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PBS
By 2027, nearly 90 percent of Americans are projected to be insured under Medicare, Medicaid or private insurance — a stable rate at pace with population growth but a slight dip from the 90.9 percent of insured Americans today. But spending on Medicare is expected to grow at a faster rate than Medicaid or private insurance, according to the study, offering a clue about why overall spending is likely to increase.
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Modern Healthcare (Subscription required)
Medicaid expansion and funding face serious political challenges in several Western and Great Plains states, following expansion ballot initiatives and legislative and gubernatorial elections in those states. In two states, Republican elected officials have pushed to limit and delay expansions to low-income adults that were approved by voters in November. A third state where voters passed an expansion ballot initiative is moving to implement it. Meanwhile, existing Medicaid expansions in two other states are under threat from GOP leaders.
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The Washington Post
States that expanded their Medicaid health insurance programs are hunting for ways to fund the new enrollees in 2020 as they face a final drop in federal contributions.
The federal government will still cover the bulk of the costs of care for the roughly 13 million Americans newly eligible for Medicaid under the Affordable Care Act, which allowed states to expand the program to people earning somewhat above the federal poverty level. But the gradually decreasing federal contribution — originally set at 100 percent but reduced to 90 percent starting next year — has left some states with budget holes to fill.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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Georgia Health News
The Senate Health and Human Services Committee passed legislation Tuesday to allow Georgia Gov. Brian Kemp to pursue healthcare waivers from the federal government.
The panel's 9-4 vote came after Senate Minority Leader Steve Henson (D-Stone Mountain) sought to open up the bill's Medicaid waiver request to cover more Georgians.
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ZeOmega
Watch how Kern Health Systems, a large Medicaid organization in California, uses Jiva—the industry’s leading PHM platform—to achieve seamless integration and single sign-on while also streamlining workflows, lowering costs, and improving overall health outcomes for its members.
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The Associated Press via WCTV-TV
The Georgia House Democratic Caucus has slammed Gov. Brian Kemp's Medicaid waiver proposal, saying it will be more expensive, cover fewer people and take longer than the full Medicaid expansion they support.
Democrats called the Republican-sponsored bill "heinous" and "ill-conceived" in a news conference Wednesday.
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MetroNews
West Virginia's Legislature is considering joining a handful of states that have work requirements for people on Medicaid.
The House Finance Committee took up the issue Wednesday afternoon as a bill originating from the committee, meaning that few observers were up to speed on the ins and outs prior to its introduction.
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Washington Examiner
Oklahoma lawmakers in committee on Tuesday advanced legislation that would expand healthcare coverage to people who would be eligible for Medicaid expansion under Obamacare. Instead of taking on the expansion itself, however, the bill would have the Oklahoma Health Care Authority set up a premium assistance program to help people get private health insurance. Oklahoma does not contract with private plans to administer Medicaid now and, instead, operates as fee-for-service program.
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Costs for members with undiagnosed opioid use disorder are significant. In one Medicaid population, members suspected to have opioid use disorder cost nearly 5x PMPM versus diagnosed members receiving medication assisted treatment. Learn how our solutions can identify members at risk in your population.
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The Hill
Lawmakers are zeroing in on the skyrocketing cost of insulin and putting pressure on manufacturers as they work to address high drug prices.
Congressional Democrats, Republicans and the Trump administration say that lowering drug prices is a priority, and drugmakers are on the hot seat.
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A commercial Medicaid plan in Nevada leveraged MCG solutions in its community health program and reduced ER visits by 20% and hospital readmissions by 30%. Click here to learn more about how MCG can support improved member outcomes and cost control.
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The Hill
A bill introduced by Rep. Peter Welch (D-Vermont) on Wednesday would let patients import cheaper insulin from Canada and other countries.
"Prices for insulin have gone through the roof and are hammering diabetes patients who cannot live without this life-saving medicine yet cannot afford to pay for it," Welch said in a statement.
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Kern Health Systems (Kern) is overcoming numerous care management challenges using Jiva, the industry’s leading PHM platform. Learn how the powerful end-to-end platform is helping Kern consolidate data, streamline workflow, manage compliance, create holistic assessments, improve overall health outcomes, and plan for future expansion into new lines of business.
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The Hill
Florida Gov. Ron DeSantis (R) on Wednesday proposed importing cheaper prescription drugs from Canada into the state and said that President Trump had given his support to the idea.
The announcement from DeSantis at a press conference Wednesday represents a potentially major step in bringing down the cost of drugs and one usually associated with Democrats.
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