February 2019

Protections Overlooked as Medicaid Reforms are Implemented

In its eagerness to help states introduce changes in their Medicaid programs and reduce administrative burdens, the Centers for Medicare & Medicaid Services is ignoring regulatory requirements designed to understand and measure the impact of those changes on beneficiaries. According to an analysis by the Los Angeles Times, many states seeking to implement Medicaid work requirements have not projected how many of their beneficiaries would be affected by those requirements nor have they projected how many beneficiaries who are removed from the Medicaid rolls will gain employment after losing their Medicaid benefits.  Both projections are required under Medicaid regulations adopted [...]

2019-02-15T06:00:51-05:00February 15, 2019|Centers for Medicare & Medicaid Services, MACPAC, Medicaid, Medicaid regulations|
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Hospital Prices Lead Rise in Health Care Costs, Study Finds

A new study has concluded that rising hospital prices, not increased utilization, is primarily responsible for rising health care costs. Overall, according to a new analysis by the Health Care Cost Institute, health care costs continue to rise despite declining health care utilization. Among the report’s findings: Hospital prices are rising faster than physician prices. ER prices rose more than twice as much as ER utilization in 2017. Increases in spending for psychiatric services outpaced increases in utilization of those services. Inpatient spending rose 10 percent between 2013 and 2017 even though inpatient utilization fell five percent during that period. [...]

2019-02-14T06:00:19-05:00February 14, 2019|hospitals|
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Government More Effective Than Private Sector at Controlling Health Care Costs

For the past dozen years, Medicare and Medicaid have done a better job of controlling rising health care costs than private insurers. Since 2016, according to a new report from the Urban Institute, private insurers’ costs per enrolled member have risen an average of 4.4 percent a year.  By contrast, Medicare costs have risen an average of 2.4 percent per enrollee and Medicaid costs have risen just 1.6 percent per enrollee. The primary driver of Medicare cost increases has been prescription drug spending.  For Medicaid the primary driver has been physician services and administrative costs.  For private insurers, the main [...]

2019-02-13T06:00:47-05:00February 13, 2019|Medicaid, Medicare|
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New Study Zeroes in on ER Use

A new study has concluded that more than four million emergency room visits a year are for chronic medical problems that, if treated more effectively at the primary care level, could have been avoided. And that those more than four million visits cost $8.3 billion a year. According to a new analysis performed by Premier, Inc., more than 24 million ER visits a year are by patients with six chronic medical conditions:  asthma, chronic obstructive pulmonary disease, diabetes, heart failure, hypertension, and behavioral health problems.  Thirty percent of those visits, the study concluded, could have been prevented with better care [...]

2019-02-11T06:00:17-05:00February 11, 2019|hospitals|
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