Medicaid Archive

The Real Cost of Hospital Readmission Rates

Starting this year, the Centers for Medicare and Medicaid Services (CMS) fees are being strongly enforced and will affect many non-complying hospitals. The cost of hospital readmission is already extensive for health care payors and patients, and now hospitals will be financially impacted as well. CMS’s hospital penalties are expected to reach $428 million inRead the Rest…

Low-Income Patients and Medicaid Managed Care Providers

In November 2012, The Centers for Medicare and Medicaid Services (CMS) ruled for a temporary increase on fee-for-service reimbursement rates. This increase in payment rates was set to encourage doctors to participate in Medicaid, which received substantially lower repayment rates compared to Medicare—about two-thirds lower. To lessen the payment gap between the two government healthRead the Rest…

Will Changes to Five-Star Rating System Bring Improvement?

As of 2014, there were 15,800 nursing home facilities caring for approximately 1.4 million residents in the United States, according to the Centers for Medicare and Medicaid Services (CMS). Of the entire U.S. population, 0.9% age 65-74, 3.2% age 75-84 and 11.2% over the age of 85 reside in nursing facilities, according to the U.S.Read the Rest…

States Contributing to Medicaid and Medicare Savings

Many elderly and disabled low-income Americans qualify for both Medicare and Medicaid coverage. They are referred to as dual eligible. Medicare, which was created to provide medical coverage for seniors and people with disabilities has 37 million enrollees. Medicaid, which was created to provide medical coverage for the poor has 51 million. There are currentlyRead the Rest…

Doc Fix Could Depend on Post-Acute Care

In 1997, as part of the Balanced Budget Act, the Medicare Sustainable Growth Rate (SGR) was enacted in an attempt to manage Medicare’s spending on physician services. Every year since the SGRs inception, Congress has attempted to avoid implementing its proposed physician reimbursement cuts. This past March, another “patch” was plastered on the SGR –Read the Rest…

4.3 percent of Medicaid beneficiaries receive a third of all benefits

In 2012, Medicaid spent $435.5 billion on 72.6 million providing healthcare coverage to its beneficiaries. Since then, the Affordable Care Act has prompted many states to expand Medicaid services to even more people. A February 2014 report from the Government Accountability Office (GAO) used data from the most recent fiscal year, 2009, available to determineRead the Rest…

75% of Medicaid Recipients Will Be Covered by an MCO by 2015

An increasing number of Medicaid recipients are receiving their benefits through a managed care organization. Most of the new Medicaid enrollees under the Affordable Care Act will also be covered by an MCO. A managed care organization was already providing Medicaid coverage to 63% of recipients in 2012. With all the new enrollees, that numberRead the Rest…

Affordable Care Act and Doctors Q and A

When the topic turns to the Affordable Care Act and doctors, a pair of issues always seem to come up and raise concerns about Obamacare’s effect on doctors and their practices. The last time we took a look at some of the questions relating to the ACA and how it impacts patients, this time we’reRead the Rest…

Affordable Care Act Q & As

It’s still too soon after implementation to have many questions raised by the Affordable Care Act answered definitively, and of course, debates in courts across the nation will likely change things. But, some of the details about how it’s impacting quality patient care are beginning to come into focus even as they raise more questions.Read the Rest…