Bad Medicine: Medicaid Managed Drug Plan Rollback
By DEVON HERRICK
Many states have been looking for alternatives to reimbursing Medicaid providers piecemeal on a fee-for-service (FFS) basis. Increasingly they have been moving beneficiaries into Medicaid managed care plans. Today 39 states contract with managed care organizations to care for at least some Medicaid beneficiaries. States have been slower to integrate drug benefits with managed care, however. The Medicaid Drug Rebate Program requires drug manufacturers to rebate a portion of the drug costs to states and the federal government. Prior to the Affordable Care Act states did not qualify for drug maker rebates unl...
Source: The Health Care Blog - March 22, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Why Do We Need ACOs and Insurance Companies? Part 3. The HMOs Strike Back!!!
By KIP SULLIVAN, JD
This is the last installment in a three-part series that asks why we need both an insurance industry and an ACO industry. We are now stuck with the worst of all possible worlds – an inefficient insurance industry layered on top of an inefficient ACO industry.
I noted in Part I of this series that ACOs’ inability to cut costs explains why 90 percent of Medicare ACOs refuse to accept anything resembling insurance risk. In Part II I discussed ACO proponents’ expectation that many ACOs would accept full insurance risk, and I described the Medicare Payment Advisory Commission’s (MedPAC’s) reactio...
Source: The Health Care Blog - March 20, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Health Wonk Review - upcoming hosts
2018 Schedule
Apr 19 - Louise Norris, Colorado Health Insurance Insider
May 17 - Jason Shafrin, Healthcare Economist
June 14 - Hank Stern - InsureBlog
July 12 - Peggy Salvatore - Health System Ed Blog
August 16 - TBA
September 20 - TBA
October 18 - Joe Paduda, Managed Care Matters
November 15 - TBA
December 13 - Julie Ferguson, Workers Comp Insider (Source: Health Wonk Review)
Source: Health Wonk Review - March 15, 2018 Category: Health Management Source Type: blogs
Are physicians ready for single-payer health care?
Single payer health care is enjoying a boomlet in public opinion.
A Pew Research Center poll released in June 2017 found that, “Overall, 33 percent of the public now favors such a ‘single payer’ approach to health insurance, up 5 percentage points since January and 12 points since 2014.” 58 percent of those surveyed by Pew said that the government has a responsibility to ensure health for all, with a third saying it should be through a single national government program and 25 percent through a mix of government and private programs. Another 33 percent said the government is not responsible to ensure health...
Source: Kevin, M.D. - Medical Weblog - March 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/bob-doherty" rel="tag" > Bob Doherty < /a > Tags: Policy Public Health & Washington Watch Source Type: blogs
Why Do We need ACOs and Insurance Companies? Part II
By KIP SULLIVAN
In my last post , I made fun of Ezekiel Emanuel and Joseph Liebman for predicting that ACOs would replace insurance companies by 2020. I noted that the 800 to 1,000 ACOs reportedly in existence today are nowhere near ready to accept full insurance risk because they have shown no ability to cut costs. [1]
Although Emanuel and Liebman were foolish to predict most ACOs would quickly evolve into successful insurance companies, they shared with all other ACO advocates the understanding that that’s what ACOs are supposed to do – over time they’re supposed to bear more and more financial risk. It’s just ne...
Source: The Health Care Blog - March 11, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Why Do We Need ACOs and Insurance Companies?
By KIP SULLIVAN, JD
Six years ago Ezekiel Emanuel and Jeffrey Liebman made the foolish prediction that ACOs would eat the insurance industry’s lunch. “By 2020, the American health insurance industry will be extinct,” they wrote. “Insurance companies will be replaced by accountable care organizations….” This would happen, they argued, because ACOs are just so darned good at lowering costs compared with insurance companies.
The first Medicare ACO programs began in 2012. Today there are 800 to 1,000 ACOs in business. [1] But ACOs aren’t even close to displacing the insurance industry. The most obvious reason...
Source: The Health Care Blog - February 26, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACOs HMOs Kip Sullivan Source Type: blogs
HealthBI ’s Scott McFarland says Step Away From the Fax Machine — Harlow on Healthcare
We've Moved! Update your Reader Now. This feed has moved to: http://feeds.healthblawg.com/healthblawg Update your reader now with this changed subscription address to get your latest updates from us. http://feeds.healthblawg.com/healthblawg (Source: HealthBlawg :: David Harlow's Health Care Law Blog)
Source: HealthBlawg :: David Harlow's Health Care Law Blog - February 19, 2018 Category: Medical Law Authors: David Harlow David Harlow Tags: Audio EHR Harlow on Healthcare Health care policy Health Insurance Health Law Healthcare Innovation HIT Interview Managed Care Medicaid Pay for performance Physicians Podcast Population Health Public Health Social Determina Source Type: blogs
Health Wonk Review Archives: 2006-2018
May 17, 2018 - Jason Shafrin Healthcare Economist
April 19, 2018 - Louise Norris - Colorado Health Insurance Insider
March 15, 2018 - David Williams - Health Business Blog
February 15, 2018 - Steve Anderson - HealthInsurance.org blog
January 18, 2018 - Joe Paduda, Managed Care Matters
December 14, 2017 - Julie Ferguson - Workers Comp Insider
November 30, 2017 - Andrew Sprung - xpostfactoid.
November 9, 2017 - Jason Shafrin at Healthcare Economist
October 26, 2017 - David Williams at Health Business Blog
October 12, 2017 - Hank Stern - InsureBlog
September 28, 2017 - Brad Wright - Wright on Health
September 1...
Source: Health Wonk Review - February 16, 2018 Category: Health Management Source Type: blogs
Health Wonk Review - upcoming hosts
2018 Schedule
Mar 15 - David Williams, Health Business Blog
Apr 19 - Louise Norris, Colorado Health Insurance Insider
May 17 - Jason Shafrin, Healthcare Economist
June 14 - Hank Stern - InsureBlog
July 12 - TBA
August 16 - TBA
September 20 - TBA
October 18 - Joe Paduda, Managed Care Matters
November 15 - TBA
December 13 - Julie Ferguson, Workers Comp Insider (Source: Health Wonk Review)
Source: Health Wonk Review - February 15, 2018 Category: Health Management Source Type: blogs
