Explaining Obamacare to foreigners – CommonWealth Magazine

April 2, 2015

when it comes to providing universal coverage and financial protection from the costs of illness and injury, non-Americans have almost nothing of value to learn from us. Even after the ACA’s health insurance expansions are fully implemented by 2016-2017, the US will still have the most inefficient, expensive, wasteful, and unfair coverage system of any advanced nation on the planet.

via Explaining Obamacare to foreigners – CommonWealth Magazine.

Surge in Newly Identified Diabetes Among Medicaid Patients in 2014 Within Medicaid Expansion States Under the Affordable Care Act

March 24, 2015

The number of Medicaid-enrolled patients with newly identified diabetes increased by 23% (14,625 vs. 18,020 patients) in the 26 states (and District of Columbia) that expanded Medicaid compared with an increase of 0.4% (11,612 vs. 11,653 patients) in the 24 states that did not expand Medicaid during this period. Similar differences were observed in younger and older adults and for both men and women.

CONCLUSIONS This study suggests that in the states that expanded Medicaid under the ACA, an increased number of Medicaid patients with diabetes are being diagnosed and treated earlier. This could be anticipated to lead to better long-term outcomes.

via Surge in Newly Identified Diabetes Among Medicaid Patients in 2014 Within Medicaid Expansion States Under the Affordable Care Act.

Health Care Systems Try to Cut Costs by Aiding the Poor and Troubled – NYTimes.com

March 23, 2015

A patchwork of experiments across the country are trying to better manage these cases. The Center for Health Care Strategies, a policy center in New Jersey, has documented such efforts in 26 states. Some are run by private insurers and health care providers, while others are part of broader state overhaul efforts. The federal government is supporting some, too, through its $10 billion Innovation Center, set up under the Affordable Care Act.

via Health Care Systems Try to Cut Costs by Aiding the Poor and Troubled – NYTimes.com.

Treating Medicaid patients is charity work. This bill proves it.

February 18, 2015

A physician friend of mine posted a copy of her Medicaid reimbursement on Facebook. Take a look at the charges compared to the actual reimbursement. She is paid between $6.82 and $17.54 for an hour of her time (i.e., on average, she makes less than minimum wage when treating a patient on Medicaid).

The enthusiasm for expanding Medicaid coverage to the previously uninsured seems misplaced. Improved “access” to the health care system via Medicaid programs surely cannot result in lasting coverage. In-network physicians will continue to dwindle as their office overhead exceeds meager reimbursement levels.

In reality, treating Medicaid patients is charity work. The fact that any physicians accept Medicaid is a testament to their generosity of spirit and missionary mindset. Expanding their pro bono workloads is nothing to cheer about.  The Affordable Care Act’s “signature accomplishment” is tragically flawed – because offering health insurance to people that physicians cannot afford to accept is not better than being uninsured.

via Treating Medicaid patients is charity work. This bill proves it..

Safety-Net Emergency Departments: A Look at Current Experiences and Challenges | The Henry J. Kaiser Family Foundation

February 11, 2015

The ED directors we spoke with in hospitals in Medicaid expansion states reported reductions in the share of ED patients without insurance and corresponding increases in the share with Medicaid. However, uninsured rates remained high in all the safety-net EDs.

The ED directors’ expectations regarding trends in ED visit volume over the next few years varied. Some anticipated increased visits, citing pressures on primary care access, remaining large uninsured populations, or expanded ED capacity. Others anticipated flat or declining ED visits due to expanded coverage and access and the impact of new models of health care delivery and payment.

The ED directors we interviewed were not certain what the net impact of expanded coverage, large remaining uninsured populations, DSH cuts, delivery system reforms, and other ongoing changes will be on ED finances.

via Safety-Net Emergency Departments: A Look at Current Experiences and Challenges | The Henry J. Kaiser Family Foundation.

Insured, but Not Covered – NYTimes.com

February 8, 2015

The Affordable Care Act has ushered in an era of complex new health insurance products featuring legions of out-of-pocket coinsurance fees, high deductibles and narrow provider networks. Though commercial insurers had already begun to shift toward such policies, the health care law gave them added legitimacy and has vastly accelerated the trend, experts say.

The theory behind the policies is that patients should bear more financial risk so they will be more conscious and cautious about health care spending. But some experts say the new policies have also left many Americans scrambling to track expenses from a multitude of sources — such as separate deductibles for network and non-network care, or payments for drugs on an insurer’s ever-changing list of drugs that require high co-pays or are not covered at all.

Continue reading the main story


Paying Till It HurtsAPRIL 18, 2014

For some, like Ms. Pineman, narrow networks can necessitate footing bills privately. For others, the constant changes in policy guidelines — annual shifts in what’s covered and what’s not, monthly shifts in which doctors are in and out of network — can produce surprise bills for services they assumed would be covered. For still others, the new fees are so confusing and unsupportable that they just avoid seeing doctors.

via Insured, but Not Covered – NYTimes.com.

Who will treat the flood of Obamacare Medicaid patients? | NJ.com

February 8, 2015

If you want to understand Medicaid’s problems in New Jersey, just ask the Holstein men.

Justin Holstein, 39, of Ocean Township, spent a year on the government health insurance program when he was starting his own business. Long under treatment for chronic migraines, he lost all his doctors the moment he enrolled.

His new doctor said only a neurologist could renew his medication, but the insurance network’s neurologist couldn’t see him for four months, he said. That meant four months of sleepless nights battered by pain, and four months of getting through the days courtesy of the caffeine in Excedrin.

“You have a card saying you have health insurance, but if no doctors take it, it’s almost like having one of those fake IDs,” he said. “Your medication is all paid for, but if you can’t get the pills, it’s worthless.”

via Who will treat the flood of Obamacare Medicaid patients? | NJ.com.


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