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Medicare, Medicaid, Health Reform

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Monthly Archives: February 2005

Medicare Drug Benefit: Risks to Dual Eligibles in Nursing Homes?

When the Medicare prescription drug benefit begins on January 1, 2006, about seven million beneficiaries face more restricted drug formularies. Currently, these "dual eligible" individuals receive their drug benefit through state Medicaid programs, which offer more liberal formularies than what will be expected of the new Medicare drug plans. In addition, most of these high-risk patients will be enrolled in...

Is the Clawback Constitutional: Debate Over State Financing of the New Medicare Drug Benefit

Some legal gurus are questioning the constitutionality of a key provision of the Medicare prescription drug benefit: the so-called "clawback" provision that requires states to send the federal government cash to help cover the cost of drugs for dual eligibles. The mandatory payments are enormous - $6 billion in 2006 and over $48 billion (likely much more) during the...

Medicaid: Understanding America’s Largest, Most Complex Health Program

Under President Bush's FY 2006 budget, state Medicaid programs face the prospect of significant changes, including funding cuts of $60 billion, some new expansions, and additional flexibility. Now costing taxpayers over $300 billion a year and growing at 8-12 percent in most states, Medicaid is a hot topic inside the Beltway and in state capitols. However, Medicaid is extraordinarily complex....

Rise of the Hospitalist

A new breed of physician is coming to a hospital near you: the hospitalist. And they hold tremendous promise for improving quality and lowering costs. Hospitalists, who specialize in caring for hospitalized patients, are specially trained to effectively diagnose and treat high-acuity patients. Assuming primary responsibility for managing medical and surgical patients, hospitalists also help determine admissions from emergency departments...

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