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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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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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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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Medicaid surge triggers cost concerns for states

Medicaid surge triggers cost concerns for states | Medicaid Reform for Patients and Doctors | Scoop.it

#WASHINGTON (AP) — From California to Rhode Island, states are confronting new concerns that their Medicaid costs will rise as a result of the federal health care law.

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For Medicaid Patients, Access To Primary-Care May Not Be As Advertised

Texas Medical Association's insight:

"Using “mystery shoppers” looking for access to health care, Public Health – Seattle & King County has found troubling indications that access to primary-care providers may not be as advertised.

About half the time, primary-care providers listed as accepting new patients on Medicaid managed-care organization websites in fact told the “shoppers” they were not accepting new Medicaid patients."

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Medicaid Rolls Grow in States Resisting Health Law

Medicaid Rolls Grow in States Resisting Health Law | Medicaid Reform for Patients and Doctors | Scoop.it
States that thus far have refused a federal offer to expand Medicaid are still seeing significant sign-ups for the safety-net program that serves the poor, according to a report Tuesday that raises political and budget implications. The market analysis firm Avalare Health estimated that at...
Texas Medical Association's insight:

"

But Texas, with the highest proportion of uninsured residents of any state, saw hardly any increase.

 "
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Medicaid HMO Shift Fuels Rush for Profitable Clients

Medicaid HMO Shift Fuels Rush for Profitable Clients | Medicaid Reform for Patients and Doctors | Scoop.it
A Medicaid overhaul in New York has shifted $6 billion in public spending on long-term services for disabled and aged people to managed care companies.
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Expanding Medicaid increases access to subspecialty procedures

Expanding Medicaid increases access to subspecialty procedures | Medicaid Reform for Patients and Doctors | Scoop.it
Expanding Medicaid opens patient access to surgical-subspecialty procedures, according to University of Michigan researchers who studied how the proportion of Medicaid patients having certain operations increased 7.2% in New York after Medicaid coverage was expanded there in 2001.
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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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Indiana Gov. Pence Details His Medicaid Expansion Alternative

In a speech to the American Enterprise Institute, the governor outlined a plan that he says will expand health coverage for low-income state residents while also giving people more control over their health care choices. Meanwhile, the stand-off over Virginia's Medicaid expansion is causing the budget situation to worsen. News outlets also provide related updates from Wisconsin, California and Missouri.
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Gov. Mike Pence to offer refined plan for Healthy Indiana program

Gov. Mike Pence to offer refined plan for Healthy Indiana program | Medicaid Reform for Patients and Doctors | Scoop.it
He has been negotiating for months with the federal government over using it as an alternative to Medicaid
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Health Centers Hurt In States That Skipped Medicaid Expansion

Health Centers Hurt In States That Skipped Medicaid Expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Most of the affected patients live in the South, because every state in the region except Arkansas and Kentucky opted against expanding the Medicaid program for the poor.
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Missouri budget bill has no $$ for Medicaid expansion

Missouri budget bill has no $$ for Medicaid expansion | Medicaid Reform for Patients and Doctors | Scoop.it
The budget includes funding increases for public K-12 schools and higher education institutions.
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