Another Study Shows Impact Of Medicaid Reimbursement Cuts To States
A second study finds the major impact of reducing federal dollars for Medicaid to states. States that expanded Medicaid coverage could have to find $44.3 billion annually in state budget cuts or increased revenue to maintain what they have. The Urban Institute and Robert Wood Johnson Foundation (RWJF) say state spending would be hiked by about 25.6% on average if that occurred. Twelve states have trigger laws that would drop the expansion if the enhanced reimbursement is halted.
I told you yesterday about a Kaiser Family Foundation (KFF) analysis of the spending reductions related to a Medicaid per capita cap program. KFF finds that capping per enrollee spending could reduce federal Medicaid expenditures by $532 billion to nearly $1 trillion over 10 years depending on how states respond. KFF also finds that eliminating the Medicaid expansion matching rate as well could push the federal Medicaid spending savings to as much as $2.1 trillion.
#medicaid #budgetreconciliation #coverage
https://www.healthcaredive.com/news/federal-medicaid-cuts-shift-costs-expansion-states/740966
KFF Outlines Key Facts On Medicaid
As Medicaid cuts are debated on Capitol Hill, the Kaiser Family Foundation (KFF) has issued a brief on Medicaid. Among its findings:
- 42 states use capitated managed care to furnish services.
- Over half of all Medicaid dollars go to risk-based managed care.
- 75% received their services through managed care plans.
- Five publicly traded national plans account for half of all enrollment.
#medicaid #managedcare #healthplans
https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-managed-care/
Peterson-KFF Looks At Barriers in Health Plan Price Transparency Requirements
The Peterson-Kaiser Family Foundation (KFF) Health System Tracker published a great analysis of the problems and barriers seen with the price transparency rule that requires group health plans and insurers to make detailed provider rate data available. The rule was finalized under President Trump in his first term, with the goal to increase price competition and ultimately drive down healthcare costs.
The study finds that the vast troves of data include misleading and unlikely prices, inconsistencies, and other oddities that pose significant analysis challenges. Its key findings are:
- Unlikely rates reported for providers that do not provide the service.
- Multiple rates reported for the same service.
- Repetitive rates for multiple services.
- Challenges identifying rates for hospitals.
- Different, valid approaches to summarizing rates can meaningfully affect results.
- Rate structures differ across payers.
- Reporting structures can change materially over short periods of time.
Additional article: https://www.kff.org/health-costs/issue-brief/challenges-with-effective-price-transparency-analyses/
#pricetransparency #cms #hhs #hospitals #healthplans
https://www.healthsystemtracker.org/brief/challenges-with-effective-price-transparency-analyses/
— Marc S. Ryan
