Mississippi Today
Lawmakers weigh possible changes to certificate of need law
A new committee convened this week at the Capitol to discuss changes to the state’s law requiring medical facilities to seek state approval before offering new or expanded services.
Health leaders said there is room to strengthen the law with reforms but cautioned against doing away with it entirely.
The law, which requires medical facilities to apply for a โcertificate of need,โ aims to lower costs and increase the accessibility and quality of health care in the state by avoiding duplication of services.
Critics argue that the law stifles competition in the state’s already sparse health care ecosystem and does little to decrease costs. Advocates say it ensures that communities have access to a range of services, not just those that are profitable for providers.ย
Nationwide, the laws have not accomplished much of what they were intended to, like increase quality or reduce costs, State Health Officer Dr. Daniel Edney told committee members on Monday.
But the law has been โextremelyโ successful at preventing health care companies from choosing only to offer only the most profitable services to patients, he said.
โWhen we’re looking at a very fragile health care framework, especially in rural areas of the state, cherry-picking can be disastrous,โ he said. โIt can be catastrophic.โ
When health centers choose to offer only services with a high-profit margin, he explained, it can draw business away from hospitals that provide services at a loss, like inpatient and emergency care. He said this applies in both rural and urban areas.
Rural hospitals in Mississippi are struggling to stay afloat. Over half are at risk of closing, and 64% are operating with losses on services. More than half of Mississippi residents live in a rural area.ย
Richard Roberson, the incoming president and CEO of the Mississippi Hospital Association, said he believes it is unlikely that removing certificate of need requirements will incentivize investment in areas of the state with the highest need for new health care services.
โWhat I suspect is you’re going to see an overproliferation of services in more commercially insured areas,โ he said. โAnd if you’re talking about folks coming in and investing money, that’s where they’re going to put it, where they can make their money back.โ
Gov. Tate Reeves has advocated for abolishing certificate of need laws in the state, arguing that it will allow more competition and innovative health care services to flourish.
Last session, a bill sponsored by Sen. Angela Burks Hill, R-Picayune, sought to repeal the state’s certificate of need law, but it died in committee.ย
Bills seeking to repeal or reform the law have become run-of-the-mill in the statehouse. Last year, over two dozen bills sought to modify the state’s certificate of need law.ย
Legislators in 2016 made several changes to the law, including shortening application review timelines and increasing capital expenditure thresholds.
States were first required to implement certificate of need laws in 1974 in order to receive funding for certain federal programs. Today, 35 states operate certificate of need programs, and 12 have repealed their laws entirely, according to the National Conference of State Legislatures.ย
Laurin St. Pรฉ, CEO of the nonprofit Singing River Health System, said that without the certificate of need law, private equity-backed companies could open health centers near existing hospitals, drawing away patients with insurance.
Hospitals with emergency departments are required to provide emergency care to patients regardless of insurance status under the Emergency Medical Treatment and Labor Act. These hospitals depend on providing services to patients with insurance to offset losses from uncompensated care.
โIf they siphon (insured patients) off, we’re not going to be able to take care of those with the most need,โ he said.
Over 10 percent of Mississippians do not have health insurance, according to data from KFF.ย
Edney said that Medicaid expansion could offset risks associated with repealing the certificate of need law by lowering the rate of people in the state without insurance in response to a question from House Medicaid Chair Missy McGee, R-Hattiesburg.
McGee authored the Medicaid expansion bill that died earlier this year.ย Mississippi remains one of 10 states in the country not to have expanded Medicaid.
โAs we close the coverage gap, that does create more revenue into the system that flows to the hospitals,โ Edney said.
Keith Norman, vice president and chief government affairs officer for Baptist Memorial Health Care, agreed.
โI believe expansion goes hand in hand with this conversation,โ he said.
Though Edney and Roberson cautioned lawmakers of the impacts of repealing certificate of need law, they agreed that reforms could improve the program.
Roberson suggested that allowing hospitals to offer dialysis services without a certificate of need would reduce patient transfers to other hospitals. Many small hospitals do not have their own dialysis centers.
He also proposed allowing hospitals to operate home health services, which would reduce rates of readmission to the hospital. The Centers for Medicare and Medicaid Services penalizes hospitals when readmissions top the national average. Hospitals in the Delta have in the past faced high penalty rates for readmissions.ย
Edney added psychiatric and perinatal care to the list of services he believed should not have to undergo the review process due to the state’s dearth of such care.
The application itself should also be reformed to prevent long, costly appeals, said Edney.
Last year, an applicant vying to provide โmuch-neededโ ambulatory care in the Delta โ a region of the state with limited health care services โ withdrew its application after its certificate of need approval was contested. He said the hospital did not have the resources to sustain a potentially years-long legal struggle.
โWe go through these long battles that are very costly, just to get to the same ruling,โ Edney said.
The State Department of Health approves 95% of certificate of need applications, he said.
Edney also suggested that lawmakers consider more vigorous enforcement of existing certificates of need, noting that some health care facilities do not follow through on the commitments made in their applications.
โWe’re lacking accountability and transparency in the CON world,โ he said.
Rep. Henry Zuber III, R-Ocean Springs, co-chair of the committee, said the group will explore a range of possibilities for certificate of need reform before drafting any legislation. The group will meet again on Sep.10.
โEverything, everything is on the table,โ Zuber said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Crooked Letter Sports Podcast
Podcast: New Orleans sports columnist and author Jeff Duncan joins the podcast to talk about his new Steve Gleason book and the new-look New Orleans Saints.
