HLAC Health News

We conclude that in terms of coverage, cost, and federal payments, states would do best to expand Medicaid.

The $10 million sponsorship from AstraZeneca will allow the ACC to create a Patient Navigator Program that will support a team of caregivers to help patients overcome challenges during their hospital stay and in the weeks following discharge when they are most vulnerable. The ultimate goal will be to create a program that supports a culture of patient-centered care that can be implemented in other hospitals.

"Hospitals that take part in CMS' Inpatient Quality Reporting Program will receive 0.8% in extra payments, while those not successfully participating would have payments reduced by 2%, the Centers for Medicare and Medicaid Services (CMS) proposed on Friday to the USA's 3,400 acute care hospitals."

"New findings . . show that Medicaid coverage had no detectable effect on the prevalence of diabetes, high cholesterol, or high blood pressure, but substantially reduced depression, nearly eliminated catastrophic out-of-pocket expenditures, and increased the diagnosis of diabetes and the use of diabetes medication among low-income adults."

"If 14 states decide not to expand Medicaid under the Affordable Care Act as intended by their governors, those state governments collectively will spend $1 billion more on uncompensated care in 2016 than they would if Medicaid is expanded. "In addition, those 14 state governments would forego $8.4 billion annually in federal payments and an additional 3.6 million people will be left uninsured, according to findings published in the June edition of the journal Health Affairs."

"Public insurance makes a real difference in the health of children. Those who are covered are significantly more likely to have a usual source of care than those who are uninsured, which is strongly associated with better outcomes. "The Affordable Care Act (ACA) changes Medicaid into a universal program for all people, children and adults alike, in families with incomes below 138 percent of the federal poverty line. This is not an insignificant change. About half of the more than 30 million currently uninsured who are expected to get coverage under the ACA will do so through the Medicaid expansion. Many of the people who will get coverage are parents. . . . "Although a debate might continue in the political sphere, the evidence is quite clear that expansion of the program has many benefits for states and their low-income residents. . . ."

"Insurers hope that clinicians will be so hassled by authorization procedures that they won't seek admission for their patients, saving insurance companies money," he said. "Placing profits ahead of the health of patients when mental illness makes them vulnerable is immoral. A single-payer Medicare-for-all health care system would represent a great leap forward for patients and providers alike."

"Private insurance companies that participate in Medicare under the Medicare Advantage program and its predecessors have cost the publicly funded program for the elderly and disabled an extra $282.6 billion since 1985, most of it over the past eight years. In 2012 alone, private insurers were overpaid $34.1 billion. "That's wasted money that should have been spent on improving patient care, shoring up Medicare's trust fund or reducing the federal deficit, the researchers say."

". . . immigrants generated surpluses totaling $115 billion from 2002 to 2009. In comparison, the American-born population incurred a deficit of $28 billion over the same period. ". . . Immigrants are crucial in balancing the age structure of American society, providing an infusion of young, working-age adults who support the country's aging population and help cover the costs of Medicare and Social Security. And with the largest generation in the United States, the baby boomers, now starting to retire, the financial help from immigrants has never been more needed, experts say."

If all the proposed religious and secular combinations go through, almost half of the hospital beds in the state [Washington] - the highest percentage in the nation, and up from less than a third at the beginning of last year - would be controlled by the Catholic health systems. . . .

"If you decide to dive into the data, be aware-especially if you have private insurance (not Medicare)-that appearances can be deceiving. It may look like Hospital A charges more than Hospital B, but that may not be so. Your insurer and Hospital may have actually agreed on a lower payment. So the data don't necessarily say what your insurance company is actually going to pay."

"As part of the Obama administration's work to make our health care system more affordable and accountable, data are being released that show significant variation across the country and within communities in what hospitals charge for common inpatient services."

". . . seniors with lower cognition and lower basic math abilities were less likely to enroll in Medicare Part D, and less likely to apply for the subsidy if they did enroll in Part D. . . . . . Those who qualify for Medicaid and are also in Medicare are automatically enrolled and get the subsidy without needing to take any action on their own. Other low-income adults must apply for the benefit, and estimates suggest that more than 2 million people who would qualify for a benefit fail to apply. . . . [T]his is not 'Here's thirty plans, pick the best one.' This is, 'Here's free money, do you want it?'" . . . . . "Choice is generally a good thing, but options in health care can be very complex and consumers can have great difficulty identifying the best one," McWilliams said. "To improve decisions and enhance competition, the government and exchanges may need to play more active roles. Expecting the availability of choices and information for consumers alone to cure our health care system is unrealistic."