During the first year of the global pandemic, medical consumers in Colorado received more than one million low-value healthcare services - diagnostic tests, screenings and treatments where the risk of harm outweighs any likely benefit to the patient.

Cari Frank, vice president for communications with the Center for Improving Value in HealthCare - the group behind a new report, said consumers and insurers paid $134 million for these services in 2020.

"Even in spite of COVID, when people weren't accessing health-care services the same way," said Frank, "we still saw high numbers of these low-value care services. And they cost a lot of money, both to the health plans and to the patient, and actually can cause harm to patients."

The most obvious example of low-value care is when providers prescribe opioids for acute back pain without first trying alternative medication - a remedy that comes with significant risk of addiction and even death.

Health providers across the nation, working with medical boards and other professional associations, have created a list and guidelines for low-value services through an initiative called Choosing Wisely.

Frank said getting the word out can help bring down overall health costs. She said many services now considered low-value care were considered best practices at one time.

"A lot of things are just, historically, the way the provider has treated patients," said Frank. "And it takes a while when the guidelines change, for there to be an actual adoption of the guidelines."

The average cost for low-value services is $130 - but some, including peripheral catheters for patients with late-stage kidney disease, cost more than $14,000 per incidence.

Frank noted that every patient is different, and some procedures flagged as low-value may actually be the right course for patients.

"There might be family history, or there might be medical history where they have tried some other alternative," said Frank. "So there still needs to be that kind of communication between the provider and the patient."

The Montana Legal Services Association has started a program to help young attorneys get started on a path to success - becoming community leaders, run socially conscious law firms, and maintain sustainable businesses.

The Rural Incubator Program for Lawyers creates a way for new attorneys to start their careers by helping connect them to rural clients with pro-bono and reduced-rate services.

Gillian Ellison, the incubator program coordinator, said it helps underserved people in Montana - while also giving lawyers a leg up on networking and kick-starting, or incubating, their careers.

"It's looking at the problem from both ways," said Ellison, "trying to get more attorneys in the rural places and also trying to facilitate the growth of new businesses that serve low-to moderate-income Montanans."

Montana Tribal members also stand to benefit from the rural lawyer incubator program, which requires the attorneys to perform 25 pro bono hours and 225 reduced rate service hours in exchange for training and assistance with business and client development.

Ellison said while the incubator program is especially helpful to underserved Montanans and members of the state's Indigenous tribes, it is also especially useful to lawyers who are just starting out and need the help that comes from more experienced attorneys - which can be difficult to get.

"Especially in a place like Montana where things are so spread out to have networking capacity because the networking and the mentoring is invaluable to a new attorney," said Ellison, "especially if you're not going to be working in a - or getting hired on to work in - a firm. "

The program also makes some tuition reimbursement assistance available for some lawyers who participate.




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Aiming to close the financial literacy divide among teens and young adults, one investment company has set a goal of reaching one million of them by 2025.

The National Center for Education Statistics reported among 15-year-olds, only one in four regularly discusses economics or financial matters with their parents.

The Edward Jones Financial Fitness program is one way to get the information to them.

Nolan Jeter, financial adviser for Edward Jones in Atlanta, said increasing a young person's financial knowledge is also a way to build and enhance their confidence and well-being.

"The biggest difference between people reaching their full potential and financial success is discipline," Jeter contended. "The sad truth is, most people don't know what those disciplines are."

Jeter pointed out the program tackles topics like saving strategies, how to start and use a 401(k) account, and planning for a secure future. To date, he said the program has helped more than 485,000 students, and is on track to double in two years.

A survey by the website WalletHub ranks Georgia 39th among states for overall financial literacy.

Jeter noted it is a common misconception money management skills are not needed if you do not have much to manage. He emphasized students can learn to handle whatever amount they have more effectively.

"This is one of the ways that we're really focused and delivering that impact to these communities," Jeter stressed. "We know that that's where we see the biggest gap between people and working with financial professionals. We know that there are underserved communities, particularly -- especially in the minority communities -- that just simply don't know."

State initiatives also have been set in motion to help increase financial literacy in teens. Last year, Gov. Brian Kemp approved a bill making financial literacy courses compulsory for high school students starting in the next academic year. All students in grades 11 and 12 must complete a half-credit course to be eligible for graduation.


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Starting a business is fraught with decisions ranging from defining the type of business to start, choosing whether to be a home-based, online, or a brick-and-mortar company, hiring staff and calculating startup and operational costs.

According to the Indiana Small Business Economic Profile 2021, there are nearly 530,000 small businesses in Indiana, employing more than 1.2 million Hoosiers.

David Watkins, senior vice president of entrepreneurship and small business for the Indiana Economic Development Corporation, said the one component large and small companies have in common also makes them competitors.

"It is not easy for a small business at times to compete on a talent basis with some of our large corporations that do great work for the community but are competing for the same workers," Watkins pointed out.

Watkins acknowledged access to capital is important, and the corporation works to connect small businesses to a bank, investor, venture capital firm or loan fund to help them expand.

The Community Reinvestment Act, enacted by Congress in 1977, encourages depository institutions to address the credit needs of the communities in which they operate. In 2019, banks issued $1.5 billion dollars in loans to Indiana businesses with revenues of $1 million or less.

The growing use of social media and online shopping can affect the costs and efficiency of a small business' operations. Watkins noted technology can be both an asset and a hindrance for a small business looking to solve problems.

"If technology can be leveraged to increase production, lower costs, increase the efficiency of their operations, their talent retention," Watkins outlined. "I think the role for the state to play, in that regard, is making sure that our small businesses are aware of and staying on the cutting edge of this technological innovation so that Indiana continues to be at the very forefront of the economy for the future. "

According to the 2021 report, construction, scientific and technical services, retail trade, real estate, rental/leasing, administrative/support and waste management are the state's leading small businesses.

Women owned 42.4% of Indiana businesses, veterans owned 7.2%, Hispanics owned 3.8%, and other racial group -- American Indian and Alaska Native, Asian, Black, or African American, Native Hawaiian, and other Pacific Islanders -- comprise 10.8% of small businesses in Indiana.

The Small Business and Entrepreneurship Council's Small Business Policy Index 2019 researched 50 states based on their public policy climates for the risk-taking that drives economic growth and job creation and ranked Indiana as the eighth-most entrepreneur-friendly state in the nation.