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Privatizing the Medicaid expansion: ‘Every state will be eying this.’

Privatizing the Medicaid expansion: ‘Every state will be eying this.’ | Medicaid Reform for Patients and Doctors | Scoop.it
A few states have asked for permission to expand Medicaid through the private insurance system—an option that one Medicaid expert expects "to spread like wildfire." (Privatizing the Medicaid expansion: 'Every state will be eying this.': Welcome to...
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Medicaid Reform for Patients and Doctors
Find a way to provide health care to low-income Texans with realistic payment, less stifling bureaucracy, and no fraud-and-abuse witch hunts
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Avoiding Medicaid expansion, lawmakers seek a ‘Texas way’

Avoiding Medicaid expansion, lawmakers seek a ‘Texas way’ | Medicaid Reform for Patients and Doctors | Scoop.it
Texas lawmakers are exploring ways the state could provide more access to health care for 1.9 million uninsured poor people without acquiescing to guidelines set under the Affordable Care Act, sometimes referred to as Obamacare.
Texas Medical Association's insight:

Texas physicians want to ensure all Texans have access to coverage and, more importantly, access to physicians and health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance results often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering and even death. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care.

 

Any Texas-style solution expanding access must:

Draw down all available federal dollars to expand access to health care for poor Texans;Give Texas the flexibility to change the plan as our needs and circumstances change;Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; andContinue to uphold and improve due process of law for physicians in Texas as it relates to the Office of Inspector General.
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Texas Medical Association's curator insight, August 15, 8:39 AM

Texas physicians want to ensure all Texans have access to coverage and, more importantly, access to physicians and health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance results often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering and even death. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania . TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care.

 

Any Texas-style solution expanding access must:

Draw down all available federal dollars to expand access to health care for poor Texans;Give Texas the flexibility to change the plan as our needs and circumstances change;Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; andContinue to uphold and improve due process of law for physicians in Texas as it relates to the Office of Inspector General.
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What Is the Result of States Not Expanding Medicaid?

What Is the Result of States Not Expanding Medicaid? | Medicaid Reform for Patients and Doctors | Scoop.it
This brief looks at the economic impact on states that did not expand Medicaid.
Texas Medical Association's insight:
Key Findings

States that have not expanded Medicaid will miss out on $423.6 billion in federal funding between 2013 and 2022.

The decision of state leaders not to expand Medicaid also means their local hospitals will collectively forgo $167.8 billion in Medicaid reimbursement payments over the same timeframe.

Based on analyses of state budgets, for every $1 a state spends expanding Medicaid, $13.41 in federal funding flows into the state.

In total, hospitals in states not expanding stand to forgo $167.8 billion in reimbursement funding from 2013 to 2022

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Only 10% of Medicaid ER use is unnecessary, MACPAC says

Only 10% of Medicaid ER use is unnecessary, MACPAC says | Medicaid Reform for Patients and Doctors | Scoop.it
Last year, healthcare reform supporters reeled after the media gave widespread attention to a study of a 2008 Medicaid expansion in Oregon showing it had increased emergency room use by low-income adults. This week, the Medicaid and CHIP Payment and Access Commission released its official pushback document.
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Two Americas on Health Care, and Danger of Further Division

Two Americas on Health Care, and Danger of Further Division | Medicaid Reform for Patients and Doctors | Scoop.it
The Affordable Care Act was designed to make health care more affordable and more uniform, but court rulings could deepen the disparities among states.
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Everything is Bigger in Texas...Including Medicaid

Everything is Bigger in Texas...Including Medicaid | Medicaid Reform for Patients and Doctors | Scoop.it
Medicaid enrollment has climbed by 80,000 in Texas despite the state opting out of Medicaid expansion. - Todd Campbell - Health Care
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Wide variation in states' Medicaid spending detailed in GAO report

Wide variation in states' Medicaid spending detailed in GAO report | Medicaid Reform for Patients and Doctors | Scoop.it
Spending on Medicaid enrollees varied widely across the country in fiscal year 2008, according to an analysis conducted by the Government Accountability Office.
Texas Medical Association's insight:

The report shows Texas overall below the national average on per-enrollee Medicaid expenditures:


