Medicaid Responds To The Opioid Epidemic: Regulating Prescribing And Finding Ways To Expand Treatment Access
Medicaid programs are at the center of the opioid epidemic. Nearly 12 percent of adults covered by Medicaid have a substance use disorder, including opioid use disorder. Available data suggest that Medicaid beneficiaries are prescribed painkillers at higher rates than non-Medicaid patients and have a higher risk of overdose, from both prescription opioids and illegal versions including heroin and fentanyl. In addition to the human toll, abuse of opioids has significant financial effects. In 2010, Arizona Medicaid paid for more than half of all opioid-related emergency department admissions, and in 2012, 81 percent of the $...
Source: Health Affairs Blog - April 11, 2017 Category: Health Management Authors: Amy Bernstein and Nevena Minor Tags: Costs and Spending Medicaid and CHIP Public Health opioid epidemic preferred drug lists prescription drug abuse prescription drug monitoring programs prior authorization requirements Section 1115 Waivers Source Type: blogs
The Children of Medicaid
This article was originally published on Complex Child.
Compiled by Susan Agrawal
I’ve been continually surprised by how many people think Medicaid is just for poor families on welfare. Those of us who parent children with complex medical needs know that Medicaid is so much more than that. After all, 72% of Medicaid enrollees are children, people with disabilities, and the elderly, and these groups account for 84% of spending.
Medicaid provides vital services for children, including home nursing care and therapies, that are not otherwise covered. In this article, we will share just a few of the children with medical co...
Source: Disruptive Women in Health Care - April 10, 2017 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs
Health Wonk Review Archives: 2006-2016
June 1, 2017 - Andrew Sprung - xpostfactoid
May 18, 2017 - Jason Shafrin - Healthcare Economist
May 4, 2017 - Julie Ferguson - Workers Comp Insider
April 20, 2017 - Brad Wright - Wright on Health
April 6, 2017 - Hank Stern - InsureBlog
March 23, 2017 - Louise Norris - Colorado Health Insurance Insider
March 9, 2017 - Peggy Salvatore - Health System Ed Blog
February 23, 2017 - David Williams - Health Business Blog
February 9, 2017 - Steve Anderson - medicareresources.org
January 26, 2017 - Joe Paduda at Managed Care Matters
January12, 2017 - Julie Ferguson - Workers Comp Insider
December 1, 2016 - Hank Stern a...
Source: Health Wonk Review - April 7, 2017 Category: Health Management Source Type: blogs
Health Wonk Review - upcoming hosts
Apr 20, 2017 - Brad Wright - Wright on Health
May 4, 2017 - Julie Ferguson - Workers Comp Insider
May 18, 2017 - TBA
June 1, 2017 - Andrew Sprung - xpostfactoid
June 15, 2017 - Joe Paduda - Managed Care Matters (Source: Health Wonk Review)
Source: Health Wonk Review - April 6, 2017 Category: Health Management Source Type: blogs
What Now?: A Four Step Plan For Bipartisan Health Reform
As I concluded in my Health Affairs Blog post last Monday, it should be clearer now than ever that new steps to improve our health care system must be pursued on a bipartisan basis. In the past week, several Members of Congress and the President himself have expressed interest in finding consensus solutions to the challenges we face. Democrats, meanwhile, have responded in kind. While it will not be easy, we ought to applaud these gestures and, as health care stakeholders, demonstrate our preparedness to support efforts to improve health care access and reduce costs.
With that in mind, I have compiled here a range of sensi...
Source: Health Affairs Blog - April 4, 2017 Category: Health Management Authors: Billy Wynne Tags: Featured Following the ACA Insurance and Coverage Medicaid and CHIP Quality bipartisanship Congress house v. price MACRA section 1333 Source Type: blogs
Health Care: What Should a Populist Do Now?
Conclusion
The most common response to the suggestion that private contracts could be useful in reforming the health-care system for the benefit of ordinary Americans is the observation that people—ordinary Americans in particular—cannot reasonably be expected to read, let alone understand and compare, the multiple contracts they would confront. This point, however, while valid, is beside the real one, which is to give adequately subsidized consumers meaningful choices with respect to the cost and content of their future health care and enough reliable help in making them that they can be reasonably content with their ...
Source: The Health Care Blog - April 1, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Modernizing And Strengthening Existing Laws To Control Drug Costs
In his first pre-inaugural press conference on January 11, President Trump stated the pharmaceutical industry has been “disastrous” and is “getting away with murder.” The remarks were very much in line with those made on the campaign trail and in the days following his election. If President Trump truly intends to control drug costs, we offer four proposals that leverage existing drug pricing systems to reduce prices for both public and private payers; in this Blog post, we will describe two of the proposals in depth.
President Trump’s rhetoric is understandable. Net spending on drugs and biologics grew 8.5 perce...
Source: Health Affairs Blog - March 31, 2017 Category: Health Management Authors: Tim Horn and Sean Dickson Tags: Costs and Spending Drugs and Medical Innovation Drugs and Medical Technology Medicare 340B program ACA section 2503 Additional Rebate Average Manufacturer Price Daraprim drug spending pricing formulas Source Type: blogs
Repealed and Misplaced
By KIP SULLIVAN
Like Joe, Michael and others, I find myself wondering what, if anything, Trump learned from the demise of the AHCA last Friday. But I’m also wondering what Democrats and other Republicans are thinking. The question I would like to ask all Republicans is: Is it clear to you now that merely saying no to any Democratic proposal to lower the uninsured rate is bad for your party? The question I would like to ask all Democrats who supported the Affordable Care Act is: Is it clear to you now that that the managed care nostrums in the ACA cannot lower costs, and that attempting to lower the uninsured rate wi...
