Topic: Medicaid

Romney-Ryan Plans for Medicare Are Kid Stuff Compared to What They’d Do to Medicaid

September 28, 2012 | John Gorman

GOP nominees Mitt Romney and Paul Ryan have big plans for Medicare reform, as we’ve written about here often. But health plans and other stakeholders need to start paying attention to their plans for Medicaid, which are game-changing, would affect millions more Americans, and would take effect much sooner: a recent Bloomberg report found that Romney/Ryan’s changes to Medicaid would lead to an estimated $1.26 trillion drop in federal funding from 2014 through 2022. Other analyses estimated that 14-27 million Medicaid beneficiaries could lose coverage if the campaign’s promise to block-grant the program became reality.

Time to Reauthorize Special Needs Plans

September 26, 2012 | John Gorman

Special Needs Plans (SNPs) are a special type of health plan for America’s most vulnerable and complex seniors that are set to expire at the end of 2013. Over 500 SNPs serve more than 1.5 million Medicare beneficiaries across the United States. Done well, the SNP significantly improves outcomes and brings down costs thanks to personal care planning, care-transition assistance, disease management, and medication therapy management. Not all SNPs are good at what they’re designed to accomplish, but there are many providing patient-centered, coordinated care to vulnerable populations showing signs of success — the program should be allowed to continue.

We Love Us Some Kitzhaber…Medicaid Reform Genius

September 20, 2012 | John Gorman

It’s happy days for us when Sarah Kliff at WaPo, one of our favorite bloggers, posts a great “get” with Oregon Governor John Kitzhaber, MD – one of our favorite Medicaid reformers. It was such a terrific interview I wanted to reprint it here, with thanks to both for an illuminating discussion of the way forward on reforming entitlements:

Newbies Slow Dual Eligible Expansion in Key States

September 20, 2012 | John Gorman

After last week’s AHIP conference on Medicare and Medicaid and MANY coffees and cocktails later, a picture emerged that the only thing slowing the movement of dual eligibles into health plans isn’t nervous advocacy groups or overstretched regulators — it’s newbies to the game of caring for the nation’s most vulnerable patients.

Join us Thursday for First in New Webinar series: Risk adjustment in the exchanges

July 25, 2012 | John Gorman

On Thursday July 26th at 1pm ET we’ll kick off our new webinar series, “Lessons from Medicare Advantage and Part D”, a monthly webinar series around what we’ve learned in Medicare that can be applied to the exchanges and other aspects of health reform. We’ll begin with a deep dive on risk adjustment in the exchanges.

Rising Chorus Urges CMS to Slow Down on Dual Eligibles

July 19, 2012 | John Gorman

CMS and at least 20 states are moving hell-bent-for-leather toward enrolling as many as 3 million of the 9 million Dual Eligibles into health plans in the next two years, creating one of the biggest opportunities for payers in history. Now a rising chorus including the Medicare Payment Advisory Commission, the American Medical Association, some policy analysts and now at least one key Senator are urging CMS to hit the brakes. I tend to think the movement of duals into plans is like the movement of water: it can be slowed but not stopped.

Medicaid Mattered Most in the SCOTUS Decision

July 12, 2012 | John Gorman

In all of the drama around the recent Supreme Court ruling on the Accountable Care Act (ACA) and the individual mandate, it was the Medicaid eligibility expansion ruling that mattered most. Hands-down, Medicaid was WAY more important: $1 TRILLION and 17 million Americans’ access to health insurance is now at stake, potentially millions more when Medicaid maintenance of effort rules on states expire in 2014, and it’s all red meat for Red State governors who will devour it at their own peril.