Unbiased Analysis of Today's Healthcare Issues
Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Over the past decade, CMMI has tested over 50 new payment models, and in just the last 3…
No, this is not coming nation-wide, but it may be on its way in California. Kaiser Health News reports: A provision in California’s newly approved state budget will eliminate the asset test for the 2 million Californians enrolled in both Medi-Cal and Medicare, the federal health insurance program for people 65 and older and people…
From a recent article in NBER by Dunn et al. (2021): Observing the back-and-forth sequences of claims’ denials and resubmissions for past visits, we can estimate physicians’ costs of haggling with insurers to collect payments. Combining these costs with the revenue never collected, we estimate that physicians lose 17% of Medicaid revenue to billing problems,…
Poor, elderly individuals who may qualify for both Medicaid (for being poor) and Medicare (for being elderly, blind, disabled or have ESRD). In these cases, Medicaid serves as a supplemental insurer, covering Medicare coinsurance and deductibles. The generosity of this supplemental coverage for so-called ‘dual-eligibles’ varies across states. These differences in Medicaid payments arise from…
Earlier this month, the Congressional Budget Office (CBO) gave an update to its federal budget projections between 2020 and 2030. As expected, things look grim for 2020. CBO projects a federal budget deficit of $3.3 trillion in 2020, more than triple the shortfall recorded in 2019. That increase is mostly the result of the economic…
As reported by Kaiser Health News: Reversing a three-year decline, the number of people covered by Medicaid nationwide rose markedly this spring as the impact of the recession caused by the outbreak of COVID-19 began to take hold.Yet, the growth in participation in the state-federal health insurance program for low-income people was less than many…
I have written about the 340b program a number of times on this blog in the past (e.g., “The 340B Program: An Overview“, “340B Facts and Figures“). A new commentary by Thomas and Schulman (2020) in Health Services Research provides some additional information. For instance, why was 340B originally enacted? Blame the Medicaid Drug Rebate…
Janet Currie has a nice review article (Currie 2020) in Health Economics covering this topic. She summarizes the literature as follows: In the past 20 years, there has been an explosion of research demonstrating that child health is an important form of human capital. Healthier children live longer and healthier lives, get more education, and…
Kaiser Family Foundation has a nice overview of how Medicaid pays for prescription drugs. Below, I except from this helpful piece, but do check out the full article here. One point that many may not realize is that State Medicaid Agencies do not actually buy pharmaceuticals directly from manufacturers. Rather, they reimburse retail pharmacies that…
Every year, the Congressional Budget Office projects how the federal budget will look over the coming decade. For the coming decade, the numbers look grim. Federal deficits in CBO’s baseline average $1.2 trillion per year and total $11.6 trillion over the 2020– 2029 period…Those deficits would average 4.4 percent of gross domestic product (GDP). Other…