Healthcare Reform Update: Can Medicaid beneficiaries find a doctor? The CMS wants to know | Modern Healthcare

July 9, 2014

The CMS is planning to conduct its first nationwide research effort to answer the question of whether adult Medicaid beneficiaries can find providers, and if factors such as being in managed Medicaid versus a fee-for-service offering aid or hurt the search. What it’s likely to find, according to interviews conducted with state Medicaid officials and medical society officials in 20 states, is a mixed picture overshadowed by general concerns that reimbursement rates remain too low to entice many doctors to accept new Medicaid patients.

Many states already conduct such surveys annually, but the CMS’ aim is to standardize the collection and analysis of data from state to state. The survey will begin this fall, with the goal of reaching roughly 29,000 adult Medicaid enrollees from each state for a total sample size of approximately 1.5 million, according to a bulletin circulated to state officials.

via Healthcare Reform Update: Can Medicaid beneficiaries find a doctor? The CMS wants to know | Modern Healthcare.


Future of Obamacare bleak for North Carolinians | Other Views | NewsObserver.com

July 7, 2014

In two years, the ACA’s structural problems will lead to substantial premium increases. Once that happens, North Carolinians will likely leave the insurance market in droves. They’ll have little choice – they won’t be able to afford health insurance because federal subsidies won’t keep up with the rapid price increases. Within a decade, this could swell the ranks of the state’s uninsured by 57 percent.This isn’t baseless speculation. I reached this conclusion by using a peer-reviewed economic model published in several health journals. It was funded by both private and government sources, including the Department of Health and Human Services, and has been cited by multiple Supreme Court justices in ACA-related rulings.But why won’t this happen until 2017? Because that’s the year the Affordable Care Act goes into full effect and certain temporary provisions begin to sunset. The changes will affect all plans sold for 2017 and beyond.

via Future of Obamacare bleak for North Carolinians | Other Views | NewsObserver.com.


Public Health Insurance Expansions and Hospital Technology Adoption

July 2, 2014

This paper explores the effects of public health insurance expansions on hospitals’ decisions to adopt medical technology. Specifically, we test whether the expansion of Medicaid eligibility for pregnant women during the 1980s and 1990s affects hospitals’ decisions to adopt neonatal intensive care units NICUs. While the Medicaid expansion provided new insurance to a substantial number of pregnant women, prior literature also finds that some newly insured women would otherwise have been covered by more generously reimbursed private sources. This leads to a theoretically ambiguous net effect of Medicaid expansion on a hospital’s incentive to invest in technology. Using American Hospital Association data, we find that on average, Medicaid expansion has no statistically significant effect on NICU adoption. However, we find that in geographic areas where more of the newly Medicaid-insured may have come from the privately insured population, Medicaid expansion slows NICU adoption. This holds true particularly when Medicaid payment rates are very low relative to private payment rates. This finding is consistent with prior evidence on reduced NICU adoption from increased managed-care penetration. We conclude by providing suggestive evidence on the health impacts of this deceleration of NICU diffusion, and by discussing the policy implications of our work for insurance expansions associated with the Affordable Care Act.

via Public Health Insurance Expansions and Hospital Technology Adoption.


eHealth Offers Fixed-Benefit Indemnity Plans for Consumers Who Want Additional Coverage Options Outside of Open Enrollment

June 25, 2014

An eHealth analysis of fixed-benefit indemnity plans offered through the company’s website reports an average monthly premium of $112.98 for fixed-benefit indemnity plans. The coverage offered through fixed-benefit indemnity health insurance products may be summarized by the following:Fixed-benefit indemnity medical plans provide set benefits, typically in the form of a cash payout, to help cover services such as doctor’s visits, urgent care, x-rays, prescription drugs in some cases, and certain hospital expenses.

These products typically do not require policy holders to meet an annual deductible, but will not provide coverage beyond specified caps. Lifetime coverage limits may also apply.Benefits are typically paid directly to the policy holder who may then apply that amount to cover a portion of his or her medical expenses.

According to guidelines issued by the Centers for Medicare and Medicaid Services, fixed-benefit indemnity plans will no longer be available for purchase as a stand-alone product beginning in 2015, which means that consumers will only be able to purchase fixed-benefit indemnity plans to supplement their major medical coverage.

via eHealth Offers Fixed-Benefit Indemnity Plans for Consumers Who Want Additional Coverage Options Outside of Open Enrollment.


Obamacare’s Exchanges Fall Well Short of Enrollment Target

June 24, 2014

“Is the new law effective in reducing the number of uninsured? Yes, but so far not very,” he says.

Key questions include: How many actually have enrolled?How many of those were previously uninsured? How has Obamacare affected the overall pool of uninsured? What percentage of eligible people have signed up? What’s the cost?

via Obamacare’s Exchanges Fall Well Short of Enrollment Target.


Emergency Rooms See Longer Waits From Health Law : Roll Call Policy

June 18, 2014

Nearly half of ER doctors responding to an April poll by the American College of Emergency Physicians said they are already seeing an increase in patients because of the health care law, and 86 percent said they expect visits to increase over the next three years.But it’s way too soon to make claims about the impact of the health law, other observers say. “Every time I read about somebody talking about the impact of the Affordable Care Act on behavior and patient volume in the emergency department it makes me cringe,” says James Scheulen, who directs ER services for the five hospitals in the Johns Hopkins University health system. He says ER use was on the rise before the health law anyway, so teasing out the effects of the ACA will be hard. At Hopkins, there’s been no uptick in volume this year compared to the last three months of 2013, he adds.“Lengthy waits in ERs has always been a constant,” says Harvard School of Public Health Professor John McDonough. “So it’s risky to generalize without real data.” Statistics have to be considered carefully, he adds, pointing to reported increases by Massachusetts physicians in waiting times for appointments after the state’s 2006 coverage law. The data “is actually quite suspect because it’s based on a volunteer survey of physicians and always gets a pathetically poor response rate.”

via Emergency Rooms See Longer Waits From Health Law : Roll Call Policy.


Stephen T. Parente: The Short Unhappy Life of ObamaCare – WSJ

June 11, 2014

This leaves the newly uninsured with two options: If they qualify by their income, sign up for Medicaid or stay uninsured and face a penalty. Many will choose the first option. In a newly completed, as yet unpublished paper by George Washington University’s Bianca Frogner and me, we estimate that Medicaid enrollment will increase by 2%-3% annually through 2024. Yet this will not capture everyone. Many will not be eligible for the program, because either they earn more than 133% of the federal poverty level currently $11,670 for an individual, $23,850 for a family of four or their state did not expand Medicaid.Either way, there will be a significant number of uninsured Americans unwilling or unable to pay for the inflated insurance available on the exchanges and forced to pay penalties, which for 2016 and thereafter will be the greater of $695 or 2.5% of income. More will choose this option every year. By 2024, Ms. Frogner and I estimate that there will be more than 40 million uninsured, roughly 10% more than today.

via Stephen T. Parente: The Short Unhappy Life of ObamaCare – WSJ.


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