To Extend or Not to Extend the Primary Care “Fee Bump” in Medicaid?

December 5, 2014

Policy makers and researchers are eager to learn the effects of the Patient Protection and Affordable Care Act of 2010 (ACA) and its many provisions, but to date, they have been frustrated by the dearth of robust evidence on the ACA’s true impacts on important health care and patient outcomes (e.g., access to primary care services). The present limitations of evidence, often a consequence of delays and inconsistencies in the law’s implementation, have begun to affect policy making in the ACA’s wake.

In this article, we consider the ongoing debates among state and federal policy makers aboutwhether to extend the ACA’s so-called fee bump provision, whereby Medicaid fees for primary care services were increased to 100 percent of Medicare levels during 2013 and 2014. We describe the difficulties state Medicaid programs have experienced in implementing the fee bump as well as how the resulting evidence gap and the broader political context today shape the deliberations. To conclude, we identify policy alternatives and other factors policy makers should consider when deciding whether to extend the fee bump.

To Extend or Not to Extend the Primary Care “Fee Bump” in Medicaid?.


Underinsurance Remains Big Problem Under Obama Health Law – NYTimes.com

December 1, 2014

But the A.C.A. has not done as much as many had hoped it would to reduce underinsurance. In fact, it may be helping to spread it. And proposed modifications to the law, like those that would introduce a new tier of “copper” plans in addition to bronze, silver, gold and platinum, might make underinsurance worse.

This is important, because research shows that those who are underinsured are more likely to go without needed care.

In the most recent update of the Commonwealth Fund survey, conducted in September and October of this year, investigators found that 13 percent of all adults 19-64 spent more than 10 percent of their income on out-of-pocket health care costs. Poor adults were the most likely to spend this amount. More than 30 percent of nonelderly adults earning less than the poverty line spent more than 10 percent of their income on out-of-pocket costs, and 18 percent of those making between 100 percent and 200 percent of the poverty line did so. All of these people were insured.

via Underinsurance Remains Big Problem Under Obama Health Law – NYTimes.com.


Cost Still a Barrier Between Americans and Medical Care

November 28, 2014

One in three Americans say they have put off getting medical treatment that they or their family members need because of cost. Although this percentage is in line with the roughly 30% figures seen in recent years, it is among the highest readings in the 14-year history of Gallup asking the question.

via Cost Still a Barrier Between Americans and Medical Care.


Obamacare could be crippled since 214,000 Doctors withdrew

November 6, 2014

More than 214,000 doctors will not participate in new plans under the Patient Protection and Affordable Care Act ACA.

According to a survey conducted this year by the Medical Group Management Association MGMA, a trade association comprised of multi-physician medical practices, “as many as 214,524 American physicians will not be participating in any ACA exchange products.” Reasons abound as to why, but, “chief among them is the fact that exchange plans are more likely to offer significantly lower reimbursement rates than private market plans, confusion among consumers about the obligations associated with high deductibles, and fear that patients will stop paying premiums and providers will be unable to recover their losses”

via Obamacare could be crippled since 214,000 Doctors withdrew.


Medical Progress Report 18 | Health Savings Accounts Under the Affordable Care Act: Challenges and Opportunities for Consumer-Directed Health Plans

October 18, 2014

Initial skepticism from HSA advocates was understandable; but based on our current research, it appears that the Obama administration was true to its word and that HSAs at least for the moment remain widely accessible on public exchanges. The report finds that, far from becoming obsolete under the ACA, high-deductible plans are widely available—98 percent of uninsured Americans have access to at least one HSA-eligible plan. Moreover, these plans also make up about 25 percent of total offerings on Obamacare exchanges. We also found that they remain significantly less expensive than traditional plan designs, offering savings of about 14 percent, on average.

Nonetheless, our analysis indicates that it remains difficult for consumers to identify HSA-eligible plans and that much more could be done to simplify their administration and educate exchange consumers on their advantages and limitations.

via Medical Progress Report 18 | Health Savings Accounts Under the Affordable Care Act: Challenges and Opportunities for Consumer-Directed Health Plans.


Revealed: The Secret Reason ObamaCare’s Insurance Options are So Mediocre – Amy Ridenour’s National Center Blog – A Conservative Blog

October 3, 2014

A just-released federal study reveals the secret behind the inferior insurance options presented on the ObamaCare exchanges.The small health insurance companies apparently are being driven out of the exchanges

via Revealed: The Secret Reason ObamaCare’s Insurance Options are So Mediocre – Amy Ridenour’s National Center Blog – A Conservative Blog.


For Many New Medicaid Enrollees, Care Is Hard to Find, Report Says – NYTimes.com

September 28, 2014

Enrollment in Medicaid is surging as a result of the Affordable Care Act, but the Obama administration and state officials have done little to ensure that new beneficiaries have access to doctors after they get their Medicaid cards, federal investigators say in a new report.

The report, to be issued this week by the inspector general at the Department of Health and Human Services, says state standards for access to care vary widely and are rarely enforced. As a result, it says, Medicaid patients often find that they must wait for months or travel long distances to see a doctor.

via For Many New Medicaid Enrollees, Care Is Hard to Find, Report Says – NYTimes.com.


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