Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Medicaid/Medicare' Category

Insurance does not equal health care

One part of the Affordable Care Act extended Medicaid benefits to millions of Americans.  One problem, however, is that patients with Medicaid insurance often have trouble finding doctors who will treat them.  The New York Times reports: Large numbers of doctors who are listed as serving Medicaid patients are not available to treat them, federal […]

Read the rest of this entry »

Medicaid Expansion States

Which states have decided to receive additional federal funds to expand the share of people they cover under Medicaid?  The Kaiser Family Foundation has the answer. Alabama Not Moving Forward at this Time Alaska  Not Moving Forward at this Time Arizona Implementing the Medicaid Expansion  Arkansas Implementing the Medicaid Expansion California  Implementing the Medicaid Expansion Colorado Implementing the Medicaid Expansion […]

Read the rest of this entry »

Treating Dual Eligibles

The PBS Newshour has an interesting story on the treatment of the 9 million dual-eligible beneficiaries in the US.  They discuss integrated care model in California, Cal MediConnect.  

Read the rest of this entry »

Donuts and drugs

Medicare patients are likely to discontinue their medication in December. Why? Are they busy with the Christmas holidays? Do they have additional expenses for gifts and limited funds for prescription drugs? Perhaps. Another idea advanced by Kaplan and Zhang (2014) is that Medicare’s benefit structure encourages discontinuation. Why is that? Medicare’s Part D drug plan […]

Read the rest of this entry »

Regulatory Tsunami?

Medicare is working hard to make sure that doctors are efficiently providing high-quality care. Programs such as the Physician Quality Reporting System (PRQS) and the Value-Based Payment Modifier all are aimed to improve quality and lower cost. The downside of such programs, however, is that the impose reporting burdens on physicians. For instance, Medicare can […]

Read the rest of this entry »

Reimbursement Rates and Quality

How do reimbursement rates affect quality?  One school of thought holds that decreased reimbursement decreases quality in the short-run and decreases innovation in the long-run.  Another school of thought believes that there is so  much inefficiency in the health care system, that reducing reimbursement rates will have no affect  on quality.  Which answer is correct? A study […]

Read the rest of this entry »

What can Geographic Variation in Health Care Spending Tell Us About Efficiency?

In a project with the Institute of Medicine (IOM), I examined the sources of regional variation in Medicare and Medicaid spending and spending growth. The IOM wisely concluded that policymakers should target decision-makerss rather than geography when attempting to improve the efficiency of the healthcare system. I recent paper by the Louise Sheniner of the […]

Read the rest of this entry »

Docs benefiting from Medicaid Expansions

PwC’s Health Research Institute reports that times are good if you are a safety net provider in a state that expanded Medicaid coverage: Physicians, hospitals and health systems operating in the 26 states and the District of Columbia that pursued the option to broaden Medicaid coverage with federal dollars have seen a significant rise in […]

Read the rest of this entry »

Why don’t payers adopt my technology?

Why don’t payers adopt innovative approaches to treat mental illness? For instance, crisis intervention programs, recovery-focused consumer education programs, telehealth programs, and on-line treatment programs have sometimes have had problems receiving reimbursement from payers. Monica Oss of OpenMinds takes the payers’ perspective: Often, the organization proposing the new program comes to the table with an […]

Read the rest of this entry »

Medicare Advantage Plans: Thumbs Up or Down?

Austin Frakt says although Medicare Advantage plans used to be considered high cost, low-quality options, in recent years, these Medicare Advantage plans have vastly increased quality of care and have become less focused on cream-skimming healthier patients.   Medicare Advantage plans — private plans that serve as alternatives to the traditional, public program for those […]

Read the rest of this entry »