Keeping up With the Dizzying Pace of New COVID-19 Policies

The COVID-19 pandemic has brought an unprecedented strain on health care communities worldwide as we rush to flatten the curve. Federal and state governments in the United States have been putting out a flurry of new policies to help facilitate care and coverage of care. We have compiled these policies and will discuss how insurers, with the right technologies in place, can best respond to the policies to quickly solve this crisis.

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How the Presidential Candidates Plan to Control Health Care Costs

Per capita, the United States spends more on health care than any other developed country. Despite growing awareness over the issue, new reports show the numbers are getting worse. According to the Health Care Cost Institute’s 2018 Health Care Cost and Utilization Report, average health care spending for people with employer-sponsored insurance rose to an all-time high in 2018, costing $5,892 per person annually. From 2014 to 2018, total annual spending per person increased 18.4%. Average out-of-pocket spending increased to $907 per person annually.

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Waste Accounts for 25% of Health Care Spending. Addressing Fraud and Abuse Can Help.

It already hurts to hear that the United States spends more on health care than any other country, with costs approaching 18% of the gross domestic product and more than $10,000 per individual.

A report published last week in The Journal of the American Medical Association makes those numbers even more painful as it reveals the estimated cost of waste in the United States ranges from $760 billion to $935 billion, accounting for approximately 25% of total health care spending. This amount exceeds national military spending, as well as total primary and secondary education spending.

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Let the Data Speak for Itself: The Relationship Between Work and Health

Both before and after the Centers for Medicare and Medicaid Services’ (CMS) policy reversal on work requirements, stakeholders have debated whether employment leads to improved health outcomes. CMS and states that have implemented or are trying to implement work requirements argue they do, while others disagree. The recent research of the Kaiser Family Foundation (KFF), a nonpartisan organization, illuminates what the data says on the relationship between work and health. This piece provides a recap of KFF’s findings.

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Rising Uninsured Rate and How States Can Respond

Earlier this month, many noted the Census Bureau’s report of the increasing number of uninsured Americans. 8.5 percent, about 27.5 million people, lacked health insurance in 2018, up from 7.9 percent in 2017. It was the first year-to-year increase in the uninsured rate since the Affordable Care Act (ACA) in 2010.

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CMS Continues Mission on Integrity with Affiliations Final Rule

Last week, the owner and CEO of Video Doctor Network pled guilty to a $424 million Medicare kickback scheme. He admitted to receiving kickbacks and bribes from recruiters, pharmacies and brace suppliers in turn for arranging doctors to order medically unnecessary orthotic braces for Medicare beneficiaries. As reported by Healthcare Dive, this is one of the largest schemes to defraud Medicare ever investigated by the Federal Bureau of Investigation (FBI) and the Health and Human Services (HHS) Office of the Inspector General and prosecuted by the Department of Justice.

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HMA Conference Recap

The Health Management Associates (HMA) conference brought together hundreds of industry executives from health plans, governments and community-based organizations serving Medicaid, Medicare and vulnerable populations. Set in Chicago, Illinois, the conference shed a light on the challenges and opportunities for health care entities in the publicly sponsored health care arena.

In case you were not able to attend, here is a recap of the key topics discussed:

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