Source: The Health Care Blog - March 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized AHCA Freedom Caucus Trump William Kristol Source Type: blogs
Evidence-Based Health Reform
By MARGALIT GUR-ARIE
President Trump campaigned on making health care better, cheaper and available to all Americans, regardless of ability to pay. Once Mr. Trump was safely in the White House, the Republican thought leaders in Congress were quick to supply him with plans to repeal and replace Obamacare. Most were written in protest to President Obama’s policies and were never meant to be implemented.
When scrutinized by the rank and file of the Republican Party, it turned out that the Ryan/Price American Health Care Act was neither repealing enough for some, nor replacing enough for others.
The Democratic Party lost no...
Source: The Health Care Blog - March 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
I Dub Thee “ Three Pronged ” Care
By MARGALIT GUR-ARIE
There are approximately 18 million Americans who purchase health insurance on the so called individual market, on and off the Obamacare exchanges. There are another 14 million or so who could be buying insurance on the individual market, but choose not to buy anything. This puts the total individual market at about 10% of Americans. Half of those are, or are eligible to be, heavily subsided through Obamacare (including those huge deductibles). The other 5% are facing the full brunt of health insurance price increases under Obamacare. Of those, 3% are paying for Obamacare health insurance and getting ga...
Source: The Health Care Blog - March 22, 2017 Category: Consumer Health News Authors: John Irvine Tags: 2016 Election Repeal Replace Uncategorized Source Type: blogs
The House Manager ’s Medicaid Amendments: The State Block Grant Option
The 1995 Medicaid block grant provisions contained in the Balanced Budget Act of 1995 that was sent to (and vetoed by) President Clinton consumed 100 pages of dense legislative drafting. The block grant provisions of the American Health Care Act (AHCA)—which faces an imminent vote on the House floor—are much more efficient, taking up about eight pages in the House Manager’s Amendment (Policy Changes).
Read in some detail—although there is not much detail to read—the block grant option can be read as an astonishing expression of legislative policy, and even more so perhaps, a statement of child hea...
Source: Health Affairs Blog - March 21, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Following the ACA Medicaid and CHIP ACA repeal and replace AHCA block grants Medicaid block grants Medicaid per capita cap Source Type: blogs
Democrats Paid a Steep Price For Ignoring the CBO. Republicans Will Too.
BY KIP SULLIVAN
Eight years ago it was Democrats who were criticizing the Congressional Budget Office. Now it’s Republicans who are bashing the CBO for estimating that 14 million Americans will lose their health insurance next year if the House Republicans’ “repeal and replace” bill becomes law.
The media and the blogosphere have done a reasonably good job of debunking the Republicans’ criticisms of the CBO. Any citizen paying attention can discover that although fewer people enrolled in the Obamacare exchanges in 2014 than the CBO predicted in 2010, the CBO correctly forecast that the uninsured rate would fall b...
Source: The Health Care Blog - March 21, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The Unfolding Medicaid Story: Congress, Governors, And The Trump Administration
Anyone who has had the chance to witness (or be part of) any of the epic health reform dramas that continually play out in Washington D.C. will agree: in the end, it always comes down to Medicaid. We have once again arrived at one of those moments.
The typical starting point for this continuing drama is the initial reaction to Medicaid’s sheer size and reach—16 percent of all health care spending in FY 2014, and 74 million people enrolled as of December 2016. These figures are especially astonishing to the newly initiated when one compares them to where Medicaid was only 37 years ago in 1980—fewer than 20 mil...
Source: Health Affairs Blog - March 21, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP block grants governors per capita caps States Source Type: blogs
Taming Health Care Spending: Could State Rate Setting Work?
For more than three and a half decades health care expenditures in the United States have grown at a much higher rate than those in other wealthy nations. Although this trend has moderated in recent years, most observers believe that expenditures, which by international standards are already high, will continue to rise. These increases will put more pressure on employers, employees, states, and the federal government, particularly on the public programs on which millions rely for their health insurance.
Evidence clearly shows that for the most part high prices historically have been the primary driver of this growth; moreo...
Source: Health Affairs Blog - March 20, 2017 Category: Health Management Authors: David Frankford and Sara Rosenbaum Tags: Costs and Spending Featured Health Policy Lab Insurance and Coverage Payment Policy Medicare DRG program national health expenditures rate regulation Resource-based relative value scale Vermont all-payer ACO System Source Type: blogs
Value-Based Purchasing and “ Free Lunch Syndrome ”
By KIP SULLIVAN
Imagine that a drug company released a “study” that claimed to find that if all 75 million Americans with high blood pressure took the drug company’s hypertension drug the nation’s annual medical expenditures would drop by $20 billion. Imagine as well that the “study” failed to take into account the $40 billion cost to patients and insurers of buying all those hypertension drugs. Such a study would be roundly criticized for failing to take into account an essential component of cost – the cost of the intervention that led to lower medical expenditures.
But studies like the hypothetical drug c...
Source: The Health Care Blog - March 15, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
