Perhaps the most important paper on the effect of health insurance on health, spending, and access to care was released this week. Although randomized controlled trials are rare for measuring the effect of insurance, the design of the Oregon Medicaid program introduced random variation into who received Medicaid coverage. The authors write: In 2008, Oregon [...]
Read the rest of this entry »Medi-Cal expansion contentious in California
Health reform has expanded Medicaid access to millions of Americans. The question is, will the poor even want Medicaid insurance? As finances are tightening, many states are attempting to reduce the generosity of their current Medicaid benefits. In California, (where Medicaid is known as Medi-Cal), Governor Jerry Brown wants to reduce Medicaid’s benefit generosity. He [...]
Read the rest of this entry »Do Medicaid Expansions Crowd Out Private Health Insurance?
According to Hamersma and Matthew Kim (2013), the answer is no. The authors use data from the 1996, 2001, and 2004 panels of the Survey of Income and Program Participation (SIPP). This data is supplemented with state-level information on Medicaid income eligibility rules. The authors classify each person as either: holding no insurance, private insurance, [...]
Read the rest of this entry »The Effect of Medicaid P4P on Nursing Home Quality
Over 10 million Americans need long-term services and supports to assist them in life’s daily activities. Of these, 1.6 million reside in a nursing home. Nursing home care, however, is expensive ($74,800 per year) and and quality is highly variable. To improve the quality of care, many states have begun adopting pay-for-performance (P4P) programs for nursing homes. Between [...]
Read the rest of this entry »Medicaid Pays less for Drugs than Medicare
How does it do this? Through the Medicaid Drug Rebate Program. Medicaid.gov explains: The Medicaid Drug Rebate Program is a partnership between CMS, State Medicaid Agencies, and participating drug manufacturers that helps to offset the Federal and State costs of most outpatient prescription drugs dispensed to Medicaid patients. Approximately 600 drug manufacturers currently participate in [...]
Read the rest of this entry »California: Mandatory Enrollment of Seniors and the Disabled into Managed Care
In 2010, CMS approved California’s “Bridge to Reform” waiver request that authorized the state to expand its mandatory managed care to seniors and people with disabilities covered by Medi-Cal. Authorized under a Section 1115 waiver, the policy affected nearly 400,000 Medi-Cal enrollees, including 240,000 who were moved from fee-for-service into managed care between June 2011 [...]
Read the rest of this entry »Aetna bets on Obamacare
Today, Aetna, the third-largest U.S. health plan, agreed to buy Coventry Health Care for $5.6 billion. Aetna paid a 20 percent premium for Coventry. Why is Coventry such an attractive target? The answer is that President Obama’s Health Reform will greatly expand the number of people eligilbe for Medicaid. Since many states are moving towards [...]
Read the rest of this entry »How will your healthcare change if Paul Ryan is the Vice President?
To answer this question the best place to look is Paul Ryan’s budget proposal. The proposal would convert Medicare and Medicaid into voucher-based programs. Individuals and families not covered by either of these programs would receive assistance through a refundable tax credit based on the individual’s income. You can find more information on Mr. Ryan’s [...]
Read the rest of this entry »Medicaid’s Effect on Mortality
Does Medicaid coverage decrease mortality? According to a recent study in NEJM, the answer is yes. “Mortality declined significantly (by 19.6 deaths per 100,000, for a relative reduction of 6.1%; P=0.001). Reductions were greatest among nonwhites and older adults, with smaller but significant reductions among whites and no effect among persons under the age of [...]
Read the rest of this entry »Does expanding insurance coverage improve access to care?
Although Health Reform did little to reduce the cost of health care, it did make significant strides to expand access to care. For low-income individuals, the increased access comes along two dimensions: expanded Medicaid eligibility and increased physician fees. Specifically, Health Reform required to Make all individuals with incomes below 138% of the Federal Poverty [...]
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