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State forgoes federal funds to go its own way on Medicaid expansion
Wisconsin’s Republican governor wants to expand Medicaid to some of the poorest adults in the state while placing others on the state’s health insurance exchange, but he’s not going to get enhanced federal matching dollars to do so. The Affordable Care Act gives states the option to expand their Medicaid programs to everyone up to 133% of poverty (an effective rate of 138% when certain income is discounted from consideration) starting in 2014. Although some Republican governors — such as Nevada’s Brian Sandoval and Arizona’s Jan Brewer — decided to take up this provision after initial resistance, GOP holdouts remain, including Wisconsin Gov. Scott Walker. Walker has rejected the idea of fully expanding Medicaid under the ACA. Instead, his upcoming budget proposal outlines a plan for Medicaid to cover non-disabled, non-elderly adults up to 100% of poverty. As part of the proposal, Walker would lift a 2009 enrollment cap on the BadgerCare Plus Core program, which cove [Read more]
Has mobile health monitoring hit a wall?
The number of technical tools available to help patients live healthy lifestyles or control chronic health conditions has grown considerably during the past few years. But the percentage of patients who use some form of technology, such as mobile apps, to track health indicators has remained virtually unchanged for three years. The Pew Internet & American Life Project published a report Jan. 28 that found 69% of U.S. adults track at least one health indicator such as diet, exercise or weight. The survey of 3,014 adults conducted between Aug. 7 and Sept. 6, 2012, found that 49% monitor their progress in their heads, 34% track the information on paper, and 21% utilize some form of technology, including mobile apps, which 7% use. The results mirror findings from a Pew survey in 2010. “As a tech industry thought leader, I’m disappointed when I see a survey like that,” said Bill Crounse, MD, senior director of worldwide health at Microsoft Corp. “But as somebody who has served [Read more]
Health plans add financial motivation to wellness programs
As the insurance industry continues to expand wellness programs, it is taking on care-giving roles that health plans believe are meant to complement and not compete with doctors’ efforts. “As a health plan, we don’t want to insert ourselves in the middle of the doctor-patient relationship,” said Cigna spokesman Joe Mondy. “Instead, our role is to support both the doctor and patient with the great health care challenge of the 21st century — helping individuals change unhealthy behaviors and make health a fun and interesting part of everyday life.” Cigna recently developed a wellness info-graphic website that helps members understand what health system reform means to them with a personalized survey. The survey asks members for general demographic and insurance information before telling them how heath reform will affect them specifically. Consultants say they understand doctors’ skepticism, given ongoing battles over coverage, about health plans’ sincerity in [Read more]
Harm of hospital “July effect” further cast into doubt
The country is deep in winter, but attention again is returning to that summertime phenomenon dubbed “the July effect.” That’s the name given to a supposed spike in medical mistakes and poor patient outcomes at teaching hospitals during the seventh month of the year, when newly minted MDs start providing care. Numerous studies have reached conflicting conclusions about the extent of the July effect and whether it even exists. A massive study of spinal surgery outcomes published Jan. 29 online further complicates the picture, finding that patients going under the knife at teaching hospitals in July largely fare just as well as their counterparts during the rest of the year but do slightly worse on a couple of metrics. Researchers examined nearly 1 million spinal procedures between 2001 and 2008, and found that patients who underwent surgery in July had similar rates of in-hospital mortality, adverse reactions to implanted devices and wounds reopening post-operatively. Howeve [Read more]
Medicaid-eligible but not enrolled? ACA a likely stimulus
Near-nudity may not be an obvious strategy to get people insured, but one county agency in California has employed this very approach to grab the attention of people eligible for Medi-Cal, the state’s Medicaid program. The ad campaign shows families minimally dressed and holding up signs urging people to get health insurance. “Our message is that you wouldn’t let your family go without clothes — why let them go without health coverage?” said Lori A. Cox, director of the Alameda County Social Services Agency. County officials estimate that there are thousands of residents eligible for the state’s Medicaid program but not enrolled, including about 15,000 children. The agency also has set up a phone number to provide information about Medi-Cal eligibility, and those interested in applying may do so online. Alameda’s “Cover Your Family” strategy caught the attention of Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured. At a [Read more]
Medical students urge Congress to preserve GME
Hans T. Zuckerman, a third-year medical student at the Philadelphia College of Osteopathic Medicine, painted a grim picture of what may await future students like him if federal support for graduate medical education either is reduced or not expanded. “In the next couple of years, they’re projecting that there may not be enough slots for all the students graduating from medical school to get into a residency,” said Zuckerman, who was one of about 300 medical students from around the country who participated in the American Medical Association’s student advocacy day on Feb. 11. The medical students met with members of Congress during the event to urge lawmakers to preserve Medicare funding for residencies and take additional steps to boost the number of Medicare-supported residency positions. Graduate medical education funds often have been the target for cuts during congressional budget negotiations. There’s concern throughout organized medicine that talks regarding the [Read more]
Summit focuses on alternatives to Medicare pay system
The Medicare program cannot move forward without a plan to change its payment structure to a higher-performing system, physicians and analysts said during a recent policy summit underwritten by the American Medical Association. There has been little movement to transition the program’s payment system away from fee for service and a seemingly endless cycle of pay cuts threatened by the sustainable growth rate formula. Health policy analysts and industry leaders discussed issues preventing reforms to how Medicare doctors are paid and offered insight on what action is needed to bring innovation to the system during the Jan. 29 event, hosted by National Journal. New efforts to change Medicare will not proceed until the hurdle of the Medicare SGR formula is cleared, said AMA Executive Vice President and CEO James L. Madara, MD. The AMA has drafted a framework for a transition plan that starts with eliminating the SGR. The formula is a problem that has lingered for far too long and p [Read more]
Hospitals promote economic role amid talk of federal cuts
As Congress debates ways to cut health care spending, the American Hospital Assn. wants to remind it of the contributions the health care industry, particularly hospitals, makes to the economy and how any threat to the access of health services would have a negative impact on the nation’s financial stability. In a report issued in January, the AHA said the importance of hospitals extends far beyond health care. Hospitals are job creators, the organization said, employing nearly 5.5 million people and generating $2 trillion in annual economic activity, according to the AHA. “The economic contribution of hospitals … is often critical to communities,” the AHA said in a statement. The report said that even during a slow economy, health care continued to add jobs. In 2012, an average of 28,000 jobs per month were added, and the “ripple effect” of hospitals helped support 9.9 million jobs outside of health care, according to the report. The AHA also said its members h [Read more]
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