- Direct primary care for Medicaid.
- Senators demand release of NIH study on transgender care.
- Preauthorization denials: they are twice as high in Medicaid as they are in Medicare Advantage.
- Study: hospital upcoding in 2019 (relative to 2011 coding practices) was associated with $14.6 billion in hospital payments, including $5.8 billion from private health plans, $4.6 billion from Medicare, and $1.8 billion from Medicaid.
- Relative to employer small-group plans, Marketplace plans paid 6.9% lower doctor fees, 13.3% lower hospital fees, and were 26.3% lower outpatient prices.
Category: Single-Payer/Medicare-for-All
Critics: Work Requirements for Medicaid Enrollment Off to a Slow Start
Republicans have wanted to tie welfare benefits to work requirements for many years. One such proposal is to require some form of work in return for Medicaid benefits. Democrats opposed such measures, with the Obama and Biden Administrations blocking most applications. George is the only state so far with work requirements tied to Medicaid expansion under the Affordable Care Act. Critics argue that the program is boosting inefficiencies and slowing down enrollment in other welfare programs, like food stamps and Temporary Assistance for Needy Families. In Georgia employment verification for Medicaid eligibility and enrollment has been slow.
Thursday Links – 5 December 2024
- To do want he wants to do, RFK Jr will be head of the wrong agency.
- More than 50% of the AMA’s revenue in 2023, or $266 million, came from a budget category that includes medical billing codes. (Statnews)
- From 1997 to 2011, 85% of the increase in real per-capita Medicare spending was on newly created procedure codes.
- Final House Select Committee report: Covid likely came for the Wuhan lab.
- More than one-third of 100 hospitals reviewed did not properly post machine-readable pricing data, as required by law.
Saturday Links
- Can access to credit affect the quality of health care hospitals deliver?
- Viewpoint: we are at the start of a 4th industrial revolution.
- Medicare Advantage telehealth primary care visits. They are more likely when the beneficiary is frail (39.4%), when the beneficiary is disabled (20.1%) and when low income (8.3%).
- Elevance study: Medicare Advantage saved Medicare as much as $144 billion over ten years. (I’ll have more to say about this study in the near future.)