When it comes to health care policy, California is one of the most progressive states in the nation. This past year, Governor Newsom signed into law a state-level individual mandate.…
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.
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.
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.(more…)
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:(more…)
Between the Center for Medicare and Medicaid Services’s (CMS’s) recent release of the Early 2019 Effectuated Enrollment Report and the Trends in Subsidized and Unsubsidized Enrollment Report and CMS’s newly…
The Medicaid Enterprises Systems Conference (MESC) ended on a positive note by discussing how analytics has been used by state Medicaid agencies to solve the opioid crisis and how Florida has successfully modernized its member service experience.
In case you were not able to attend, here is our recap of the key topics discussed:
The Medicaid Enterprise Systems Conference (MESC) continued day 2 and day 3 by discussing the most pertinent issues facing Medicaid: modularity, user acceptance testing, automation, mobility and enterprise transformation. Attendees are addressing state challenges and keeping the Medicaid modernization at the forefront of proposed solutions.
In case you were not able to attend, here is our recap of key topics discussed:
Policymakers are recognizing the impact that social and economic factors have on a consumer’s approach to healthcare. Access to housing, healthy food, and income must be taken into consideration as a person determines the appropriate health plan coverage. Social determinants of health (SDOH) can control up to 80% of health outcomes according research by the Robert Wood Johnson Foundation (RWJF). This statistic encompasses mainly Medicaid’s low-income enrollees who struggle with covering basic needs.
In this blog we’ll discuss the growing focus around Medicaid Managed Care and how social determinants of health can recover health outcomes.(more…)