Jeff Duncan went from the Mississippi Book Festival in Jackson on Saturday to Jerry World in Dallas on Sunday where he watched and wrote about the Saints’ total dismantling of the Dallas Cowboys. We talk about both events and also about what happened in high school and college football last weekend and what’s coming up this weekend.
Stream all episodes here.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1899
Sept. 18, 1899
Scott Joplin, known as โthe King of Ragtime,โ copyrighted the โMaple Leaf Rag,โ which became the first song to sell more than 1 million copies of sheet music. The popularity launched a sensation surrounding ragtime, which has been called America’s โfirst classical music.โย
Born near Texarkana, Texas, Joplin grew up in a musical family. He worked on the railroad with other family members until he was able to earn money as a musician, traveling across the South. He wound up playing at the World’s Fair in Chicago in 1893, where he met fellow musician Otis Saunders, who encouraged him to write down the songs he had been making up to entertain audiences. In all, Joplin wrote dozens of ragtime songs.
After some success, he moved to New York City, hoping he could make a living while stretching the boundaries of music. He wrote a ragtime ballet and two operas, but success in these new forms eluded him. He was buried in a pauper’s grave in New York City in 1917.
More than six decades later, his music was rediscovered, initially by Joshua Rifkin, who recorded Joplin’s songs on a record, and then Gunther Schuller of the New England Conservatory, who performed four of the ragtime songs in concert: โMy faculty, many of whom had never even heard of Joplin, were saying things like, โMy gosh, he writes melodies like Schubert!’โ
Joplin’s music won over even more admirers through the 1973 movie, โThe Sting,โ which won an Oscar for the music. His song, โThe Entertainer,โ reached No. 3 on Billboard and was ranked No. 10 among โSongs of the Centuryโ list by the Recording Industry Association of America. His opera โTreemonishaโ was produced to wide acclaim, and he won a Pulitzer Prize in 1976 for his special contribution to American music.ย
โThe ragtime craze, the faddish thing, will obviously die down, but Joplin will have his position secure in American music history,โ Rifkin said. โHe is a treasurable composer.โ
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Insurance chief Chaney hopes Mississippiโs homeowner rates are stabilizing
Mississippi Insurance Commissioner Mike Chaney says he is hopeful that the homeowner insurance rates that have spiked in recent years are now beginning to stabilize.
Chaney said he is hopeful that legislation passed during the 2024 session that provides grants to help homeowners put more wind resistant roofs on their homes will help lower the cost of premiums. He said the Legislature placed $5 million in the program.
โWhile this will help launch the program, the Legislature will need to provide additional annual funding well above this amount so that the program can provide the necessary benefits to reach a significant number of policyholders across our state,โ Chaney said via email.
While homeowners’ insurance rates in Mississippi have risen significantly, the increases have been less than in many surrounding states, according to various studies.
Chaney said his agency, which regulates the insurance industry in Mississippi, has received requests for double digit increases.
โWe worked with companies to consider less than what their indicated need was โฆ We feel that rate pressures will begin to stabilize along with inflation. Some companies that requested rates over 15% last year are now seeing a much lesser need โ many are now in single digits,โ Chaney said.
Inflation and the frequency of severe weather causing insurance claims are the two primary reasons for the increases in the homeowners’ insurance rates, according to Chaney.
Earlier this year the U.S. Senate issued a report addressing the rising costs of homeowners insurance premiums. The Democratic majority cited weather associated with climate change as the primary reason for the increase. Republicans discounted climate change and blamed the increase on inflation.
According to data compiled by Insurance.com and updated this month, the average cost of a policy for a $300,000 home in Mississippi is $3,380 per year, which is $779 or 30% above the national average.
The cost in Mississippi, though, is lower than many other Southern states. For instance, the cost in Louisiana is 38% above the national average and 52% above the national average in Arkansas. Florida is 70% above the national average while Texas is 48%. Other Southern states — Georgia, Alabama, Tennessee and Kentucky — are below the national average.
Realtor Magazine in May cited a report from Insurify, a virtual insurance company, saying, โThe states with the highest home insurance costs are prone to severe weather events. Florida, Louisiana, Texas, Arkansas and Mississippi are vulnerable to hurricanes. Texas, Colorado and Nebraska face a growing wildfire risk. Nebraska, Texas and Kansas are at high risk for tornadoes, being located in an area nicknamed โTornado Alley.’โ
Chaney said there are two types of processes for how insurance companies get rate increases. He said Mississippi is โa prior approvalโ state where the companies must receive approval from the regulator before an increase can be enacted. Other states –file and use states โ allow the company to enact the increase before receiving approval.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
-
Mississippi News Video5 days ago
Woman arrested after reposting school threat in Calhoun County
-
News from the South - Louisiana News Feed5 days ago
Food drive underway for Hurricane Francine victims in Kenner
-
Mississippi Today2 days ago
On this day in 1925
-
News from the South - Kentucky News Feed4 days ago
The search for Joseph Couch intensifies
-
News from the South - Alabama News Feed2 days ago
Diddy Arrested In Manhattan | September 16, 2024 | News 19 at 10 p.m.
-
News from the South - Alabama News Feed4 days ago
Sylacauga Church welcomes Haitian migrants amid speculations
-
Mississippi Today2 days ago
Another Midwest drought is causing transportation headaches on the Mississippi River
-
News from the South - Florida News Feed6 days ago
Tropics update: Tropical Depression 7, 2 other disturbances brewing in Atlantic