The American Health Care Act And Medicaid: Changing A Half-Century Federal-State Partnership
Based on page length alone, it is evident that Medicaid is a focal point of the American Health Care Act, released on March 6. Although its fate is uncertain, the bill provides a clear sense of where the Affordable Care Act repeal and replace strategy is heading. Where Medicaid is concerned, what has been discussed for years has now become real: using ACA repeal/replace as the vehicle for a wholesale restructuring of the very financial foundation of the Medicaid program as it has existed over an unparalleled, half-century federal/state partnership.
As expected, the House bill essentially eliminates the enhanced funding lev...
Source: Health Affairs Blog - March 10, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Featured Medicaid and CHIP ACA repeal and replace Planned Parenthood Source Type: blogs
Bringing on-demand rideshare to medical transport. Interview with Veyo ’ s CEO
Uber and Lyft have transformed (and largely destroyed) the taxi industry. Now startup companies like Veyo are applying similar approaches to the medical transportation field. I interviewed Veyo’s CEO, Josh Komenda to get his take.
1.How is non-emergency medical transportation (NEMT) defined? What’s included? How big is it?
Non-Emergency Medical Transportation (NEMT) is a transportation benefit for Medicaid or Medicare members who need to get to and from medical services, but have no means of transportation. NEMT provides eligible patients with trips that are non-emergency in nature, meaning there is no i...
Source: Health Business Blog - March 9, 2017 Category: Health Management Authors: dewe67 Tags: Entrepreneurs Patients Podcast Technology medical transportation NEMT rideshare Source Type: blogs
Health Wonk Review - upcoming hosts
Mar 23, 2017 - Louise Norris - Colorado Health Insurance Insider
Apr 6, 2017 - Hank Stern - InsureBlog
Apr 20, 2017 - Brad Wright - Wright on Health
May 4, 2017 - TBA
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 - March 9, 2017 Category: Health Management Source Type: blogs
R & D Costs For Pharmaceutical Companies Do Not Explain Elevated US Drug Prices
That pharmaceutical companies charge much more for their drugs in the United States than they do in other Western countries has contributed to public and political distrust of their pricing practices. When these higher US prices (which are sometimes cited as being two to five times the prices in Europe) are challenged, the pharmaceutical industry often explains that the higher prices they charge in the US provide them with the funds they need to conduct their high-risk research.
This claim—that premiums earned from charging US patients and taxpayers more for medications than other Western countries funds companies’...
Source: Health Affairs Blog - March 7, 2017 Category: Health Management Authors: Nancy Yu, Zachary Helms and Peter Bach Tags: Costs and Spending Drugs and Medical Innovation Payment Policy Big Pharma drug pricing Source Type: blogs
How to Blow Up the Health Insurance Market In One Easy Step
By ROBERT LASZEWSKI
I call support for giving insurance companies the ability to sell insurance across state lines the cockroach proposal.
As bad as it is, you just can’t kill the damn thing!
Last night, President Trump once again listed this idea in his address to Congress as one of his health care talking points.
Any candidate that suggests such a scheme only shows how unsophisticated he and his advisers are when it comes to understanding how the insurance markets really work––or could work.
I gave a speech to 750 health insurance brokers and consultants in DC last week.
When selling health insurance across s...
Source: The Health Care Blog - March 2, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Health Wonk Review Archives: 2006-2016
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 at InsureBlog
November 11, 2016 - Joe Paduda - Managed Care Matters Post-election special
November 3, 2016 - Brad Wright at Wright on Health
Octobe...
Source: Health Wonk Review - March 1, 2017 Category: Health Management Source Type: blogs
From Machine-Readable Provider Directories, A Preview Of A Revolution
In this study, we define an integrated health plan as a network of providers that care for a particular patient population. Our definition focuses on health systems that also offer their own health plan, as opposed to systems that are integrated but are not also functioning as payers.
Medicaid: Insurers offering qualified health plans in the exchange whose primary or original line of business was Medicaid managed care.
Nationally, 93.4 percent of adult primary care physicians participating in exchange plans in states where the federal government administers the exchange reported via the plan’s directory that they are acc...
