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Healthcare News

 

KFF: ACA significantly narrowed disparities in coverage for people of color—but those trends may be reversing

2/15/2019


(FierceHealthcare)
The implementation of the Affordable Care Act (ACA) has significantly narrowed the disparities in coverage experienced by people of color, but those gains may be slowing, according to a new report.


A new brief from the Kaiser Family Foundation looks at the disparity in health coverage by race and ethnicity between 2013 and 2017 using American Community Survey data. In 2013, 16.8% of the nonelderly population lacked insurance, with the scales tipping higher for people of color, KFF found.


After the ACA coverage expansion in 2014, the Hispanic population experienced the largest coverage gain, followed by Asians, American Indians and Alaskan Natives (AIAN) and blacks, compared to whites. 


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Payers, providers push back on Democrats' Medicare buy-in plan

2/14/2019


(FierceHealthcare)
Earlier this week, Democrats introduced a bill that would allow people ages 50 and over to buy in to Medicare coverage, and the plan is already getting pushback from payers and providers.


Under the most recent proposal, people between the ages of 50 and 65 could buy a Medicare plan and qualify for subsidies and tax credits under the Affordable Care Act (ACA). The Medicare at 50 Act, led by Sen. Debbie Stabenow, D-Mich., would fund enrollment through premiums and would eventually lower costs for younger people by moving more people into the higher age bracket, its sponsors argue. 


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Health Care Cost Institute: Spending in employer-sponsored plans hits all-time high

2/13/2019


(FierceHealthcare)
Spending for people enrolled in employer-sponsored plans hit an all-time high in 2017, according to a new report.


The Health Care Cost Institute released its annual report (PDF) diving into costs and utilization of services among people with employer-sponsored plans and found that per-member expenses reached an average of $5,641 in 2017. 


That’s an increase of 4.2% from 2016, and prices for services are driving that trend, according to the report, which is based on data from between 2013 and 2017.


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HIMSS19: Seema Verma says proposed information blocking rules with 2020 deadlines 'realistic'

2/12/2019


(FierceHealthcare)
As part of the proposed rules released by the Office of Management and Budget this week, the Trump administration has said it would give 125 million patients electronic access to their medical claims information by 2020. 


But how realistic a goal is that?


It's totally reasonable because it's already happening, Centers for Medicare & Medicaid Services Administrator Seema Verma told FierceHealthcare at the Healthcare Information and Management Sytems Society's (HIMSS) annual conference and exhibition.


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Molina Healthcare’s financial turnaround continues, despite a drop in 2018 membership

2/12/2019


(FierceHealthcare)
Despite a dip in membership last year, Molina Healthcare’s financials continue to make a significant rebound.


Molina reported a 14% decrease in 2018 enrollment as part of its fourth-quarter and year-end earnings, but regardless of those losses, income reached $707 million in 2018, following a net loss of $512 million the year prior.  


CEO Joseph Zubretsky said on the company’s earnings call Tuesday morning that the improvement in financial performance has allowed Molina to make significant investments in improving operation and making their processes more efficient.


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Medicare, Medicaid better than private insurers at containing costs, study finds

2/12/2019


(FierceHealthcare)
Medicare and Medicaid are better than private insurers at keeping spending per-beneficiary low, a finding that has crucial implications for the current health policy debate, according to a new report.


The Urban Institute dived into data from the Centers for Medicare & Medicaid Services’ national health expenditure reports from between 2006 and 2017 and found that per-enrollee spending increased by 2.4% each year in Medicare and 1.6% each year in Medicaid, while it went up by 4.4% annually in private plans. 


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Access to insurance coverage improved under the ACA, but more of those covered are now underinsured: survey

2/8/2019


(FierceHealthcare)
The Trump administration's actions to cripple the Affordable Care Act haven't notably changed the number of uninsured people, according to the Commonwealth Fund, but they have weakened protections for those that have insurance.


About 12% of Americans were uninsured in 2018, according to the Fund's biennial survey—statistically unchanged from 2016, the last time the survey was taken. However, more of those who did have insurance were considered underinsured, meaning their out-of-pocket medical expenses exceeded a certain threshold. 


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AMA survey: 28% of physicians say prior authorizations led to serious adverse events

2/6/2019


(FierceHealthcare)
Prior authorizations are hazardous to patients’ health, according to more than one-quarter of physicians.


In a survey (PDF) by the American Medical Association, 28% of 1,000 responding physicians said the prior authorization process required by health insurers for certain drugs, tests and treatments has led to serious or life-threatening adverse events for patients.


The survey specifically asked doctors if the prior authorization process ever affected care delivery and led to a serious adverse event, such as a death, hospitalization, disability or permanent bodily damage or other life-threatening event for a patient in their care.


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Low reimbursement rates from private payers to mental health providers may curb patient access

2/6/2019


(FierceHealthcare)
Reimbursement rates from commercial insurers to mental healthcare providers may hinder patient access to such care, according to a new study.


Researchers from the Congressional Budget Office analyzed data from the Health Care Cost Institute—which includes claims for 39 million Aetna, Humana and UnitedHealthcare members—and found that commercial plans paid in-network providers 13% to 14% less than fee-for-service Medicare for psychotherapy or evaluation and management services. 


However, the payouts to out-of-network providers were significantly higher, the study found. Private payers paid 43% more to these doctors for E&M care, for example, and 53% more for out-of-network psychotherapy.


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Voter-backed Medicaid expansion hit snags in 4 states. Where are they now?

2/5/2019


(FierceHealthcare)
Voters in several states approved Medicaid expansion in ballot measures in the 2018 election.


But whether politicians in those states actually decide to embrace them is another story.


Voters in Idaho, Utah, Nebraska and Maine approved ballot measures to expand Medicaid after leaders in all three red states shunned the option to do so under the Affordable Care Act in 2014.


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