Long-Term Care Providers ‘Clobbered’ by Managed Medicare

While the skilled nursing industry worried about the rise of accountable care organizations (ACOs), managed Medicare plans slowly established a firm foothold that isn’t going anywhere soon. “The growth of ACOs and bundled payments has kind of leveled off,” Jill Kreuger, president and CEO of pharmacy and rehab solutions provider Symbria said at LeadingAge Illinois’s […]

Adding a Work Requirement to Medicaid Could Hurt Kentucky’s Economy

In January 2018, the Centers for Medicare and Medicaid Services approved a waiver of Medicaid rules requested by the state of Kentucky. Under the HEALTH (Helping to Engage and Achieve Long-Term Health) waiver, Kentucky will require an estimated 350,000 able-bodied Medicaid beneficiaries who are not primary caregivers and/or pregnant to work, complete job training, or […]

Medicaid Retroactive Coverage Waivers: Implications for Beneficiaries, Providers, and States

On October 26, 2017, the Centers for Medicare and Medicaid Services (CMS) approved an amendment to Iowa’s Section 1115 demonstration waiver eliminating 3-month retroactive coverage for nearly all new Medicaid applicants as of November 1, 2017.1 Populations affected by Iowa’s waiver include low-income parents, children over age 1, Affordable Care Act (ACA) expansion adults, seniors, and […]

HEALTHCARE SPENDING AND UTILIZATION IN PUBLIC AND PRIVATE MEDICARE

ABSTRACT We compare healthcare spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their healthcare spending. Healthcare spending is 25 percent lower for MA enrollees than for enrollees in traditional Medicare (TM) in the same county with the same risk […]