The Voice of Nathan Goldstein
I don’t often pick fits with the GAO…But when I do, I prefer it’s about Medicare Advantage
The non-partisan GAO doesn’t much like the demonstration plan that accelerated the MA Quality based payment initiative, known as the Star Rating System. You can read why here, here, or here. For my colleague John Gorman’s great summary, visit us over here.
Put down the pitchfork, Mr. Governor
Not as discussed as the Mandate, but also under consideration by the Supremes is the provision of ACA that expands Medicaid eligibility under age 65. The States’ position is this is a “coercive” expansion. The politics is that the provision is anti-Federalist, forcing the states to spend as wildly as the Feds. Well, the Feds may very well be spending wildly. But it’s pretty hard to say that they’re dragging the states down with them on this issue.
No one has a clue what will happen
… And anyone who tells you differently is trying to impress you.
A good friend who clerked for both Alito (when an appeals judge) and Chief Roberts (his first year on the SCOTUS) and his father who is a prominent conservative law school dean and Ambassador agree: it’s too close to call. (Not namedropping here, just establishing the sources as being “familiar with the thinking…” Quite the resumes on those two.) Unless something substantially weird happens during the Court’s deliberations, they’re not going to kick it out on procedural grounds. As for the main issue, it comes down to whether Roberts or Kennedy buys the argument that you’re born into the health care market.
Careful: You might get what you wish for
My friend Will Wilkinson has a nice post over at the Economist regarding the politics of the ACA being overturned by the SCOTUS next week. Increasingly, the legal community thinks the law will be upheld, and that it will be the Chief himself who casts the swing vote. Who knows. As many have noted over the last few weeks, few expected the case to make it to the Court in the first place. Will’s most interesting point is an ironic one: that the repeal of Obamacare, which famously implements a GOP-designed system piloted in a GOP-led state, may lead to a more successful case for a single-payer system.
Don’t waste your travel budget
We’re less than three months from the GHG Forum. This is NOT your usual conference. We’ve developed a unique educational retreat for management teams working in government programs. I’m thrilled at the presentations our faculty are preparing: we’re putting our senior consultants on the stage to deliver case studies, war stories and tales of best practices. But just as importantly, we’re building in time for you to react to these sessions with your team— to develop questions for your track faculty, compare notes, discuss implementing the best practices you’ve learned about.
My Crystal Ball
IF the Supreme Court (SCOTUS) find the mandate unconstitutional, THEN the Exchanges begin to unravel.
GHG hosting Revenue Forum Oct 6-7 in Las Vegas
Your payment is coming down. Your blood pressure is going up.
• How are you planning to mitigate the coming payment reductions?
• Can we make the difference up through efficiencies alone or do we need to look to top-line solutions, too?
• What strategy have you developed to integrate revenue management into operations?
• When will we know if what we’re doing is working?
