Higher Minimum Wages Reduce Employer ‐​Sponsored Health Insurance Provision
Ryan BourneThe debate around raising a minimum wage typically centers on how it impacts both pay and employment. The higher hourly pay for beneficiaries is measured against any reduction seen in employment due to the higher labor costs for businesses (termed “disemployment”). In theory, policymakers then evaluate if the trade‐​off is worth it.Theoverwhelming majority of academic studies still find that raising minimum wages costs jobs, particularly for young, black, and low ‐​skilled workers. But in recent decadesa large minority of studies have found no significant job loss effects, suggesting t...
Source: Cato-at-liberty - February 15, 2023 Category: American Health Authors: Ryan Bourne Source Type: blogs

All Three Legs of the Obamacare Stool Are Working Well
BY GEORGE HALVORSON When the Affordable Care Act was passed, the politics were so intense and the debates were so filled with rhetoric in all directions that most people actually didn’t understand that there were three major component parts to the strategy and program that function very directly as a package, and should be looked at now in the context of several years of implementation to see how each part of that law is currently doing. Medicaid was our first priority. The first component part — and the one that had the highest need for passage when the law was passed because we were doing such a horrible job...
Source: The Health Care Blog - February 15, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Affordable Care Act George Halvorson Medicaid Medicare Medicare Advantage Source Type: blogs

#HealthPolicyValentines – Happy Valentine ’ s Day
Happy Valentine’s Day everyone!  If you’re on Twitter, then you probably know that today many in the healthcare world are sharing what they call #HealthPolicyValentines.  You can see the latest feed of tweets here.  This is a humorous and informative way to talk about some of the nuances of healthcare and specifically healthcare policy.  We decided to celebrate the holiday, that we’d share a few of the best ones we saw below.  We hope you enjoy and get a good laugh. Health policy wonks logging onto Twitter to check #HealthPolicyValentines this morning pic.twitter.com/X0gsFT1wau — Dania Palanker (@...
Source: EMR and HIPAA - February 14, 2023 Category: Information Technology Authors: John Lynn Tags: Healthcare IT Regulations #healthpolicyvalentines Personal Musings Valentine's Day Source Type: blogs

Mark Cuban Cost Plus Drug Company ( " MCCPDC " ) PBC May Be Able to Say " Mission Accomplished " Even if Sales Stop Growing
On January 19, 2022, a startup called theMark Cuban Cost Plus Drug Company ( " MCCPDC " )opened its doors to the American public as a new online pharmacy and generic manufacturing startup. Initially, MCCPDC was also planning to launch its own Pharmacy Benefit Manager, but it later scrapped those plans, instead announcing several PBM partnerships with some PBM startups which do not engage in " spread pricing " , including on generic, biosimilar and " authorized generic " drugs. The company bears the name of its famous principal investor, multibillionaire Mark Cuban, who is perhaps best known as both owner of the NBA te...
Source: Scott's Web Log - February 7, 2023 Category: Endocrinology Tags: authorized generic 2023 Alex Oshmyansky authorized generics Biosimilar biosimilars Cost Plus costplus drug company drug prices drug pricing generic drugs mark cuban Mark Cuban Cost Plus Drug Company Source Type: blogs

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As states prepare to resume Medicaid eligibility redeterminations, government officials are focused on strategies to promote continuity of coverage.        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - February 7, 2023 Category: International Medicine & Public Health Authors: Sabrina Corlette, Maanasa Kona Source Type: blogs

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A court ruled Georgia can proceed with a Medicaid expansion demonstration that excludes hundreds of thousands of low-income adults by subverting ACA rules.        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - February 3, 2023 Category: International Medicine & Public Health Authors: Sara Rosenbaum Source Type: blogs

13 Year Old McAllen
BY IAN MORRISON As a Scot, obviously I am a whisky fan, and although I prefer the smoky malts of Islay (where my grandfather was from and where I visit my friends there frequently), I am also a huge fan of McCallan 18-year-old whisky, the sticky toffee pudding of single malts. But as all policy wonks know, McAllen Texas is not famous for whisky but for Atul Gawande’s “Cost Conundrum” article in the New Yorker, in 2009 which is still required reading in medical school and MPH classes and was arguably the cornerstone of Obama health policy and the ACO movement. Dr. Atul Gawande described overutilization and hi...
Source: The Health Care Blog - February 2, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: The Business of Health Care Affordable Care Act Atul Gawande Ian Morrison McAllen Texas Source Type: blogs

The Power of a Quality Review: Your Best Defense Against OIG Audits
The following is a guest article by Rebecca Darnall, Risk Adjustment Leader at Episource. You don’t have to be a fortune teller to see the future of auditing at the Office of Inspector General (or OIG). It has given every indication that it intends to investigate fraud, waste, and abuse more robustly in the foreseeable future. To that end, the agency doubled its budget for audits in 2022. The clear message is to expect — and prepare for — more audits. These actions are more than just saber-rattling. The risk of audits is a legitimate threat to all payer organizations. As proof, several health plans have been making h...
Source: EMR and HIPAA - February 2, 2023 Category: Information Technology Authors: Guest Author Tags: Administration Healthcare IT Regulations Revenue Cycle Management Audits Centers for Medicare & Medicaid Services CMS Coding Errors Demographic Error Encounter Error Episource Health Plans Insurance Missed Condition Mock RADV A Source Type: blogs