Estimated Medicaid spending per enrollee
- All enrollees: Texas - $6,540; National average - $7,847
- Children: Texas - $3,345; National average - $3,973
- Adults: Texas - $7,131; National average - $5,497
- People with Disabilities: Texas - $15,680; National average - $19,135
- Aged: Texas - $10,495; National average - $17,609

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Number Of California Doctors Accepting Medicaid Plummets After Obamacare

Number Of California Doctors Accepting Medicaid Plummets After Obamacare | Medicaid Reform for Patients and Doctors | Scoop.it
The number of doctors accepting Medicaid patients in California dropped by a quarter from 2013, at the same time that two million new Obamacare expansion patients are joining the rolls. In spring 2
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States' Obamacare Medicaid alternatives worth trying

States' Obamacare Medicaid alternatives worth trying | Medicaid Reform for Patients and Doctors | Scoop.it
If Republican governors think they have a better way to expand Medicaid, why not put it to the test?
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Medicaid overhaul plan easily clears N.C. House

Medicaid overhaul plan easily clears N.C. House | Medicaid Reform for Patients and Doctors | Scoop.it
The state House has agreed to give health-care systems and physicians more skin in the state’s Medicaid reform initiative.
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States test Medicaid ACOs to cut costs

States test Medicaid ACOs to cut costs | Medicaid Reform for Patients and Doctors | Scoop.it
Looking to control Medicaid costs, several states are launching accountable care initiatives that mirror experiments underway with Medicare and private insurers but vary significantly in their approaches.
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Understanding the Effect of Medicaid Expansion Decisions in the South

Understanding the Effect of Medicaid Expansion Decisions in the South | Medicaid Reform for Patients and Doctors | Scoop.it

Infographic from JAMA and Kaiswer Family Foundation — Understanding the Effect of Medicaid Expansion Decisions in the South

Texas Medical Association's insight:

This Visualizing Health Policy examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the South remain low; that nearly 80% of the 4.8 million uninsured US adults who fall into the coverage gap live in the South; and that the coverage gap in the South disproportionately affects people of color.

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Virginia’s governor has begun planning for Medicaid expansion

Virginia’s governor has begun planning for Medicaid expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Texas Medical Association's insight:

Virginia Gov. Terry McAuliffe is quietly planning the nuts-and-bolts of enrolling an extra 400,000 Virginians in Medicaid even as the House of Delegates seems firmly opposed as ever to expanding the health-care program for the poor.

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N.C. Senate budget would cut elderly, blind and disabled from Medicaid rolls

N.C. Senate budget would cut elderly, blind and disabled from Medicaid rolls | Medicaid Reform for Patients and Doctors | Scoop.it
Deep disagreements with the McCrory administration over the Medicaid program's direction and budget are reflected in the Senate budget.
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Arkansas Private Option's Latest Boondoggle: "Health Independence Accounts" Increase Dependence and Increase Costs

Arkansas Private Option's Latest Boondoggle: "Health Independence Accounts" Increase Dependence and Increase Costs | Medicaid Reform for Patients and Doctors | Scoop.it
Private Option cheerleaders in Arkansas have long promised that their ObamaCare Medicaid expansion plan would give patients “skin in the game” and “encourage personal responsibility.” A closer look at the newly introduced Health Independence Accounts highlight that they do the exact opposite, while also increasing dependence and costs. The HIAs are nothing like HSAs.
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TMA-Backed Law Prompts Medicaid Red-Tape Relief

TMA-Backed Law Prompts Medicaid Red-Tape Relief | Medicaid Reform for Patients and Doctors | Scoop.it
Texas Medical Association's insight:

Apparently, the state got the message loud and clear: Physicians and patients are overly frustrated with the myriad administrative roadblocks that came along with the expansion of Medicaid managed care in Texas. Thanks to the Texas Medical Association's advocacy during the 2013 legislative session and the successful passage of Senate Bill 1150, relief from red tape may finally be in sight.

