Medicaid and SCHIP effectively get discounts by paying providers below-market rates. But as more people enroll in these plans providers will need to shift more costs to commercial payers. That’s the conclusion of a report released by the Colorado Department of Regulatory Agencies. Continue reading As Congress Expands Medicaid/SCHIP, Expect Everyone Else’s Costs to Rise
Category Archives: Medicaid
Medicaid Payment: Low and Slow
Newly signed Medicaid patients may have a tough time finding a doctor. Only about half of all physicians will accept new Medicaid enrollees, far less than the number of doctors taking on new Medicare patients or the privately insured. The reason? Medicaid reimbursement rates are low and the payment is slow. A study [gated but with abstract] in Health Affairs finds that the average Medicaid pay cycle ranges from a low of 37 days in Kansas to a high of 115 days in Pennsylvania.
Unapproved Drugs in Medicaid
Almost $200 million over four years, and to read the media accounts you would think this is a bad thing. I suspect it is a good thing – for the patients and for the taxpayers. Aspirin was never approved by the FDA and many experts think that under today's ridiculous rules it probably couldn't pass. [link]
Crowding Out Hawaii Style
Hawaii, the only state with a universal child health care program in the country, is dropping the scheme just seven months after it launched. The reason:
“People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink, the administrator at the Department of Human Services in charge of the program. [link]
Currently, Hawaii’s families can qualify for Medicaid with incomes that are 300 percent of the federal poverty level – or about $73,000 for a family of four. Keiki Care was designed to cover “gap” kids from families too rich to qualify for Medicaid and SCHIP. However, according to the Honolulu Star Bulletin, about 85% of the 2,000 kids enrolled in the Keiki Care program had previously been enrolled in a private plan.
Hat tip to Grace Marie-Turner at her site.
httpv://www.youtube.com/watch?v=ATkeoBqSeGE
Elvis Presley singing “Blue Hawaii”
Three Cheers for Rhode Island Medicaid Reform
In return for a significant amount of flexibility, Rhode Island has offered to let the federal government cap its Medicaid contribution to the state for the next several years. As part of the proposed deal, Rhode Island would not have to spend more than 23% of its state budget on Medicaid.
The Center for Budget and Policy Priorities calls this a "block grant" and hates the idea [here]. It looks like a "block grant" to us, too, and we love it. The New York Times [here] can't make up its mind. Bush Administration officials at HHS have not yet approved the waiver but they are working with Rhode Island officials to iron out any differences.
Who Needs Medicaid?
A new study, released by the George Washington University Medical Center, finds that:
- Uninsured patients seeking care at community health centers (CHC) are 22% more likely to receive a Pap smear and 17% more likely to have a breast exam than similar non-CHC patients.
- When Medicaid patients are included, CHC patients are 14% more likely to receive either procedure than non-CHC patients.
CHCs are located in medically-underserved areas and adjust their fees based on ability to pay. They are apparently more efficient than the alternatives:
- CHCs spend 41% less ($1,810) per patient than other primary care providers.
- They saved between $10 billion and $18 billion in 2004.
Florida Medicaid Reform; One Year’s Progress
Florida's Medicaid reform demonstration is entering into its second year. Now operating in five counties, the reform has unambiguously led to greater competition. Many plans now offer more services and products than conventional Medicaid. There are also a variety of benefit packages. The most popular expanded benefits include over-the-counter drugs and adult preventative dental care. Continue reading Florida Medicaid Reform; One Year’s Progress
Medicaid Data: Is It Any of Your Business?
This is from Jim Frogue's testimony to the House Energy and Commerce Committee.
Medicaid patient encounter data is sometimes available to researchers, but not to the general public. That's too bad. Taxpayers should know where their money goes. In one state:
- Only 17% of Medicaid women over age 50 were given an annual mammogram. (Many doctors think the number should be 100%)
- Less than half the children received well child checkups.
- One beneficiary visited hospital emergency rooms 405 times in three years-more than once every three days.
Medicaid is only Marginally Better than Being Uninsured
Once they see a doctor, patients get the same treatment, regardless of insurance status according to a RAND study. But do the uninsured delay seeing doctors when they need attention? Apparently, according to an American Cancer Institute study (full study is gated). Unfortunately, rationing by waiting and other obstacles, makes Medicaid enrollment almost as bad.