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|

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. MACPAC looked ahead to its June 2019 report to Congress on the initial day of the March 2019 Commission meeting. In the morning, sessions focused on potential recommendations to create a grace period for states to determine coverage policies for outpatient prescription drugs and removing or raising the rebate cap; a uniform definition of therapeutic foster care; and treatment of third-party payment when determining hospitals’ Medicaid shortfall for disproportionate share hospital payments. In the [...]

iqtsupport2019-03-13T06:00:16-04:00March 13, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission|

Rural Nursing Homes Struggle With Challenges

Across rural parts of the country skilled nursing facilities are struggling, and growing numbers are faltering in the face of many problems. Among the challenges they face are: difficulty passing health and safety standards evolving health care policies that encourage people to remain in their homes instead of choosing to enter nursing homes growing proportions of patients covered by Medicaid the failure of Medicaid payments in many states to cover the cost of nursing home care These challenges are especially acute in rural areas. Today, many regions have enough skilled nursing beds, at least on paper, but they are not [...]

iqtsupport2019-03-06T06:00:27-05:00March 6, 2019|Medicaid, post-acute care|

Nursing Home Study: More Medicaid Patients=Worse Care

Nursing homes that serve larger proportions of Medicaid patients have lower quality ratings, according to a new study from the American Health Care Association, a long-term-care provider trade group. The study also found that: For-profit nursing homes care for more Medicaid patients than non-profits. Rural nursing homes care for more Medicaid patients than urban facilities. Large facilities care for a higher proportion of Medicaid patients than smaller facilities. Learn more about the study and the theories behind some of these findings in the McKnight’s Long-Term Care News article “AHCA study: Facilities with higher Medicaid populations have poorer quality outcomes.” [...]

iqtsupport2019-02-28T13:00:01-05:00February 28, 2019|Medicaid, post-acute care|

States Taking Different Paths to Pay for Medicaid Expansion

With the federal share of Medicaid expansion falling to 90 percent next year, states that expanded their Medicaid programs under the Affordable Care Act are now exploring new ways to raise the money to pay for the 10 percent for which they will soon by responsible. Some are implementing hospital or insurer taxes while others are increasing existing taxes on hospitals and health insurers. New Hampshire is directing part of the proceeds from a liquor tax for this purpose and other states have introduced cigarette taxes. Some are charging premiums to Medicaid beneficiaries and introducing Medicaid work requirements so they [...]

iqtsupport2019-02-25T06:00:37-05:00February 25, 2019|Affordable Care Act, Medicaid|

Medicaid Expansion: A Good Financial Decision for States?

Medicaid expansion is a good financial deal for states, according to a new analysis by The Commonwealth Fund. At the heart of this conclusion are three primary considerations: The federal government pays 90 percent of the total cost of Medicaid expansion. States save money by expanding their Medicaid programs – even after paying their 10 percent share, because they shift the cost of care for some of their residents, currently paid entirely by the state, to Medicaid, for which the federal government pays 90 percent of the cost. Any remaining additional state costs represent only a very small portion of [...]

iqtsupport2019-02-20T06:00:57-05:00February 20, 2019|Affordable Care Act, Medicaid|

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 [...]

iqtsupport2019-02-15T06:00:51-05:00February 15, 2019|Centers for Medicare & Medicaid Services, MACPAC, Medicaid, Medicaid regulations|

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 [...]

iqtsupport2019-02-13T06:00:47-05:00February 13, 2019|Medicaid, Medicare|

Docs Still Less Likely to Treat Medicaid Patients

Medicaid patients continue to be last in line when it comes to finding doctors willing to serve them. At least that’s the conclusion drawn in a new analysis prepared by the Medicaid and CHIP Payment and Access Commission. According to a presentation delivered at a MACPAC meeting last week: Doctors are less likely to accept new Medicaid patients (70.8 percent) than they are patients insured by Medicare (85.3 percent) or private insurers (90 percent), with a much greater differential in acceptance rates among specialists and psychiatrists. Pediatricians, general surgeons, and ob/gyns have a higher acceptance rate of Medicaid patients than [...]

iqtsupport2019-01-29T13:00:57-05:00January 29, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission|