Topic: Policy & Health Reform

Congress reintroduces bill addressing Medicaid “Churn,” a Major Issue for Health Plans

Thomas Johnson

The reintroduction of the bipartisan “Stabilize Medicaid and CHIP Coverage Act of 2017” in the House (Green, D-Texas, and Barton, R-Texas) and the Senate (Brown, D-Ohio) provides 12 months of continuous eligibility to Medicaid and Children’s Health Insurance Program (CHIP) enrollees, mitigating the effect of what is known as “churn” for enrollees and health plans. “Churn” affects millions of enrollees who are disenrolled from Medicaid or CHIP due to changes in income or paperwork, despite being otherwise eligible.

Read more

Leave a comment | Share | |

What Does the Better Care Reconciliation Act Mean for Medicare Advantage Plans?

David Sayen

In a word, it’s trouble. Let me count the ways.

Top of mind is the Medicaid overhaul. Block Granting Medicaid has been the Holy Grail on the Republican side since Reagan. And why not: the Department of Health and Human Services (HHS) wants to download the risk to the states. Whether it is the per capita limits required by law or the optional Hobson’s Choice of the block grant for the entire population, it means one thing. Pain. States have to balance their budgets, unlike Uncle Sam who has that bottomless checkbook.

Read more

Leave a comment | Share | |

Still Mean: Senate GOP Releases ACA Repeal Bill That’s Worse Than House

John Gorman

After six weeks of intensely secret negotiations, the “Better Care Reconciliation Act of 2017” (BCRA) is out, and it’s much worse than the House’s AHCA. The story remains the same: worsening benefit cuts for the poor to provide a tax cut for the rich. After Trump called it “mean,” and literally every healthcare organization has rallied against it, the hoped-for moderating influence of the august upper body of the U.S. Congress is gone. TrumpCare is still mean.

Read more

Leave a comment | Share | |

Seven Major Takeaways from the Proposed 2018 MACRA Regulation

Olga Walther

On Tuesday, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule making changes to the second year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). In the proposed rule, CMS continues to use a flexible approach to the implementation of the legislation, marking the second year of the program another transition year. Comments on the proposed rule are due by August 21st, 2017.

Read more

Leave a comment | Share | |

Global Warming Comes to Healthcare

David Sayen

On June 7, the Health Subcommittee of the House Ways and Means Committee heard and responded to testimony about Medicare Advantage (MA) and, in particular, how the program can be an instrument to advance care coordination and integration. The tenor of this hearing, combined with the recent unanimous passage of the bipartisan Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act by the Senate Finance Committee tells this reader ice isn’t just melting at the North Pole. There is a thaw in the chill that seemed to blanket parts of the healthcare industry since the election.

Read more

Leave a comment | Share | |

One in Three People in Medicare Now Enrolled in Medicare Advantage

Olga Walther

For the first time, one in three people in Medicare are now enrolled in Medicare Advantage (MA), according to a new analysis from Kaiser Family Foundation. The new analysis, “Medicare Advantage 2017 Spotlight: Enrollment Market Update,” examines trends in the MA market, including cost sharing and premiums, market penetration, and market share of the top three MA firms by state.

Read more

Leave a comment | Share | |

CBO Discredits TrumpCare Talking Points on ACA Repeal Bill

John Gorman

By now I’m sure you’ve seen the Congressional Budget Office (CBO) assessment of TrumpCare/the American Health Care Act (AHCA) and its topline findings: 23 million would lose coverage, it cuts $1.1 TRILLION in coverage assistance to low-income Americans, it would increase premiums for those age 50-64 by more than 850%, all while providing a massive tax cut to the wealthy and various healthcare industries like device manufacturers.

Read more

Leave a comment | Share | |