2017 October

New Rules Facilitate Integration of Physical, Behavioral Care

New federal regulations are facilitating better integration of physical and behavioral health services for the Medicaid population. Two developments, in particular, are advancing this integration: the 2016 Medicare managed care rule and a 2016 rule implementing the Mental Health Parity and Addiction Equity Act of 2008. Together, these rules encourage providers to perform comprehensive assessments of their patients, increase flexibility for providers in how they use Medicaid payments, and pave the way for improvements in the use of information technology that foster better integration of physical and behavioral medical care. A new issue brief from the Commonwealth Fund presents in [...]

iqtsupport2017-10-31T06:00:27-04:00October 31, 2017|Medicaid managed care, Medicaid regulations|

AMA: Health Insurance Concentration in Urban Areas Threatens Competition

Too much market share by insurers in urban areas can inhibit competition, and according to the American Medical Association, there is too little competition among insurers in too many urban markets today. According to a new AMA study, 69 percent of 389 metropolitan statistical area-level markets are “highly concentrated” in 89 percent of MSAs, at least one insurer issues at least 30 percent of commercial health insurance policies in 43 percent of urban MSAs, a single insurer owns at least 50 percent of the market In a statement accompanying release of the report, an AMA spokesperson explained that After years [...]

iqtsupport2017-10-30T06:00:28-04:00October 30, 2017|Uncategorized|

Survey Says: More Than One in Four Underinsured

28 percent of insured adults under the age of 64 were uninsured in 2016, according to a Commonwealth Fund survey. The survey also found that: More than half of the uninsured are insured through their employer. Nearly one in four insured through their employer are underinsured. More than one in four Medicaid recipients were underinsured. Half of the underinsured report problems paying their medical bills. Individuals with higher deductibles are more likely to report problems paying their medical bills. More than 45 percent of the underinsured report skipping care they need because of cost. Low-income people and those with chronic [...]

iqtsupport2017-10-27T10:56:29-04:00October 27, 2017|Uncategorized|

Despite Uncertainty, States Plan to Raise Medicaid Rates

Even though events in Washington leave the future of Medicaid unclear, 44 states still intend to raise at least some of their Medicaid rates in 2018. Inpatient payments to hospitals are not among the major targets of the planned rate increases: only 17 states plan to increase Medicaid inpatients payments while the others plan to keep those rates as they are or even reduce them. Learn more about trends in Medicaid enrollment, spending, and rates in the Kaiser Family Foundation’s annual survey of state Medicaid programs, the results of which can be found here.

iqtsupport2017-10-26T06:00:12-04:00October 26, 2017|Medicaid|

PA Governor Vetoes Medicaid Work Requirement

Pennsylvania Governor Tom Wolf has vetoed a bill that included a requirement that certain Medicaid recipients either work or search for work. Learn more about the governor’s veto, and his reason for doing so, in this Associated Press news report.

iqtsupport2017-10-24T06:00:15-04:00October 24, 2017|Pennsylvania Medicaid|

Braving the Unknown, States Increase Medicaid Benefits

Despite the prospect of Congress and the administration enacting major reductions of federal Medicaid spending as part of repealing and replacing the Affordable Care Act, more than half the states expanded their Medicaid programs in 2017 and many plan to do so in 2018 as well. In all, 26 states expanded or enhanced Medicaid benefits this year while 17 plan to do so next year. Most of the changes involve enhancing mental health and substance abuse treatment services. Learn more about expanded Medicaid benefits in the face of anticipated reductions in Medicaid spending in this Healthcare Finance News report.

iqtsupport2017-10-23T06:00:49-04:00October 23, 2017|Medicaid|

Helping With Homelessness Reduces ER Costs

Hospitals are finding that helping homeless, frequent emergency room visitors find housing can reduce their unreimbursed ER costs. Throughout the country, hospitals are investing money – in some cases, millions of dollars – in housing programs for the homeless. What they are finding when they do so is that the stability of reliable housing – coupled with supportive social services – appears to be reducing the frequency with which such individuals appear in their ERs. Examples of such programs can be found in Sacramento, Orlando, Portland, New York City, Los Angeles, and elsewhere. Learn more about what hospitals are doing, [...]

iqtsupport2017-10-20T06:00:26-04:00October 20, 2017|Uncategorized|

A New Twist on Telehealth

Residents of urban areas often have the same access-to-care problems as rural residents, although the latter receive far more attention. So concludes a new report published on the Health Affairs Blog. According to the analysis, urban and rural residents have similar access problems – and among urban residents, the problems in some instances are even greater. One distinction: …while rural America has access problems because there are not enough doctors, urban America has access problems because there are not enough appointments. One potential solution to this problem, the report suggests, is focusing on access instead of geography and making telehealth [...]

iqtsupport2017-10-17T06:00:14-04:00October 17, 2017|Uncategorized|

Non-Profit Hospitals Tout Community Benefit

Non-profit hospitals invest $11 for every one dollar they do not pay in taxes because of their tax-exempt status. Or so says a study prepared for the American Hospital Association. According to the study, in 2013 non-profit hospitals provided $67.4 billion worth of benefits to their communities compared to the $6 billion they would have paid in taxes had they been for-profit hospitals. Those community benefits came in four forms: financial assistance and means-tested government programs (such as unreimbursed Medicaid costs) community-building activities Medicare shortfalls bad debt attributable to charity care Learn more about what the study found and how [...]

iqtsupport2017-10-13T06:00:32-04:00October 13, 2017|Uncategorized|

Pay Issues Slow Telehealth Spread

While most health care organizations and providers intend to make greater use of telehealth in the coming years, the manner and speed with which that use grows is being limited in part by reimbursement issues. A survey conducted for the College of Healthcare Information Management Executives found that About half of the study respondents listed reimbursement as a limitation, noting that some payers have been slow to reimburse telehealth visits and or reimburse at rates that are lower than face-to-face care. Survey participants reported using telehealth in three primary ways: scheduled patient “visit,” on-demand urgent needs, and specialist consultations. Learn [...]

iqtsupport2017-10-12T06:00:27-04:00October 12, 2017|Uncategorized|

October 2017