Noteworthy News

Archive for health care reform

 

Affordability a Challenge for Many Newly Insured

Many Americans who have obtained private health insurance through the Affordable Care Act continue to have problems affording health care. According to a Kaiser Family Foundation report based on focus groups six states, low-income individuals with new private insurance report continued problems with: medical debt affording care that is not covered by their insurance plans handling out-of-pocket expenses, including deductibles unexpected bills for treatment they thought was covered Such patients pose a challenge for many urban safety-net hospitals because of their inability to afford their co-pays and deductibles, leaving these hospitals with unexpected uncompensated care and bad debt. Because they [&hellip

Background Information on Payment Methodologies and Benefit Design

The Urban Institute has issued two new papers with background information on health care payment methodologies and the design of health care benefits packages. The first paper, Payment Methods: How They Work, describes nine payment methodologies: fee schedules primary care capitation per diem payments to hospitals for inpatient visits DRG-based payments to hospitals for inpatient visits global budgeting for hospitals bundled payments global capitation for organizations shared savings pay for performance The second paper, Benefit Designs: How They Work, explains seven different types of benefit designs: value-based design high-deductible health plans tiered networks narrow networks reference pricing centers of excellence benefit design [&hellip

Safety Net Still Needed, Study Finds

Despite Affordable Care Act policies that have enabled millions of Americans to obtain health insurance, the health care safety net is still needed. Or so concludes a new report from the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms. For the report A Tale of Three Cities: How the Affordable Care Act is Changing the Consumer Coverage Experience in 3 Diverse Communities, researchers visited and examined conditions in Tampa, Columbus, and Richmond (Virginia), and among their conclusions was: We still need a safety net. Safety net programs in existence before the ACA were expected to become less necessary once the [&hellip

New Medicaid Enrollees Cost Less to Serve

Contrary to fears that the long-time uninsured who became eligible for Medicaid under Affordable Care Act eligibility expansion would turn to providers with a long litany of expensive-to-treat medical problems, preliminary data suggests that such individuals are actually less costly to treat than the average Medicaid recipient. Preliminary data released by the Centers for Medicare & Medicaid Services based on claims data from the first quarter of 2014 – the first time period after Medicaid expansion began in some states – found that the average new adult Medicaid enrollee cost $4513 to serve, as opposed to the $7150 it cost [&hellip

OIG Reveals 2016 Plans

The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) has published its work plan for the 2016 fiscal year. In 2016, the OIG will continue to examine all aspects of HHS endeavor, including Medicare, Medicaid, hospital services, public health activities, and more. In the coming year it will continue a number of hospital-focused projects while also focusing more on health care delivery, health care reform, alternative payment methodologies, and value-based purchasing initiatives. Among the OIG’s planned Medicare projects in 2016 – some of them continued from the past and some of them new, quoted directly from [&hellip

Search for
Noteworthy News

Related posts

    [exec] boposts_show(); [/exec]