Noteworthy News

Archive for October, 2012


Programs for Dual Eligibles May Produce Only Modest Savings

The federal government’s planned demonstration projects seeking to find better, more economical ways to serve the dual eligible (Medicare and Medicaid) population may not be as productive as enthusiasts for such programs hope. This is the conclusion reached in the new study “Best Bets for Reducing Medicare Costs for Dual Eligible Beneficiaries:  Assessing the Evidence,” just published by the Kaiser Family Foundation. The study examines past efforts to provide better coordination of care for the dual eligible population, and while it found examples of programs that reduced hospitalizations, the overall cost savings to Medicare generally were modest.  While not evaluating [&hellip

Implementation of Reform Act’s Medicaid Doc Pay Raise Uncertain

With the Affordable Care Act-mandated increase in Medicaid payments to primary care physicians now just a little more than two months away from taking effect, much remains unknown about how the increase will be implemented. Under the 2010 reform law, payments to Medicaid primary care physicians will be increased to the same level as comparable Medicare payments, with the federal government picking up the entire $11 billion tab. At this point, however, there are no regulations delineating how the increase will be achieved, leaving unanswered a number of questions, including what the new rates will be; how and when they [&hellip

Dual Demos Rolling Out Slower Than Expected

A new federal program that will enable states to shift as many as two million low-income, chronically ill, dually eligible (Medicare and Medicaid) seniors into managed care plans is taking longer to launch than federal officials anticipated. Twenty-five states have applied to participate in the program, and while 14 requested permission to launch their demonstrations in 2013, only one state – Massachusetts – has received federal approval for its plans so far.  The other 11 states anticipate launching their programs in 2014. While the program has many supporters in the health care community, it also has its share of critics.  [&hellip

Where Does Your State Stand on Medicaid Expansion?

When the Supreme Court transformed the Affordable Care Act’s Medicaid expansion mandate into an option for states, it left 50 governors with a choice:  to expand or not to expand? According to the Washington Post, six governors have stated that their state will not expand Medicaid eligibility and 13 have decided that they will; the rest are undecided. Medicaid expansion is essential to the ability of the nation’s private, non-profit urban safety-net hospitals to continue meeting the health care needs of the low-income residents of the communities they serve. See which states are expanding, which are not, and which are [&hellip

Will States Take a Second Look at Rejecting Medicaid Expansion?

While a number of governors have indicated that they will reject the Affordable Care Act’s Medicaid expansion now that the Supreme Court has empowered them to do so, it appears some may need to reconsider the budgetary implications of rejecting the federal government’s offer of significant health care resources with little required state matching funds. According to the Detroit News, the Center for Healthcare Research and Transformation has told Michigan officials that complying with the Affordable Care Act’s Medicaid expansion provision would add 600,000 Michigan residents to the ranks of the insured while saving the state approximately $1 billion over [&hellip

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