Here is an article that stood out amid the tidal wave of media coverage of Medicare and Medicaid’s 50th anniversary this year. It’s a piece about why Medicaid matters, posted on the Health Affairs blog.
As you read, keep in mind that the article is written by two people who strongly support the program: former Denver Health Chief Executive Patricia Gabow, who serves on the Medicaid and CHIP Payment and Access Commission and on the National Governors’ Association Health Advisory Board, and former Senate Democratic Leader Tom Daschle. It is not, by and large, a critique. Continue reading
We’ve all written a lot about the “Medicaid gap” – the low-income people who can’t get coverage under the Affordable Care Act because their states have opted out of Medicaid expansion. The Kaiser Family Foundation has estimated that 4 million people fall in this gap.
According to Moody’s Investors Service, nonprofit hospitals in expansion states have seen their bad debt from unpaid bills drop an average of 13 percent as they treated more patients who have coverage. In non-expansion states, bad debt rose.
Reuters’ Robin Respaut recently looked at how the Medicaid gap has affected two iconic urban safety net hospitals who treat a lot of low income people – Cook County in Chicago and Grady Memorial in Atlanta. Continue reading
Source: 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care. © Towers Watson 2014.
For the purpose of this blog post, let’s leave aside the decade-plus ideological fight about whether health savings accounts (HSAs) are a good or bad idea.
Let’s just look at what happens to people who have them, at least according to this recent article by Michael Fletcher, a national economics correspondent for The Washington Post. His argument is that people could save money on health care – if they knew how to use their HSAs. Continue reading
The months-long controversy between Florida and the federal Medicaid program over funding for hospitals and clinics that serve uninsured low-income people drew attention to these uncompensated care pools. In Florida the arrangement is called the Low-Income Pool – better known as “LIP” (a gift to headline writers).
So what are these payments? And how do they differ from a Disproportionate Share Hospital (DSH) arrangement?
At least nine states, including Florida, have some kind of Medicaid waiver arrangement with the federal government that involves payments to safety net hospitals and, in at least some states, community health centers.
Joanne Kenen, AHCJ’s core topic leader on health reform, explains in a new tip sheet. Read more.
The tip about troubles in Texas’ Medicaid dental system was part of a routine conversation. But it was enough to make reporter Byron Harris start digging.
He and his colleagues at WFAA-Dallas spent nine months scrutinizing data, wearing out shoe leather, following up on leads and trying to get people to talk.
In 2011, the “Crooked Teeth” stories raised profoundly troubling questions about oversight of the Medicaid dental program in Texas; the millions upon millions spent on orthodontic services for beneficiaries; the suspect billing practices of many providers. The 11-part investigative series uncovered one of the largest Medicaid scandals in the history of Texas. Government audits, reform efforts and lawsuits followed in its wake.
Harris continues reporting on the issue. He recently filed another story after federal officials concluded that the state owes $133 million for unnecessary dental work. “Texas paid $191,410,707 for unallowable orthodontic services from 2008 through 2010, according to a federal investigation,” Harris told viewers on June 3. “And officials say the federal government now wants a large portion of that money back.”
In this “How I Did It” article, Harris takes us back to the very beginning of “Crooked Teeth.” He explains how the project began, and how it unfolded. He also shares some wisdom on how to use data to follow up on a tip.
The 50th anniversary of Medicare and Medicaid is July 30.
Over the years, these programs have evolved from basic safety nets to comprehensive care models designed to improve quality and offer affordable health care for millions. According to the Centers for Medicare and Medicaid Services, about 55 million Americans have Medicare this year and more than 70 million have Medicaid in any given month
Bob Rosenblatt, a veteran at reporting on issues around aging, has put together a tip sheet with background on the Medicare program and some things to consider as you plan coverage of the anniversary. It includes story ideas and useful links as well as contact information for sources.
In the wake of last month’s Supreme Court ruling on marriage, same-sex married couples in all 50 states should now qualify for financial protection against impoverishment under Medicaid if one of them goes into a nursing home.
Before the high court’s decision, spousal financial protection rules were unavailable to same-sex couples if their state of residence did not recognize their marriage. With a semi-private room in a nursing home costing $80,000 a year, many couples can easily wipe out all their assets without such protection. Continue reading
Indiana is embarking a new way to deliver mental health care to Medicaid members. John Wernert, M.D., a psychiatrist who heads Indiana’s Medicaid agency, is introducing telemedicine to deliver psychiatric and other mental health services to patients, including the approximately 85 percent of patients who have what he calls rather modest behavioral health needs.
Indiana’s telemedicine initiative is important because the state is one of only a few adopting telehealth statewide. More widespread use of telehealth has been slow due to concerns about costs, as Phil Galewitz reported for Kaiser Health News last month. Continue reading
Photo by ianus via Flickr
An estimated 8 percent of Medicaid dental providers in California submitted questionable bills to the program during one recent year, a recent federal report concluded.
Half of the dentists whose bills raised concerns worked for dental clinic chains.
The findings are the latest in an unfolding examination of Medicaid dental billing practices led by the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG). Continue reading
Lauren Sausser of The Post and Courier in South Carolina was surprised by an email from a reader asking her to write more about Medicaid expansion in South Carolina – specifically, the state’s refusal to expand the low-income health insurance program under the Affordable Care Act.
This year, health insurance subsidies have played a much more prominent role in The Post and Courier’s health care coverage. Like other news outlets, her newspaper is waiting to find out what the Supreme Court decides in King v. Burwell. If the court rules in favor of the plaintiffs, subsidies will end in states using the federal exchange.
In South Carolina, a King victory would mean that coverage will become unaffordable for an estimated 200,000 people who have purchased subsidized policies through the federal insurance marketplace. It’s been a big story. Meanwhile, Medicaid expansion, with a few exceptions, is relatively stagnant there.
Read more about her reporting on the topic.