 

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A Hospital Reboots Medicaid To Give Better Care For Less Money

A Hospital Reboots Medicaid To Give Better Care For Less Money | Medicaid Reform for Patients and Doctors | Scoop.it
In Cleveland, a public hospital may be succeeding at the seemingly impossible: saving money while making patients healthier. It's doing so by giving patients personalized attention.
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Arkansas Weighs Plan To Make Some Medicaid Enrollees Fund Savings Accounts

Arkansas Weighs Plan To Make Some Medicaid Enrollees Fund Savings Accounts | Medicaid Reform for Patients and Doctors | Scoop.it
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Texas' working poor suffer without Medicaid expansion

Texas' working poor suffer without Medicaid expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Texas is failing Texans. And the working poor are falling into the coverage gap - even dying - as a result.
Texas has one of the highest rates of residents without health insurance in the nation; prior to the implementation of the Affordable Care Act (ACA) in 2010, Texas ranked 46th nationally in access to health care. Thirty-one percent of adults and 15 percent of children were without health insurance coverage.
The ACA initially mandated that states expand Medicaid, with the federal government paying the lion's share of the cost, $100 billion over 10 years, to cover those who might not qualify for coverage under the act. The U.S.
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A Health Reform Framework: Breaking Out Of The Medicaid Model

A Health Reform Framework: Breaking Out Of The Medicaid Model | Medicaid Reform for Patients and Doctors | Scoop.it

"It is possible to expand insurance coverage for the poor and lower-income households without reliance on the flawed Medicaid insurance model. Opponents of the ACA should embrace plans to replace the current law with reforms that would give the poor real choices among a variety of competing insurance offerings, including the same insurance plans that middle-class families enroll in today. Specifically, we propose a three-part plan that includes a flexible, uniform tax credit for all those who lack employer-based coverage; deregulation of Medicaid; and improved safety-net primary and preventive care."

Texas Medical Association's insight:

TMA says: Texas physicians want to ensure all Texans have access to coverage and, more importantly, access to physicians and other health care providers. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, include Indiana, Arkansas, Iowa, Michigan, and Pennsylvania (see chart). TMA believes Texas too can create an ingenious solution that helps Texans in the coverage gap get affordable and timely care. TMA believes any Texas-style solution expanding access must include these elements.

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CMS creates fund to seed state-based Medicaid innovation

CMS creates fund to seed state-based Medicaid innovation | Medicaid Reform for Patients and Doctors | Scoop.it
The CMS is setting aside more than $100 million over the next five years to help states develop and test new Medicaid payment and delivery models.
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Florida Shifts Medicaid Mental Health Strategy

Florida Shifts Medicaid Mental Health Strategy | Medicaid Reform for Patients and Doctors | Scoop.it
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New White House report: 5.7 million people losing out on health care because 24 states won't expand Medicaid

New White House report: 5.7 million people losing out on health care because 24 states won't expand Medicaid | Medicaid Reform for Patients and Doctors | Scoop.it
WASHINGTON -- Louisiana and 23 other states that have opted not to accept federal funding to expand Medicaid will deprive 5.7 million people of health coverage in 2016, according to a report being released Wednesday by the White House Council...
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Medicaid managed care arrives Tuesday in South Florida

Medicaid managed care arrives Tuesday in South Florida | Medicaid Reform for Patients and Doctors | Scoop.it
After years of Medicaid reform experiments, the state rolls out managed care for more than 3.6 million Floridians including almost one million in South Florida starting Tuesday.
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GAO calls for more oversight of Medicaid managed care

GAO calls for more oversight of Medicaid managed care | Medicaid Reform for Patients and Doctors | Scoop.it
The Government Accountability Office (GAO) said Wednesday that state and federal Medicaid auditors need to increase their oversight of managed care organizations.
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U.S. Hospitals in Medicaid Expansion States Seeing More Medicaid Patients and Reduced Charity Care Levels

The Colorado Hospital Association (CHA) released a new study that shows hospitals in states that chose to expand Medicaid under the Affordable Care Act saw significantly more Medicaid patients and a related reduction in self-pay and charity care cases; whereas, hospitals in states that chose not to expand Medicaid experienced no changes outside normal variation in Medicaid volume or self-pay and charity care cases.

Texas Medical Association's insight:

Link to study: http://www.cha.com/Documents/Press-Releases/CHA-Medicaid-Expansion-Study-June-2014.aspx

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