Politics is likely to take center stage next year, with presidential, gubernatorial and senior state office elections on the ballot.
These campaigns may lead some people to take a highly political look at health policy and regulation. But there's a lot more going on in the health care industry than what lawmakers will do in the upcoming short legislative session. We track developments in mental health, the changing oral health landscape, and how Medicaid expansion impacts rural health care access, hospital revenues, and more.
North Carolina Health News plans to break down these topics and track other issues expected in 2024. Here's what reporters will focus on in each beat.
Legislative action likely to drive change in the business of healthcare
Perhaps because of the election, the General Assembly is unlikely to pass as many controversial bills as last year. Rather, all of the candidates will be focused on November. At that time, he will have to appeal to moderates and his party's supporters in the general election. We may see more extreme rhetoric leading up to the primaries in early March, but after that it is likely that candidates will retreat to the center during the general election. A lot of that depends on how competitive the district is.
Having covered Congress for more than a decade, I hesitate to make any big predictions, but it's likely that lawmakers will be done with their work sooner than during the 2023 session, which lasted until October.
We plan to track the implementation of several measures from the 2023 session – the distribution of opioid settlement funds, and how UNC Health and ECU Health will work together to improve rural health care access. Government policy for North Carolina as a result of Medicaid expansion, including how mental health care is funded with bonuses received, and how the federal infrastructure bill Many water and wastewater projects funded by federal money flowing into the state would be eliminated.
North Carolina hospitals are in the midst of restructuring. A little more than a decade ago, many small, independent hospitals dotted the region, but this past decade was a tough one for small regional hospitals. Some relief is expected in the form of hospital access and stabilization programs. $2.6 billion in federal dollars Provide assistance to more than 100 hospitals in North Carolina over the next year to help with the cost of care for low-income patients.
We will focus on issues arising from the consolidation of hospital systems and the emergence of intense competition for patients and federal funding.
— Rose Hoban
How will the new dental school affect the oral health environment?
The only private dental school in North Carolina We plan to accept the first 60 students. at High Point University this fall. Workman School of Dentistry, which broke ground in September, will add to the need for more oral health workers in North Carolina as population growth outpaces the number of dentists.
North Carolina Medical Research Institute led the special committee We looked at opportunities to transform oral health care in 2022 and 2023.
Issues that will be at the forefront in 2024 include: How to care for 600,000 people They gained access to oral health care through the long-awaited Medicaid expansion.
Only about 45 percent of dentists in the state accept Medicaid patients, and many dentists that treat Medicaid patients are not accepting new patients.
Medicaid reimbursement rates for oral health care have been stagnant since 2008. Supporters argue that unless changes are made, many new Medicaid recipients will not be able to receive regular preventive care.
This could also impact emergency rooms, where people with dental problems may end up seeking help because of infections or pain caused by delayed treatment. Oral health providers say those visits could decrease if people were able to see the dentist more often, especially in rural areas of the state.
The NCIOM task force examining Medicaid expansion issues also considered whether oral health should be included in the managed care plans that administer state Medicaid programs.
After years of planning, the state transitioned its Medicaid program from fee-for-service to managed care in 2022. Dental programs will continue to be offered for a fee. Some oral health providers worry that if the state pushes oral health programs toward managed care, they won't be able to cover the costs of operating their businesses.
The special committee's report is expected to be released in January.
— Ann Bryce
Extreme heat could trigger changes in health policy
People here may not be thinking about the chilly early January heat of summer 2023.
But that won't stop climate scientists and environmental health advocates from working. Rallying for new policies and regulations To protect workers, the elderly, and school children from extended periods of heat with temperatures in the 90s. heat index In 3 digits.
After all, there's a reason why “past is prologue” has become a saying.
Azley Ward, new director Duke University Thermal Policy Innovation Hubstated that last summer was not necessarily abnormal after the July 2023 declaration. Hottest July on record,World wide.
“It's not unreasonable to think that this could very well be the coolest heat season of our lifetime.” Ward told North Carolina Health News..
Ward was heartened to see leaders spend an entire day talking about the health effects of extreme heat at the United Nations Climate Change Conference in Dubai during the first two weeks of December.
“This is the first time in 28 years that a health day has been designated,” Ward said. statement Published on the website of the Duke Nicholas Institute for Energy, Environment, and Sustainability. “Those who have been committed to this goal for decades were not disappointed, as health was part of many conversations, not just on Health Day but throughout the conference. On the heels of the hottest year on record , the topic of extreme heat was particularly discussed with new urgency, resulting in an unprecedented focus on the investments needed in adaptation and resilience, and on global health policies that put climate change at the center. The focus is now on formation.”
The state Department of Labor has yet to release the results of its investigation after the incident involving Jose Arturo Gonzalez Mendoza, a 30-year-old farm worker from Guanajuato, Mexico. Died on September 5th After harvesting sweet potatoes in a field at Burns Farming in Nash County. Temperatures that week rose into the 90s; According to AccuWeather.
Migrant worker advocates rally for labor law reforms to protect migrant workers and others in extreme heat.
— Ann Bryce
Focus on Seniors in North Carolina
In just eight years, North Carolina is expected to have more people ages 65 and older than children under 18.
Therefore, it is necessary to be aware of the many health management issues associated with aging.
Governor Roy Cooper issued the following statement: Executive Order May 2023 He is calling for a “whole-of-government approach” to make North Carolina a more hospitable state with an aging population as the last baby boomers approach age 65.
Recommendations from this initiative are expected to be published next year.
Throughout the election year, advocacy groups for older voters and voters with disabilities will be closely monitoring the impact of the revised election law.
new regulations The law requires precinct officials to keep records of people entering polling places who are not voting but may be accompanied by elderly or disabled voters. The record will include the person's name, address, and signature, unless the person is a child under the age of 18 in the voter's custody.
Rep. Diamond Staton Williams, D-Concord, said in 2023 that such provisions would help get older and disabled voters to the polls, especially in a politically divided country. He said he was concerned that it could have a chilling effect on people.
Chris Brandenburg, deputy director of state advocacy for AARP North Carolina, said in 2023 that his organization plans to make sure that in 2024, voters 50 and older have access to information about all election law changes and new district drawings. He said he would work to ensure access. About Congressional Districts and State House and Senate Seats.
“We're monitoring a lot of changes,” Brandenburg told NC Health News. In a phone interview in October. “We want to deliver accurate and truthful information to voters.”
North Carolina is currently one of 26 states where Medicare Advantage covers the majority of Medicare beneficiaries. 55% of people You can benefit from the program and get coverage that way. That's up from 21% of North Carolina beneficiaries a decade ago.
In some parts of the state, Medicare Advantage (a system in which private insurance companies participate in the program and receive additional fees for providing medical services to the elderly and disabled) covers three-quarters of beneficiaries. are doing.
