motorcycle crashes accounted for 14 percent of all road traffic deaths. Nineteen states and the District of Columbia require all motorcycle riders to wear helmets. Laws that require some motorcycle riders, generally those 17 and younger, to wear helmets are in place in 28 states. The Insurance Institute for Highway Safety provides a breakdown of specific populations covered by helmet laws per state. Partial helmet laws generally require younger riders to wear helmets and may exempt helmet use for some low power cycles.  

The majority of state Medicaid programs are testing models of coordinated medical care to improve quality and reduce costs, particularly for patients with multiple chronic illnesses.  Patient-centered medical homes are similar to managed care approaches and health maintenance organizations, but ask providers to focus on improving care rather than managing costs. Such medical homes focus on improving the relationship between doctors and patients, aim to put the patient at the center of the care system, and provide coordinated and integrated care over time and across care settings. Descriptions of eleven states’ pilot programs or authorizing legislation are included.

Quitting tobacco use improves individuals’ health, but state governments also benefit. State Medicaid programs pay an average $607 million per year in tobacco-related health care costs, and employees who quit using tobacco take fewer sick days and have lower health care costs. For every dollar states spend on smoking cessation, returns to the state average $1.26 in avoided productivity losses, direct medical expenditures and premature deaths. The American Lung Association and the Partnership for Prevention analysis of insurance coverage for smoking cessation treatment is summarized, including state by state listing of coverage in state Medicaid and state employee plans for smoking cessation, as well as statewide workplace smoking bans.

This week new federal rules were released that will require insurance plans to provide preventive health services without any co-pay, co-insurance or deductible. The move to ensure that prevention is without cost to the consumer comes from the federal health reform legislation passed earlier this year.