Unbiased Analysis of Today's Healthcare Issues
Many people might know that generally the answer is commercial health plans have the most generous reimbursement compared to government plans. However, a key question is how much more do they pay? Commercial vs. Medicare rates A January 2022 report by the Congressional Budget Office finds that commercial payers reimburse hospitals at 223% of Medicare…
Where does the Centers for Medicare and Medicaid Services see Medicaid and the Children’s Health Insurance Program (CHIP) heading in the future. Based on a Health Affairs commentary from Brooks-LaSure and Tsai, the three key priority areas are (1) coverage and access, (2) equity, and (3) innovation and whole-person care. I review each of these…
Clayton 2019 is an interesting study on the impact of drug spending on Medicaid beneficiary mortality levels. The author uses variation in the roll out of Medicaid drug coverage by state across different Medicaid eligible groups in order to isolate plausibly exogenous variation in drug expenditures. Using this approach, Clayton finds that: …a $1 increase…
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…
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…
How did Medicaid expansion affect prescription drug use? At first glance, one would think that prescriptions increased; more insurance lowers patient out-of-pocket cost so we would expect more prescriptions. Medicaid insurance may crowd out other forms of insurance; if those other forms of insurance covered more drugs, then perhaps utilization would go down. A study…