The CMS may soon make it easier for states to use federal funds to pay for Medicaid enrollees to receive treatment at inpatient mental health facilities. The agency issued a letter to Medicaid directors Tuesday saying they will be able to cover an average of 30 days of care at institutions of mental disease, or IMDs, through a new waiver. In a speech shortly before the announcement, HHS Secretary Alex Azar said the Trump administration is increasingly concerned that Medicaid beneficiaries aren’t receiving critically needed care because of the IMD exclusion. “Today, we have the worst of both worlds: limited access to inpatient treatment and limited access to other options,” Azar said at the National Association of Medicaid Directors conference Tuesday. “It is the responsibility of state and federal governments together, alongside communities and families, to right this wrong.”
Humana’s shift from fee-for-service medicine to value-based payments for physicians continues to reduce costs and improve quality of care for seniors enrolled in Medicare Advantage plans, the insurer says, citing a new internal study. Medical costs were nearly 16% lower for seniors enrolled in Humana Medicare Advantage plans that paid physicians via value-based models in 2017 compared to costs of those in traditional fee-for service Medicare, the Louisville-based insurer’s study, released Tuesday showed. Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines, with some even providing vision and dental care and wellness programs.
Virginia is facing a huge bill for unexpected Medicaid costs that hamper proposed new spending on things like school improvements or tax breaks for the poor. State officials said Friday that Virginia has about $460 million in unforeseen Medicaid costs. Secretary of Finance Aubrey Layne said much of the new costs stem from faulty forecasts overestimating the benefits of having private health insurers cover a greater number of some of the state’s more costly Medicaid recipients. Another reason for the increase is a higher-than-expected enrollment of children in the state’s Medicaid program, he said.
Many Democrats have embraced “Medicare for All,” but there’s a big variation in the policies they propose under that banner. This poll asked respondents two related questions—what they think candidates mean by “Medicare for All,” and what they want that policy to mean, if they support it at all. Overall, just 52% of those surveyed said they think “Medicare for All” refers to a single, government-run health care program covering everyone. Voters were more divided over what they want “Medicare for All” to be: 34% said they would favor a single-payer system; 33% said they would prefer an optional public plan alongside private insurance; 30% wanted neither. This poll shows that Medicare for All has different meanings to different people.
The United Kingdom’s National Health Service, which celebrated its 70th anniversary on July 5, is imploding. Vacancies for doctor and nurse positions have reached all-time highs. Patients are facing interminable waits for care as a result. This August, a record number of Britons languished more than 12 hours in emergency rooms. In July, the share of cancer patients who waited more than two months to receive treatment soared. Yet enthusiasm for government-run, single-payer health care continues to build in the U.S. One look across the Atlantic, to the disaster unfolding in the U.K.’s government-run healthcare system, ought to curb that enthusiasm.
President Trump’s administration says on average prices for 2019 are 1.5% lower than they were last year on the federal health exchange. After years of double-digit price hikes on exchange plans, health insurers are starting to turn a profit on the ACA exchanges. For 2019, there are more carriers getting back into the market and offering new plan options. The Trump administration extended the length of cheaper, short-term plans with fewer benefits to provide up to 12 months of coverage. Some analysts predict those cheaper plans could attract healthier members.
Uninsured individuals, people between jobs, recent graduates, and new retirees, among others, now have access to affordable short-term plans. These plans—an opportunity that arose from flexibility granted with new federal rules—allow Americans to purchase health plans they can afford and are right for them. There will be thousands of new options on the market (see this new analysis for more detail and data), giving Americans something they haven’t had in years: choice of health insurance and carrier. By contrast, for an individual on the exchange, in a majority of U.S. counties, only one insurer is offering plans. The data also show that these choices cost significantly less for someone that is uninsured than plans on the individual market.
CMS has issued a proposed regulation that makes smaller changes to the standards states meet when running their Medicaid plans. The proposed rule would give states some new flexibility in setting rates for their managed care plans and ensuring insurance companies have adequate provider networks. The CMS worked with Medicaid directors to develop the proposal. “Today’s action fulfills one of my earliest commitments to reset and restore the federal-state relationship, while at the same time modernizing the program to deliver better outcomes for the people we serve,” CMS Administrator Seema Verma said in a statement.
President Trump’s Department of Health and Human Services recently announced welcome new guidance to states looking to improve their health care and health insurance systems through “state innovation waivers” under Section 1332 of the ACA. The new guidance gives states significantly more flexibility to devise creative solutions to meet the health care and insurance needs of their constituents and it builds upon new community engagement waivers that made Medicaid more flexible for states earlier this year. Section 1332 allows states to experiment and creatively tailor their health care coverage programs under certain conditions.
The midterm elections abruptly shifted the health-care landscape across the country, resulting in a divided Congress that could mean most changes unfold on the state level. Health care was the No. 1 issue among voters this election, according to an AP survey of about 90,000 people. The voting results suggested a rebuke to repeated Republican efforts to roll back the health law, and that many Americans care deeply about issues such as coverage for pre-existing medical conditions. The split between red and blue states means that statehouses will continue to pursue opposite directions in health care. Voters approved Democratic-backed ballot initiatives to expand Medicaid in three states—Idaho, Utah and Nebraska—while rejecting a similar proposal in Montana.