Immigrants Use Less Welfare Than Native ‐​Born Americans
ConclusionThe average immigrant consumed 27.3 percent less welfare than native-born Americans in 2020. Further reform should reduce that substantially by building a higher wall around the welfare state instead of around the country. Still better would be reducing or eliminating the welfare state for all but reducing or eliminating non-citizen access is a politically feasible first step. In the long-run, there are good reasons to think that immigrants won ’t increase the size of the welfare state and compelling evidence that they would reduce support for it. Still, the net-fiscal effects are most important – watch this ...
Source: Cato-at-liberty - February 1, 2023 Category: American Health Authors: Alex Nowrasteh Source Type: blogs

3 shocking health care statistics for 2023
As the New Year begins, a trio of health care statistics cast an intense and unflattering light on a nation in crisis. These figures, all of them unimaginable just a generation ago, set the stage for a financial reckoning in 2023 and beyond. Shocking stat #1: the number of Americans on Medicaid Without looking it Read more… 3 shocking health care statistics for 2023 originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - January 27, 2023 Category: General Medicine Authors: Tags: Policy Public Health & Policy Source Type: blogs

Medicare Advantage UpCoding Has Been Eliminated by CMS Effective 2022
By GEORGE HALVORSON Medicare Advantage now enrolls almost exactly half the people enrolled in Medicare — and has both significant fans and hardline opponents in the health care policy circles who disagree about its performance. The biggest attack point that comes from the critics deals with the issues of coding accuracy by the plans. The payment model for the program is capitation — and that capitation is based on the average cost of fee-for-service Medicare in every county. The people who designed the model believed that the country should use the average cost of fee-for-service Medicare in every county as the b...
Source: The Health Care Blog - January 23, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy CMS George Halvorson Medicare Advantage Source Type: blogs

Costco Wholesale: What Is Its Pharmacy Strategy? It's Complicated.
Conclusion: Costco Pharmacy Manages Hybrid Cash/Insurance Payments for Rx Drugs Better Than Most Other Big Pharmacy Chains. Still, Costco Won ' tALWAYS Be the Low-Price Leader Because of How the U.S. Prescription Drug Market Functions.Costco Pharmacy ' s cash prices for many prescriptions may be low enough for people to simply bypass their insurance and pay out-of-pocket, which Costco welcomes, similar to how Mark Cuban Cost Plus Drug Co. or a number of other rapidly-growing, cash-only pharmacies which are popping up nationwide operate because their cash prices may be potentially even cheaper than by using insurance. Howev...
Source: Scott's Web Log - January 21, 2023 Category: Endocrinology Tags: 2023 Big pharma bypass insurance cash pharmacy cash-only pharmacy Costco Costco Wholesale Corp. PBM ' Source Type: blogs

Congressional Pay for Performance: No Budget, No Pay
Romina BocciaImagine you are an executive at a major corporation. One of the core responsibilities of your job is to collaborate with the other executives to adopt budget and organizational policies for your corporation each year. Instead of meeting your responsibilities, most years the corporation is forced to operate without a budget as outdated policies continue and the firm bleeds red ink. Such a dysfunctional corporation likely wouldn ’t last very long. You and the other executives would also likely face pay cuts, before eventually getting fired.Now, imagine this same scenario, but you ’re a me...
Source: Cato-at-liberty - January 17, 2023 Category: American Health Authors: Romina Boccia Source Type: blogs

Activating Transparency in Health Care Pricing
The Centers for Medicare & Medicaid Services (CMS) have taken up the campaign for price transparency over the past few years. The need for this is obvious and pressing. Unlike any other industry, health care institutions have historically been totally free to charge what they want and not even tell you in advance. Most of us have had lived the horror movie that follows a hospital stay, receiving a bill in the mail…and then another bill…and another… Hospitals have trouble predicting how much a procedure will cost for many reasons. They have a welter of agreements with different insurance companies and ...
Source: EMR and HIPAA - January 13, 2023 Category: Information Technology Authors: Andy Oram Tags: Administration Analytics/Big Data Health IT Company Healthcare IT Revenue Cycle Management CMS Costs Healthcare Cost Transparency Healthcare Price Transparency Healthcare Prices Healthcare Pricing Marcus Dorstel Turquoise Health Source Type: blogs

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CMS’ new Medicaid waiver policies enable states to pursue new investments, including those addressing health disparities and focused on underserved populations.        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - January 11, 2023 Category: International Medicine & Public Health Authors: Cindy Mann, Mindy Lipson Source Type: blogs