What is MIPS?

Yesterday I posted about MIPS, the new Medicare physician reimbursement program set to begin in 2019.  The Health Affairs blog provides a nice summary of some of the changes. First and probably most importantly, the formulaic approach to setting base payment rates is gone, replaced with automatic increases for all doctors from 2015 through 2019. For…

Medicaid Expansion and States’ bottom line

A recent RWJF Issue Brief notes that states that expanded Medicaid received more revenue from the federal government and had less state-level spending on programs that support the uninsured. In examining Medicaid expansion across eight states—Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington and West Virginia—it is clear that states are realizing savings and revenue…

5 Trends 5 years after by ACA

From a PwC report on “Five trends to watch as the Affordable Care Act turns five“: Risk Shift: Raising the stakes for all healthcare players. The ACA added force to new payment models that reward outcomes and penalize poor performance such as high rates of readmission and hospital-acquired conditions. Primary care: Back to basics. Experimentation…

Medicaid Expansion States

Which states have decided to receive additional federal funds to expand the share of people they cover under Medicaid?  The Kaiser Family Foundation has the answer. Alabama Not Moving Forward at this Time Alaska  Not Moving Forward at this Time Arizona Implementing the Medicaid Expansion  Arkansas Implementing the Medicaid Expansion California  Implementing the Medicaid Expansion Colorado Implementing the Medicaid Expansion…

Who will pay the Cadillac tax?

Beginning in 2018, many individuals will face the “Cadillac” tax. What is the Cadillac tax? The Cadillac tax is a tax on high-cost health insurance plans. According to a Truven report, it is calculated as “40 percent of the excess of total per employee per year (PEPY) healthcare costs above statutory threshold limits of $10,200…

ACA, Uninsurance and American Cities

The Affordable Care Act (ACA) increased the likelihood individuals have insurance by: (i) offering states money to expand Medicaid eligibility, and (ii) offering individuals subsidies to purchase insurance through newly created health insurance exchanges.  Did it work?  A Robert Wood Johnson report examines at the effect of the ACA on uninsurance rates in 14 large…