Wednesday, September 22, 2021

Kip Piper's Health Care Blog
Medicare, Medicaid, Health Reform

The federal health reform legislation - Patient Protection and Affordable Care Act (PPACA) - includes an ambitious list of changes to long-term care (LTC) services for seniors and the disabled. Most include a massive infusion of federal funding to help state Medicaid programs provide more LTC through home and...
Following a five-year demonstration, a new report examines the Health Opportunity Accounts Demonstration Program created by the Deficit Reduction Act (DRA).  The law allowed up to 10 states to test the use of Health Opportunity Accounts as an alternative health benefit design in Medicaid. Participating states were allowed to establish Health Opportunity...
The $350 billion Medicare-Medicaid dual eligible market is an extraordinary new business opportunity for health insurers, as well as a way for state Medicaid programs to generate significant budget savings and improve access and quality of care for frail seniors and persons with severe disabilities.  A dozen states are now looking...
In deciding whether to expand Medicaid eligibility under the Affordable Care Act (ACA), governors and state legislatures face a complex, politically and fiscally challenging choice.  The decision on Medicaid eligibility expansion is already a hot topic in state capitals and state election campaigns.  Expect the politics and policy of...
Much of the nation's long-term care is paid for with Medicaid funding. Medicaid pays 43 percent of all long-term care, while Medicare pays 24 percent and a mix of private health plans and consumers funds the rest, according to the Kaiser Family Foundation. Only half of people who need...
To support demonstrations to integrate Medicare and Medicaid for dual eligibles, the Centers for Medicare and Medicaid Services (CMS) offering state Medicaid agencies grants of up to $15 million each.  The funds are for implementation of CMS approved designs to integrate care for Medicare-Medicaid enrollees.  Most of the state...
Medicaid eligibility and enrollment is being substantially streamlined.  State Medicaid agencies and their contractors are busy adapting eligibility systems and processes to a dramatically new set of federal standards, all required under the Affordable Care Act.  Starting in January 2014, the new framework for Medicaid eligibility and enrollment will...
Policy circles are abuzz with news about Arkansas Governor Mike Beebe’s creative plan to expand Medicaid under the Affordable Care Act.  While details are sketchy and there's no official federal approval yet, the basic idea is to use the federal funding for Medicaid expansion (100% in 2014-2016, no less...
Some states have expressed interest in using premium assistance to expand Medicaid eligibility under the Affordable Care Act (ACA).  Instead of serving the new ACA Medicaid expansion population through the Medicaid delivery system (through Medicaid health plans or Medicaid fee-for-service, depending on the state), the new enrollees would be...
Love it or hate it, the Affordable Care Act is unprecedented in size, scope, complexity, and uncertainty.  To project its impact, numerous policy, economic, competitive, and behavioral factors must be considered and assumptions made.  From an analytical perspective, the ACA is a simultaneous, non-linear equation from hell. A number of...

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