Noteworthy News

Archive for August, 2013


Medicine Looks to Social Contributors to Illness

New care models promoted by the Affordable Care Act seek to identify social factors that contribute to patients’ medical problems. Medical homes, ambulatory intensive care units, medical neighborhoods, and other new mechanisms may do more to help providers get to the root cause of some of their patients’ ills.  Today, that frequently is not the case.  In fact, most doctors do not believe they are prepared to help their patients address their medical ills and they also want to be paid when they do provide such assistance. The National Association of Urban Hospitals (NAUH) has long pointed to social factors [&hellip

Insurance Subsidies Will Be Common

Nearly half of all individuals and families expected to turn to health insurance exchanges for insurance policies under the Affordable Care Act will be entitled to federal subsidies to help pay their premiums. Those subsidies will average more than $5500 per family and cover two-thirds of a premium’s overall cost. These subsidies will be critical for urban safety-net hospitals, which currently find themselves providing significant amounts of uncompensated care to low-income but working individuals and families that cannot afford health insurance today. These were among the findings of a recent Kaiser Family Foundation analysis.  Read more about the analysis and [&hellip

Insurance Alternatives for Undocumented Residents

While the Affordable Care Act will do a great deal to help low- and middle-income Americans obtain health insurance, this help does not extend to the more than 11 million undocumented residents currently in the U.S. Many of these undocumented residents live in cities and are served by private, non-profit urban safety-net hospitals. In a new report, the Commonwealth Fund takes a closer look at these undocumented residents:  their health care needs and possible alternatives to help them gain access to care.  Find the report, Undocumented and Uninsured:  Barriers to Affordable Care for Immigrant Populations, on the Commonwealth Fund’s web [&hellip

States Reducing Medicaid Eligibility

At a time when many states are preparing for a major expansion of Medicaid eligibility, four states are tightening some of their Medicaid eligibility criteria. As a result, Maine, Rhode Island, Vermont, and Wisconsin could see their collective Medicaid rolls fall by 150,000 people. Some of these people will be eligible for subsidized insurance from health insurance exchanges once those exchanges open next year. Read about why these states are reducing Medicaid eligibility at a time of general Medicaid expansion in this Kaiser Health News article

CMS Sets New Guidelines for Medicaid Presumptive Eligibility

Beginning in calendar year 2014, states will be required to provide Medicaid coverage for individuals determined to be presumptively eligible for Medicaid regardless of whether the state has historically offered presumptive eligibility for such patients. The new regulation, issued by the Centers for Medicare & Medicaid Services (CMS), applies to the actions of what it calls “qualified hospitals” – that is, hospitals that provide Medicaid services and notify their state Medicaid agency of their decision to make presumptive eligibility determinations in accordance with state Medicaid policies. In return, states have the option of requiring these qualified hospitals to help such [&hellip

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