November 15, 2023

Great Series on America’s Long-Term Care Problem

Congratulations to the Kaiser Family Foundation and The New York Times on the first in a series of articles on America’s long-term care crisis. America needs an aging policy. The series shows real-life examples of the impact of not having a national agenda on aging. It clearly shows that the lack of adequate supports for the elderly also impacts other generations, including children’s loss of income to take care of an elderly loved one.

In my book (available for purchase on this website), I devote a chapter to aging and recommend ways to make services available to all in an income-based buy-in strategy. Not addressing aging will only drive long-term care and medical costs even higher in the future. In addition to the NYT story and press release at the link below, here is a link to the KFF summary of a survey on long-term care: https://www.kff.org/health-costs/poll-finding/the-affordability-of-long-term-care-and-support-services/

#aging #ltc #medicare #medicaid #kff #nyt

Link to Article

Survey of Medicaid Officials Sees Sharp Decline in Enrollment

The annual Kaiser Family Foundation Medicaid budget survey of state officials finds there will be a major decline in Medicaid enrollment due to redeterminations (8.6% down) as well as increases in state share spending. A focus on some benefit expansions, including behavioral health, and social determinants are also reported. State officials worry about supporting long-term care and community-based services when COVID add-on funding goes away. Much more is in the survey as well.

In addition to the press release link below, here is a summary of state Medicaid budget spending and enrollment on Medicaid: https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-and-spending-growth-amid-the-unwinding-of-the-continuous-enrollment-provision-fy-2023-2024/ . As well, here is additional information: https://www.kff.org/medicaid/report/50-state-medicaid-budget-survey-fy-2023-2024/ . KFF’s podcast on the topic is here: https://www.kff.org/medicaid/event/medicaid-enrollment-and-spending-trends-policy-issues-amid-unwinding-of-continuous-enrollment-provision/ . Last a Fierce Healthcare article on KFF’s survey: https://www.fiercehealthcare.com/payers/medicaid-rate-decrease-86-2024-kff .

#medicaid #redeterminations #sdoh #ltss #hcbs #behavioralhealth

Link to Article

Some Pharmacists Complain CMS Rule Backfired

Independent pharmacies (and even some large chains) say a Centers for Medicare and Medicaid Services (CMS) rule has backfired. When so-called retrospective clawbacks in Medicare end, the pharmacies will face steep reimbursement cuts upfront from PBMs. What’s worse, early in 2024 they will get hit twice — the lower fees in 2024 and final clawbacks for 2023. If all this comes to be, there is no question it stems from the fundamental lack of transparency in our drug pricing system.

#drugpricing #pbms #medicare #medicareadvantage #partd #pdp

Link to Article

CBO Annual Report Insights

The Health Affairs Forefront blog on the Congressional Budget Office report on federal healthcare subsidies is interesting. While I don’t agree with everything the author says (I think we need to keep Exchanges right now given our level of uninsured), the blog clearly shows the dysfunction of our system and the need for reform. The fracture and inefficiency of our patchwork system is clear (may require subscription).

#cbo #aca #exchanges #healthcarereform #medicaid

Link to Article

— Marc S. Ryan

Leave a Reply

Your email address will not be published. Required fields are marked *

Available Now