Unbiased Analysis of Today's Healthcare Issues
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.…
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…
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…
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…
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…
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…
Does Medicaid use pay-for-performance (P4P) for providers? If so, how does it work? And does it affect quality and cost? These are the questions of interest to Rosenthal et al. (2015) in their study of P4P programs in Alabama, Minnesota, and Pennsylvania. Although all three focus on physicians, the Alabama program is a “medical home ”…
A physician shortage may be a bit much, but it appears that physicians overestimate their availability based on a study by Coffman et al. (2016). The percentage of callers posing as Medicaid patients who could schedule new patient appointments was 18 percentage points lower than the percentage of physicians who self-reported on the survey that…
Typically, answering this question is difficult as the Medicaid program varies across states and even within states. What Amanda Kowalski and co-authors do in a paper she presented at the 2016 ASSA is collect data on the variation in Medicaid eligibility across states, across demographic groups, and across time from the inception of Medicaid in…
A recent paper in by Martin et al. (2015) finds that Medicaid Managed Care programs in Kentucky reduced monthly professional visits. Further, the decrease in the number of professional visits was larger for whites than for non-whites. The authors conclude: We find evidence that MMC [Medicaid Managed Care] has the possibility to reduce racial/ethnic disparities…