Uncompensated care was supposed to be a thing of the past, but it’s persisting in many states not expanding Medicaid eligibility. As an alternative, for some high-cost uninsured patients, hospitals are turning to a new option.
In his 32 years working in insurance operations at Forrest General Hospital in Hattiesburg, Mississippi, Pat Riley has seen the problem of uninsured patients ebb and flow — with poor health outcomes for individuals and uncompensated costs for the health system — and the Great Recession brought another surge.
Now director of insurance at Forrest General, the 512-bed flagship of Forrest Health, Riley is optimistic about the potential of the Affordable Care Act. While Mississippi, like 23 other states, isn’t expanding Medicaid eligibility to low-income childless adults, those earning above 100 percent of the federal poverty level can get premium and cost-sharing subsidies for exchange plans — a message that Riley and Forrest Health try to hammer home to the residents of greater Hattiesburg through participation in health fairs, town halls, public service announcements and outreach to patients.
“It became obvious very early on that people who were eligible for the subsidies automatically assumed that they couldn’t afford a plan,” Riley said.
Federally certified as a marketplace […]
The solvency of Medicare’s hospital trust fund was extended four years to 2030 Tuesday by the chief scorekeeper for Congress.
The Congressional Budget Office (CBO) reported that the hospital insurance trust fund would be “exhausted sometime around 2030,” which would require either an increase in Medicare taxes to maintain existing obligations or a cut in benefits. That timeframe was four years longer than the Medicare trustees, comprised of senior administration officials, projected in their 2013 report.
The solvency extension—despite surging enrollments by growing numbers of baby boomers—was credited in part to a slowdown in projected use of Medicare services, a scheduled 24 percent physician cut in April 2015, and the phasing in of payment cuts under the Affordable Care Act (ACA). Medicare spending was projected to continue a recent spending slowdown for several more years before gradually accelerating again.
Conversely, Medicaid and ACA marketplace spending are expected to accelerate in the coming years as both programs continue to rapidly grow enrollments through 2024. For instance, average ACA marketplace enrollment for 2014 of 6 million is expected to jump to 13 million in 2015.
No Cost Curve Bending
Additionally, the CBO appeared skeptical of claims and research indicating that healthcare payment and delivery reforms that […]
A new “collaboration” with states announced by the Centers for Medicare & Medicaid Services will provide $100 million in federal expertise to help Medicaid programs to improve healthcare delivery while reducing costs.
The Medicaid Innovation Accelerator Program (IAP) stemmed from recent recommendations of the National Governors Association’s (NGA) health care sustainability task force, including identifying opportunities for care improvement and addressing high-priority areas such as emergency department utilization.
The program’s funding will pay for federal technical support to help states’ efforts to improve their Medicaid programs and “jumpstart innovation” by providing federal tools and resources.
The new program’s federal expertise will include data analytics, improving quality measurement and rapid cycle evaluation capabilities, and advancing effective and timely dissemination of best practices and learning among states.
“CMS will be consulting with states, experts, consumers, providers and health plans on program priorities to which IAP resources will be applied and how best to deploy these new technical resources,” according to a fact sheet.
CMS is considering holding several meetings across the country in late summer to brief stakeholders and get input. A mailbox CMS established for IAP and other Medicaid reform feedback is MedicaidIAP@cms.hhs.gov.
Enrollment Rise Continues
The new Medicaid-focused program came as the program continues to grow […]
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