Medicaid and paperwork

When you buy a typical product, the vendor does its best to make the purchasing process as easy as possible.  There is a reason for this, clearly; they want your business.  State and federal governments, however, have no such incentive.  In fact, oftentimes reducing the number of people using government services saves money. Thus, it…

The problem of cutting Medicaid rates

A new paper by Sharma et al. (2017) finds that Medicaid patients living in states with lower Medicaid reimbursement have more challenges accessing primary care services. We found that states with higher Medicaid fees had higher probabilities of appointment offers and shorter wait times for Medicaid patients, and lower probabilities of appointment offers and longer…

Will value-based pricing be coming to the U.S.?

The answer may be yes.  One of the big inpediments to value-based pricing of pharmaceuticals was that any discount given to any single organization based on outcomes needed to be reflected in the Medicaid price.  Since outcomes are subject to random noise, there will inevitably be health plans that end up getting a low price due to worse than expected…

Medicaid Managed Care and Drug Utilization for Patients with Serious Mental Illness

How will Medicaid expansions affect patient access to pharamceuticals? This question is particularly relevant for patients with serious mental illness. The answer is complicated by the increasing presence of Medicaid managed care plans. Increasingly, states have turned to contracts with Medicaid managed care plans in order to better control costs and reduce budgetary uncertainty. However, in…

P4P in Medicaid

Does Medicaid use pay-for-performance (P4P) for providers?  If so, how does it work?  And does it affect quality and cost? These are the questions of interest to Rosenthal et al. (2015) in their study of P4P programs in Alabama, Minnesota, and Pennsylvania.  Although all three focus on physicians, the Alabama program is a “medical home ”…