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April 12, 2024

Physician Pay Increases, But Hurt By Inflation

A survey of physicians shows that pay increased by about 3% in 2023, but it was offset by high inflation.

#physicians #providers

https://www.fiercehealthcare.com/providers/physician-pay-rose-modest-3-2023-here-are-specialties-saw-biggest-gains

Corporate And Hospital Ownership Of Physicians Continues

I often talk about the pernicious effect of hospital and private equity ownership on healthcare costs. Hospitals drive changes in practice to higher-cost settings.  Together, the entities continually push fees higher.

The ugly effects of the takeover of independent practices continues.  Not too long ago, studies showed about half of all physician entities owned by hospitals or private corporations and about 70% of all physicians employed by them.  Now, the latest stats show the two types of entities owning 58.5% of all physician entities.  They now own 77.6% of all physicians. For the first time, corporate practice ownership (30.1%) exceeded hospital and health system ownership of docs (28.4%).

Additional article: https://www.fiercehealthcare.com/providers/more-and-more-physicians-are-working-under-hospitals-corporate-entities-report-finds

#physicians #providers #hospitals #privateequityfirms

https://www.healthcaredive.com/news/doctor-corporate-ownership-growing-hospital-insurer-pai-avalere/712988

Hospitals Sue HHS Over Rates

Over two dozen hospitals are suing the Department of Health and Human Services (HHS) over what hospitals say is a decades-old error in the Medicare inpatient physician formula that has meant major underpayments.

(Article may require a subscription.)

#hospitals #medicare

https://www.modernhealthcare.com/legal/cms-ipps-rate-lawsuit-xavier-becerra

Fallout From Medicaid Redeterminations Profound

A new survey from the Kaiser Family Foundation (KFF) finds that the fallout from the redetermination process has been profound. About 20 million have been disenrolled from Medicaid for at least some time when redeterminations began in April 2023.  About 70% of those disenrolled were uninsured for some time. Nearly a quarter of those disenrolled in the past year are now uninsured.  About half signed back up within weeks, showing the gross problems with Medicaid redetermination processing at the state level. About 28% found other coverage when disenrolled, most of them with employers. About one in three did not find out they lost Medicaid until they sought care.

KFF survey analysis: https://www.kff.org/medicaid/poll-finding/kff-survey-of-medicaid-unwinding/

Additional articles: https://www.beckerspayer.com/payer/1-in-4-of-those-disenrolled-from-medicaid-are-uninsured-5-things-to-know.html and https://thehill.com/policy/healthcare/4590466-adults-booted-medicaid-uninsured/

#medicaid redeterminations #coverage

https://kffhealthnews.org/news/article/quarter-medicaid-disenrolled-uninsured-kff-survey/

Alaska Passes Primary Care Subscription Health Care

Driven by Republicans in the legislature, the Alaska legislative branch has passed subscription-based healthcare.  Primary care physicians could offer patients access to care for a monthly rate.  This would be a limited form of coverage. Harkens back to the start of American healthcare, which in part had employers paying primary care doctors to see employees who were hurt or ill.

#primarycare #coverage #ak

https://www.adn.com/politics/alaska-legislature/2024/04/11/alaska-legislature-approves-subscription-health-care-bill

Physicians Clamor For All Sorts Of Reforms At Senate Finance Hearing

Physicians appeared before the Senate Finance Committee today asking for some major reforms. They argued they need more money to take care of chronically ill patients. They want relief from paperwork burdens and prior authorization. They also want an overhaul to the current Medicare physician payment system.

#physicians #medicare

https://www.medpagetoday.com/publichealthpolicy/medicare/109636

Poorest State Could Pass Medicaid Expansion

While there was hope that other southern states would pass Medicaid expansion, it looks like just Mississippi is left.  Changes remain uncertain, but perhaps reasonably good. Each house of the legislature has passed a bill and they now need to reconcile them.  The House bill goes to 133% of the federal poverty limit (FPL), has work requirements, and the law would still take effect if the federal government rejected them.  The Senate expands to 100% of FPL with less generous reimbursement and work requirements. But the expansion would not go into effect if work requirements were not approved.

#ms #obamacare #medicaid #aca #coverage

https://www.axios.com/2024/04/11/mississippi-medicaid-expansion-republicans-obamacare

KFF Finds Employer Supplemental Retiree Insurance Dropping Dramatically

A new Kaiser Family Foundation analysis finds that the number of seniors who worked at larger employers and who have supplemental retiree coverage has dropped from 66% in 1988 to between 12% and 21%. What’s more is that those who continue to offer the wrap-around coverage to Medicare have gravitated to Medicare Advantage to hold down costs of such coverage. About 5 million today get their supplement coverage through MA plans.

Given the major holes in the traditional fee-for-service benefit, the trend is worrisome.  Medicare Supplement policies are expensive.  Employer secondary coverage used to fill the voids.  Part of the rise in MA growth is explained by the erosion of employer supplement coverage. People just cannot afford to pay for it.

#medicare #medicareadvantage

https://www.kff.org/medicare/issue-brief/retiree-health-benefits-going-going-nearly-gone/

— Marc S. Ryan

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