Voters in Colorado will head to the polls this November not only to cast their ballots for the next president of the United States, but also to determine whether they will become the only state in the nation to adopt single-payer health care.

More than 20 legislators from 16 states--many of them in key leadership positions on health or budget committees that deal with Medicaid in their home states--attended a CSG policy academy in Washington D.C. on September 21-23, 2016, to learn how states are making reforms in their Medicaid program that pursue the health "triple aim": improving the quality of care for individuals, improving the health of populations, and reducing per capita costs of health care.

CSG Midwest
Before the night she suffered a severe allergic reaction that took her life nine days later, 13-year-old Annie LeGere had grown up with only minor allergy symptoms. There was no reason for her, her family or her health providers to believe she should have a prescription to an epinephrine autoinjector, the emergency treatment that can save lives in cases of anaphylaxis (a serious allergic reaction, most commonly to food).
But what if the first people often to respond to a medical emergency (including in Annie’s case) — local police officers — could carry these autoinjectors and be trained on how to administer them? The minutes saved by administering the drug on-site rather than in an emergency room could be the difference between life and death.
In Illinois, these officers now will have the opportunity, thanks to a bill passed this year (HB 4462) known as Annie’s Law. One of the leading proponents of HB 4462, Illinois Sen. Chris Nybo, worked closely on the measure with Annie’s family, which has created a foundation in her name with the goal of preventing future tragedies.
CSG Midwest
Right now in Iowa, it’s no sure bet that a child in need of mental health services is going to get them. Instead, access can depend on where his or her family happens to live. “There is no statewide system or network of care in place, and over the long term, we need to develop it because there are clear gaps,” explains Anne Gruenwald, president and CEO of Four Oaks, a Cedar Rapids-based nonprofit agency that provides a range of services for children in need.
“When you have those gaps, needs go unmet, or we have to rely on our adult system of care — and that’s not always a good fit.” Iowa appears to be taking some important first steps, thanks to the recommendations of a work group formed by the Legislature in 2015 and actions taken by lawmakers during their 2016 session. 

States are increasingly turning to community paramedicine to help fill the gap in the health care workforce. States have been experimenting with community paramedicine programs for the last five years or more. Expanding the role of licensed or certified emergency medical technicians—or EMTs—and paramedics to provide non-emergency preventive health care services directly to patients in their communities can be cost-effective and make up for health care work force shortages. 

Voters in Colorado will face a choice on the ballot this November regarding medical aid in dying for the terminally ill. The “Colorado End of Life Options Act,” or Initiative 145, is a proposal that would allow physicians to prescribe life-ending medications to adult Colorado residents who have a terminal illness with a prognosis of six months to live or less.

While technology has been a key component of medicine in the modern era, healthcare is moving towards more personalized treatments that are based on enormous amounts of data that are collected and managed in complex computer systems. Will equitable access to healthcare in the future mean not just access to medical professionals, but also access to these promising technologies that can aggregate information from multiple sources, and provide support for treatment planning?

Smartphones and digital devices are no longer just for entertainment or work. Hospitals and doctors’ offices are experimenting with how “smart” devices can support health. How prevalent is broadband access across the states? What is the prevalence of smartphones and wearables like FitBit to log data? To what degree do patients interact with their healthcare providers through technology today?

A record number of ballot initiatives regarding marijuana have been proposed this year. According to Ballotpedia, nine states have initiatives concerning marijuana on the ballot this fall. Arizona, California, Maine, Massachusetts and Nevada are considering initatives to legalize recreational marijuana, while Arkansas, Florida, Montana and North Dakota are voting on legalizing medical marijuana.

On August 16, the insurance giant Aetna announced that it will be withdrawing from insurance exchanges in 11 states beginning in 2017.  This move comes on the heels of the decision by Humana and United Healthcare to substantially reduce the number of states in which they offer coverage.

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