Source: Health Affairs Blog - February 27, 2017 Category: Health Management Authors: Mike Adelberg and Michelle Strollo Tags: Featured Insurance and Coverage Medicaid and CHIP Medicare Quality health insurance exchanges machine-readable provider directories provider networks Source Type: blogs
Health Wonk Review: Presidents ’ Day edition
With Presidents’ Day on Monday, school vacations in Massachusetts and New York, not to mention the throngs soaking it up at HIMSS, it’s relatively quiet in the healthcare wonkosphere this week. Nonetheless, I have managed to collect a few solid entries for your reading pleasure.
Workers’ Comp Insider has a “bone to pick” with former President Obama for not doing enough to fight for ObamaCare and educate the public about its merits. But the last few lines are telling as the post focuses on the cluelessness of the ‘dogs that caught the bus’ (i.e., Republicans). And the PS says it ...
Source: Health Business Blog - February 23, 2017 Category: Health Management Authors: dewe67 Tags: Blogs Policy and politics Source Type: blogs
Can Employers Take A Bigger Role In Controlling Drug Costs?
An estimated 150 million Americans receive insurance through their employer — and employees and employers alike continue to suffer from “sticker shock” for prices for new drugs, despite several years of debate and threatened congressional action to control the high prices of pharmaceutical products. While considerable attention has been paid to potential actions by Medicare or the Food and Drug Administration (FDA), there has been less focus on the role of private payers to solve the issue. Employers sponsoring health benefits are not bound by the same statutory constraints that apply to Medicare and can ...
Source: Health Affairs Blog - February 17, 2017 Category: Health Management Authors: Robert Galvin and Troyen Brennan Tags: Costs and Spending Drugs and Medical Innovation Drugs and Medical Technology Insurance and Coverage employer coverage launch prices pharmacy benefit managers prescription drug prices QALY Source Type: blogs
Don ’t Get Too Distracted By the Smoke Coming Out of Washington
By CECI CONNOLLY & MARGARET MURRAY
Health care has risen to the top of the national agenda and Washington policymakers are once again debating how to affordably provide coverage and care for Americans. It is a discussion we welcome. But in the meantime, let’s not lose sight of the fundamentals that will ultimately produce greater value for our health care dollars.
At the heart of a high-performing health system is quality outcomes. For consumers to make informed decisions, they’ll need more data—reliable, actionable data. Health plans operating in managed care are accustomed to demonstrating their value and in fa...
Source: The Health Care Blog - February 16, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The Future Of Essential Health Benefits
The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and Congress seek to repeal and replace the law. Essential Health Benefits, which define what health care benefits plans in the Marketplaces and certain other health plans must cover, go to the heart of what it means to have health insurance and what health care we, as a society, want to ensure people can access.
Today, critics of the EHB cite them as a cause of high health insurance costs and as an example of federal overreach. They say the EHB are too expansive a...
Source: Health Affairs Blog - February 14, 2017 Category: Health Management Authors: Ian Spatz and Michael Kolber Tags: Costs and Spending Following the ACA Insurance and Coverage habilitative care maternity care Mental Health States Substance Use Disorders Source Type: blogs
The Marketplace Premiums Increase: Underwriting Cycle Or Death Spiral?
The election of Donald Trump to the Presidency has accelerated and transformed health policy discussions. Another important recent development was the October 24 announcement by the Department of Health and Human Services (HHS) that the average increase in premiums for Marketplace plans would be 22 percent overall, and 25 percent for states using HealthCare.Gov. In this post, we aim to illuminate the underlying forces that led to these increases in premiums so as to clarify the historical record and provide useful information for interested parties who are dealing with the Affordable Care Act (ACA).
We have been tracking c...
Source: Health Affairs Blog - February 8, 2017 Category: Health Management Authors: Jon Gabel and Heidi Whitmore Tags: Following the ACA Insurance and Coverage employer-sponsored coverage Employer-Sponsored Insurance Massachusetts reinsurance Republicans Source Type: blogs
Health Wonk Review Archives: 2006-2016
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 at InsureBlog
November 11, 2016 - Joe Paduda - Managed Care Matters Post-election special
November 3, 2016 - Brad Wright at Wright on Health
October 20, 2016 - Peggy Salvatore - Health System Ed Blog
October 6, 2016 - Joe Paduda - Managed Care Matters
Sept 22, 2016 -Louise Norris - Colorado Health Ins...
Source: Health Wonk Review - February 8, 2017 Category: Health Management Source Type: blogs
