Medicaid

Uninsured ED and Inpatient Visits Down Since ACA

Uninsured hospital admissions and emergency department visits are down since passage of the Affordable Care Act. And Medicaid-covered admissions and ER visits are up, according to a new analysis. The report, published on the JAMA Network Open, found that ER visits by uninsured patients fell from 16 percent to eight percent between 2006 and 2016, with most of this decline after 2014, while uninsured discharges fell from six percent to four percent. The rate of uninsured ER visits declined, moreover, at a time when overall ER visits continued to rise. While the Affordable Care Act is likely the cause of [...]

iqtsupport2019-05-01T06:00:26-04:00May 1, 2019|Affordable Care Act, hospitals, Medicaid|

Bureaucratic Requirements May Be Driving Medicaid Enrollment Decline

State eligibility redetermination processes may be pushing down Medicaid enrollment nation-wide. Last year, national Medicaid enrollment fell 1.5 million, more than half of them children, and according to a new report from Families USA, much of that decline may be attributable to the challenging eligibility redetermination requirements imposed on Medicaid-eligible individuals by some states. Those requirements include a 98-page packet that Tennessee sends to individuals seeking to retain their Medicaid eligibility; Arkansas’ limit of 10 days to respond to requests for information to redetermine eligibility; and Missouri’s decision to discontinue using data from other public safety-net programs to redetermine eligibility. [...]

iqtsupport2019-04-30T06:00:02-04:00April 30, 2019|Medicaid|

Low-Income Patients More Likely to End Up in Low-Quality SNFs

Dually eligible individuals are more likely than others to find themselves in low-rated skilled nursing facilities, recent research has found. According to a study published in the Journal of Applied Gerontology, more than 50 percent of dually eligible individuals – those covered by both Medicare and Medicaid – who are admitted to skilled nursing facilities are served by facilities that have low (one or two stars) ratings under Medicare’s five-star quality rating system for nursing homes. Overall, the dually eligible are 9.7 percentage points more likely than patients not on Medicaid to be served by lower-rated facilities. The education of [...]

iqtsupport2019-04-19T06:00:35-04:00April 19, 2019|Medicaid, Medicare post-acute care, post-acute care|

MACPAC Recommends Changes in Medicaid Shortfall Definition

Hospitals’ calculation of their Medicaid shortfall would change under a recommendation that MACPAC voted to make to Congress. That change, in turn, could affect hospitals’ future Medicaid disproportionate share payments. Last week the Medicaid and CHIP Payment and Access Commission voted overwhelmingly to change how hospitals calculate their Medicaid shortfall: the difference between what they spend caring for their Medicaid patients and what Medicaid pays them for that care. Under MACPAC’s proposal, hospitals would need to deduct from their shortfall total all third-party payments they receive for the care they provide to their Medicaid patients. If this proposal were to [...]

iqtsupport2019-04-17T06:00:13-04:00April 17, 2019|hospitals, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The Commission wrapped up its work on the June 2019 Report to Congress on Medicaid and CHIP at the April meeting, with sessions reviewing four of the report’s five draft chapters on Thursday morning, and votes on potential recommendations later in the afternoon. First on Thursday’s agenda was a draft June chapter on Medicaid prescription drug policy, which contained draft recommendations to provide states with a grace period to determine Medicaid drug coverage and [...]

iqtsupport2019-04-16T06:00:59-04:00April 16, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations|

Medicaid Expansion Helping FQHCs

Federally qualified health centers have benefited from Medicaid expansion, a new survey has found. According to a new Commonwealth Fund report, a survey comparing FQHCs in states that expanded their Medicaid programs to FQHCs in states that did not expand their Medicaid programs found that FQHCs in expansion states are: more financially stable more likely to provide behavioral health services, including medication-assisted treatment for opioid addiction, counseling, and coordination of care with social service providers more likely to engage in value-based care Because of Medicaid expansion, FQHCs now are paid for services they previously provided at no charge to low-income, [...]

iqtsupport2019-04-10T06:00:05-04:00April 10, 2019|Medicaid|

ACA Repeal Would Drive Up Uninsured, Uncompensated Care

At the same time that the Trump administration announced that it has asked a federal court to repeal the entire Affordable Care Act, the Urban Institute has published a report detailing the potential impact of the health care reform law’s repeal. According to the Urban Institute report, repealing the entire Affordable Care Act would add almost 20 million Americans to the ranks of the uninsured. Medicaid and CHIP enrollment would fall by 15.4 million people and millions of others would lose the tax credits they used to purchase insurance. Some would purchase insurance with limited benefits and individual plan premiums [...]

iqtsupport2019-03-29T06:00:00-04:00March 29, 2019|Affordable Care Act, health care reform, hospitals, Medicaid|

HHS Talking to States About Medicaid Block Grants

In the absence of legislation to turn Medicaid into a block grant program, the U.S. Department of Health and Human Services is talking to some states about granting waivers that permit them – voluntarily – to turn their individual Medicaid programs into block grants. HHS Secretary Alex Azar acknowledged this last week during a hearing of the Senate Finance Committee. He did not disclose which states, or how many, with which HHS has had such discussions and he also noted that his staff is talking to state officials about waivers to permit them to adopt Medicaid per capita spending limits. [...]

iqtsupport2019-03-20T06:00:51-04:00March 20, 2019|Medicaid|

“Rejected” Medicaid Reforms May Resurface

Partial Medicaid expansion, desired by some Republican governors but rejected by the Trump administration last year, may not be so rejected after all. At least not according to Seema Verma, administrator of the Centers for Medicare & Medicaid Services, which oversees the federal Medicaid program. In a recent interview, Verma said the administration is reconsidering its rejection of partial Medicaid expansion, an idea she supports and that What I have said to states and to governors [is] “Tell me what you want to do, and it’s my job to help you get to where you want to go.” To emphasize [...]

iqtsupport2019-03-18T06:00:23-04:00March 18, 2019|health care reform, Medicaid|

Sneak Preview of Medicaid Spending Limits?

The imposition of spending limits for individual Medicaid recipients has been discussed in Washington policy circles for years and was offered in the White House’s recent FY 2020 budget proposal. While deliberations on such a proposal have never advanced in a meaningful way, the state of Utah is doing more than talking about such an approach: it has petitioned the Centers for Medicare & Medicaid Services for a Medicaid waiver that would enable it to introduce such a system in its state Medicaid program. Under the state’s proposed Medicaid waiver, Utah asks the federal government to limit its own Medicaid [...]

iqtsupport2019-03-14T13:00:42-04:00March 14, 2019|Medicaid|