Hayes for Maine | Independent for Governor

Healthcare

The Hayes Administration will work with stakeholders to devise a public health plan for Maine, drawing on successes from Maine’s business community to educate and motivate individuals to live healthier lives.

HEALTHY & WELL

All Mainers deserve healthcare that is accessible and affordable, yet healthcare costs here are among the highest in the nation and are rising faster than the national average. Maine’s percentage of uninsured at 11.6% is more than double the New England average of 5.3%. Without affordable access, a rising percentage of Mainers are missing or delaying essential medical and dental care until a crisis develops. Addressing crises in healthcare is taking a bigger bite out of family and state budgets.

Spending more on healthcare doesn’t mean Mainers are getting healthier – in fact, it often means the opposite. If we were healthier overall, Maine could spend less on healthcare. We can reduce what we each pay individually for our own care – and what we pay collectively – if we help people stay healthier and prioritize preventing chronic disease before it starts.

The Hayes Administration will work with stakeholders to devise a public health plan for Maine, drawing on successes from Maine’s business community to educate and motivate individuals to live healthier lives.

LOWER COSTS AND INCREASE THE REIMBURSEMENT RATES

Right now, we face two significant challenges: health insurance is too expensive and too many people don’t have access to the care they need. With leadership from the Governor’s Office, we will get healthcare right, and that means providing universal access to quality and affordable healthcare. Our failure to get this done puts bigger and bigger barriers in the way of employers who often shoulder higher and higher insurance premiums and Mainers who want to enter the labor force or get a better job.

UNIVERSAL BASIC HEALTHCARE FOR MAINERS

The path toward universal basic healthcare requires collaboration with Maine businesses, community leaders, healthcare providers, hospitals, nursing homes, patient advocates and policy experts to map out how we can get there from here. Whether it is through offering a public option to uninsured Mainers by opening up the health plans offered to state employees or MaineCare to those who wish to purchase coverage through the healthcare exchange or by pressing for a collaborative single payer solution with our New England neighbors, the goal is to increase coverage while lowering costs. The details of such programs are critical and require careful consideration, including how they will be funded.

The Hayes administration will implement the will of Maine voters and will accept the federal funds available under the Affordable Care Act (ACA) to expand MaineCare. This will provide insurance coverage to nearly 70,000 of our working poor, and in turn these Mainers will be able to access regular doctor’s visits, vaccinations, and other forms of preventive care as well as addiction treatment and counseling.

At the same time, the Hayes administration will take full advantage of the ACA’s opportunities to muscle down on costs through innovation, expanding access to more cost-effective home and community-based services, and focusing on wellness, prevention, and quality of life.

For example, Oregon improved the coordination of all types of healthcare providers (physical health care, addictions and mental health care) under Medicaid, and generated $2.2 billion in state and federal savings. Arkansas’s multi-payer model bundled most of the state’s insurance payers, including Medicaid, private insurers, and large employers, and saved $35 million after factoring in care coordination payments to providers and shared savings to providers.

MENTAL HEALTH

As the daughter of a woman who spent more than seven years as an inpatient at the former Augusta Mental Health Institute, the wife of a clinical social worker, and the sister of the Westbrook Chief of Police, Terry understands the importance of effectively addressing the treatment needs of those who experience brain diseases and behavioral health disorders, and to do so in appropriate settings.

Currently, our mental health system is setting up children and families for failure. We spend over $100 million in state dollars each year towards this effort, but we aren’t meeting the needs of those suffering from behavioral issues and we don’t have a strategic plan. Some diseases affecting mental health are chronic and need to be detected early and managed over a lifetime. We need to shift Maine’s focus in mental health care away from crisis management and emergency care and in the direction of screening, prevention, recovery, access and ongoing availability of evidenced-based care.

ORAL HEALTH

The integration of oral health with overall health is also critical to early intervention and prevention of disease. According to the Health Policy Institute, the number of emergency department (ED) visits for dental conditions in the United States continues to rise. In 2012, ED dental visits cost the U.S. healthcare system $1.6 billion, with an average cost of $749 per visit. In Maine, dental problems are a top reason for ED visits among poor residents.

Maine voters approved a $5.5M bond in 2010 to help create the dental school at University of New England in Portland. The first class of dentists graduated in 2017 and eleven of the graduates stayed in Maine. Each year we will benefit from this investment with additional dental professionals available to help Mainers.

