Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Medicaid' Category

The problem of cutting Medicaid rates

A new paper by Sharma et al. (2017) finds that Medicaid patients living in states with lower Medicaid reimbursement have more challenges accessing primary care services. We found that states with higher Medicaid fees had higher probabilities of appointment offers and shorter wait times for Medicaid patients, and lower probabilities of appointment offers and longer […]

Read the rest of this entry »

Can Medicaid beneficiaries access primary care providers?

In general the answer is yes, but often with some difficulty.  AJMC recaps the findings from a the CDC Morbidity and Mortality Weekly Report (MMWR) Quick Stats section from July 21, 2017. 88.9% of primary care physicians said they are accepting new patients, based on 2015 data from the National Electronic Health Records Survey. However, […]

Read the rest of this entry »

Why Medicaid patient access to physicians is limited.

In short, the reason is that Medicaid reimbursement rates for providers is too low.  Saurabh Jha, however, explains the point a bit more artistically in his Health Care Blog piece. Medicaid pays a cardiologist, with years of training, $25-40 for a consultation to manage a complex patient with multiple comorbidities, on polypharmacy, where the cardiologist […]

Read the rest of this entry »

Will Better Care deliver better care?

The Senate’s new health care bill, the Better Care Reconciliation Act of 2017, proposes a number of changes to the Affordable Care Act.  The Kaiser Family Foundation has a detailed breakdown of the bill and compares it with the Affordable Care Act that President Obama passed and the American Health Care Act that was proposed […]

Read the rest of this entry »

Do Incentives for Healthy Behaviors Work? A Case Study of Medicaid in Iowa

One of the primary changes in the healthcare system directed by the Affordable Care Act was providing funding for states to expand Medicaid.  Many states did so; many others did not.  Some states expanded Medicaid but put additional hurdles in front of beneficiaries to receive this coverage at no cost.  Consider the case of the State of Iowa. […]

Read the rest of this entry »

What is causing U.S. debt to explode?

According to the Congressional Budget Office’s (CBO’s) 2017 Long-Term Budget Outlook, you need to look no further than entitlements for the elderly. Mandatory programs have accounted for a rising share of the federal government’s noninterest spending over the past few decades, exceeding 60 percent for the past several years. Much of the growth has occurred because […]

Read the rest of this entry »

The coming U.S. debt crisis

The Congressional Budget Office provides some gloomy news on the fiscal health of the federal government in their recent 2016 Long Term Budget Outlook.  They state: If current laws governing taxes and spending did not change, the United States would face steadily increasing federal budget deficits and debt over the next 30 years, according to projections […]

Read the rest of this entry »

Will value-based pricing be coming to the U.S.?

The answer may be yes.  One of the big inpediments to value-based pricing of pharmaceuticals was that any discount given to any single organization based on outcomes needed to be reflected in the Medicaid price.  Since outcomes are subject to random noise, there will inevitably be health plans that end up getting a low price due to worse than expected […]

Read the rest of this entry »

Medicaid Managed Care and Drug Utilization for Patients with Serious Mental Illness

How will Medicaid expansions affect patient access to pharamceuticals? This question is particularly relevant for patients with serious mental illness. The answer is complicated by the increasing presence of Medicaid managed care plans. Increasingly, states have turned to contracts with Medicaid managed care plans in order to better control costs and reduce budgetary uncertainty. However, in […]

Read the rest of this entry »

Transformation of Mental Health Care in America

Mental illness is a highly prevalent class of diseases with potentially debilitating affects. About 30% of Americans have a mental illness and almost half (46%) will have a mental illness at some time in their lives.  Examples of mental illness include schizophrenia, bipolar disorder, depression, anxiety disorders. A paper by Glied and Frank (2016) summarizes the transformation […]

Read the rest of this entry »