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Preventable Medicaid Hospitalizations Vary Based on Race, Eligibility Path

Preventable hospitalizations among Medicaid patients vary based on the race of the patient and how that patient came to be eligible for Medicaid, according to a new analysis by the Urban Institute. According to a review of preventable hospitalizations in 21 states, the report concluded that: … the three most common types of potentially preventable hospitalizations for Medicaid-enrolled adults were asthma/COPD (0.2 percent of enrollees had at least one such hospitalization in 2019), diabetes (0.4 percent of enrollees had at least one such hospitalization in 2019), and heart failure (0.2 [...]

January 30, 2024|Categories: health equity, Medicaid|Tags: Medicaid, Medicaid preventable hospitalizations|

Federal Health Policy Update for January 25

The following is the latest health policy news from the federal government for January 12 - 25. Some of the language used below is taken directly from government documents. Department of Health and Human Services – Funding Models HHS has announced a new model to test approaches for addressing the behavioral and physical health and health-related social needs of people with Medicaid and Medicare. The goal of the Innovation in Behavioral Health Model (IBH) is to improve the overall quality of care and outcomes for adults with mental health conditions and/or [...]

January 25, 2024|Categories: Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|Tags: ARPA-H PARADIGM, ARPA-H Platform Accelerating Rural Access to Distributed and Integrated Medicare Care, Emergency Medical Treatment and Labor Act, EMTALA, health equity, HHS Cybersecurity Performance Goals, Inflation Reduction Act, MACPAC, Medicaid and access to behavioral health care, Medicaid and CHIP Payment and Access Commission, Medicaid and contraception, Medicaid and Hepatitis C treatment, Medicaid and prior authorization, Medicaid payment policies, Medicare and prior authorization, Medicare Behavioral Health Model, Medicare Payment Advisory Commission, Medicare payment policies, MedPAC, MedPAC Medicare payment recommendations, National Advisory Council on Nurse Education and Practice, No Surprises Act|

Analysis Looks at Problems Plaguing Unwinding of Medicaid Continuous Eligibility

Since the end of the continuous Medicaid eligibility that was a major part of the Families First Coronavirus Response Act, more than 14 million Americans have lost their Medicaid eligibility. In a new analysis, KFF looks at the challenges both consumers and states have encountered in attempting to review the eligibility of the Medicaid population and to ensure that those who are no longer eligible can be directed to other options for health insurance. Among the factors addressed in this analysis are: State outreach to affected individuals, the effectiveness of [...]

January 24, 2024|Categories: hospitals, Medicaid|Tags: Medicaid continuous eligibility, medicaid unwinding|

Congress Spares Medicaid DSH Cut – for Now

An oft-delayed cut in Medicaid disproportionate share allotments to states was delayed once again in the latest temporary spending bill passed by Congress last week. The stopgap spending bill, which runs until March 8, delays an $8 billion a year cut in Medicaid DSH payments that was part of the Affordable Care Act and has been put off by Congress on numerous occasions ever since. The reduction was envisioned as an appropriate move in anticipation of a significant increase in uninsured Americans after the 2010 reform law’s passage. While that [...]

January 23, 2024|Categories: Affordable Care Act, Medicaid, Medicaid DSH, Medicaid DSH allotments|Tags: Affordable Care Act, Medicaid disproportionate share, Medicaid DSH|

Federal Health Policy Update for January 18

The following is the latest health policy news from the federal government for January 12-16. Some of the language used below is taken directly from government documents. Congress Medicaid DSH With a partial government shutdown looming on Friday, January 19, congressional leaders have agreed to extend the current stopgap legislation temporarily funding the federal government. Under this agreement, the four spending bills scheduled to expire this Friday would be extended until March 1 and the eight bills set to expire on February 2 would be extended until March 8. The [...]

January 18, 2024|Categories: hospitals, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: Medicaid disproportionate share, Medicaid DSH, Medicare interoperability regulation, Medicare Payment Advisory Commission, Medicare prior authorization regulation, Medicare rates, MedPAC, MedPAC rate recommendations|

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