The reimbursement rates for dental care within Mainecare are too low. Maine dentists can’t afford to treat Mainecare patients and cover operating costs. We must address this financial gap in order to solve the access to dental care issue for Mainers who do not have dental insurance.

REPRODUCTIVE HEALTH

Terry supports reproductive freedom for women. The Hayes Administration will oppose federal and state efforts to restrict or to cut funding for women’s health care and Terry is committed to preserving women’s ability to access contraception through providers like Planned Parenthood. Terry will also oppose attempts to directly or indirectly restrict access to safe and legal abortion, regardless of whether women are insured privately or are MaineCare clients.

OPIOID EPIDEMIC

We must recognize the opioid epidemic as a public health emergency. Approximately one person per day is dying from a drug-related overdose, most of which are caused by opioid use. According to the American Enterprise Institute, the opioid epidemic is costing Maine the fifth-highest share of state GDP in the nation.

The opioid epidemic is an all-hands-on-deck crisis as there is a lot to unpack. Substance abuse disorders must be approached as a complex, multidimensional problem by funding prevention, effective treatment, and wraparound services including medical services, housing, employment, food, and basic household needs. Getting to the root of the problem requires bringing all stakeholders to the table as we carve our path forward.

Stemming the tide and consequences of dependence and abuse will be a top priority of the Hayes Administration. We will start with a campaign to eliminate the stigma attached to addiction and focus on making treatment available ‘upon demand’.

PAY FOR THINGS THAT WORK

The State is a direct purchaser of more than one-third of all Maine healthcare services, delivered through the mechanisms of MaineCare and via insurance coverage of its employees. These public dollars represent an enormous opportunity to advance statewide delivery, measure outcomes and advance efficiencies to make sure we’re getting the best bang for our buck.

INCREASE TRANSPARENCY

Maine’s healthcare system needs to be more transparent. Patients should understand how much their healthcare costs and why. We can make sure consumers have the information they need to make smart decisions about their own healthcare.

LOWER PRESCRIPTION DRUG COSTS

People across Maine face prohibitive prescription drug expenses. Through smarter buying and evaluating whether certain drugs are worth the price, Maine can follow the lead of New York and Massachusetts by demanding fair pricing and discounts from drug makers. For example, New York identified 30 drugs just this year that were priced too high, and those drug manufacturers agreed to deep discounts, resulting in about 60 million dollars in annual savings.

STRENGTHEN THE RELATIONSHIP BETWEEN PATIENTS AND THEIR DOCTORS

All Maine citizens deserve assurance that they will have a medical home so that together with their physicians they can better manage their chronic conditions at lower costs and with improvements in both quality and quantity of life. Recent studies show that strong relationships between patients and their primary care providers can decrease medical costs (even for the sickest patients) and increase patient health.

TAKE ADVANTAGE OF THE NEW INCENTIVES UNDER THE CHRONIC CARE ACT TO HELP SENIORS STAY IN THEIR HOMES

By beefing up Maine’s internet connections to community anchor institutions such as hospitals, assisted living facilities, nursing homes and healthcare clinics and behavioral health providers, Maine will be better able to meet the routine challenges faced by our rural aging residents by providing state-of-the-art telemedicine and, more specifically, telepsychiatry, that can help to stretch our resources over our vast geography and keep seniors in their homes.

Maine will take advantage of expanded reimbursement under the Chronic Care Act recently passed by Congress. The Act provides new financial incentives for the use of telehealth services and allows for homecare social services such as visits by a personal assistant to help with bathing and dressing; visits by a nurse or a pharmacist to make sure a Medicare beneficiary with a dozen prescriptions is taking the right medicines; and special supervised housing for a person with dementia who cannot be left alone.

BOOST MAINECARE REIMBURSEMENT RATES FOR HEALTHCARE PROVIDERS

The current level of MaineCare reimbursement rates and the inability of the Maine Legislature to fix this problem is creating a crisis for families and providers across Maine. Maine has set the MaineCare reimbursement rate for hospitals at a rate that covers about 72% of the actual cost of treating these patients in a Maine hospital. The resulting underpayments shift costs to commercial payers and contributes to almost half of Maine hospitals operating with negative operating margins and potential nursing home closures.

This system of persistent under-reimbursement is unsustainable. The Hayes administration will work with all providers and with the Legislature to devise solutions that lower the overall costs and increase the reimbursement rates.