Implementing Health Reform: Increasing Medicaid Payments for Primary Care Physicians

Timothy Jost

Posted 5/10/12 on the Health Affairs Blog

On May 9, 2012, the Center for Medicare and Medicaid Services released proposed regulations to implement section 1202 of the Health Care and Education Reform Act of 2010. Section 1202 increases Medicaid payments made to primary care physicians for primary care services during the years 2013 and 2014 to Medicare payment rates, with the additional cost covered by the federal government.

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How Obama Botched and Bungled the Health Reform Message

Michael Millenson

Posted 4/25/12 on the Huffington Post

While it’s comforting to just blame the GOP for the unhappiness with health reform threatening the president’s re-election, the truth is that Barack Obama repeatedly botched, bungled and bobbled the health reform message. There were three big mistakes:

The Passionless Play While Candidate Obama proclaimed a passionate moral commitment to fix American health care, President Obama delved into legislative details.

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The Legal Strategy To Defend Health Reform

Joe Paduda

Posted 3/15/11 on Managed Care Matter

There’s a seemingly intractable conflict facing the Obama Administration – how can they argue – simultaneously – that the mandate is crucial to the Affordable Care Act, while also arguing that the rest of the Act should and can survive if the Supreme Court rules the mandate is unconstitutional?

That’s the Hobson’s choice facing lawyers arguing for the Administration, and while the two positions seem irreconcilable, they may not be.

Merrill Goozner is convinced the two positions can comprise a reasonable and legally logical argument. He cites a recent article in the NEJM, to wit:

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Health Spending in America – Self-Rationing Slows Cost Increases

Jane Sarasohn-Kahn

Posted 1/13/12 on Health Populi

The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9%  in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts.

Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which negatively impacts providers and suppliers alike.

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Average Annual Health Costs for a US Family of Four Approach $20,000, With Employees Bearing 40%

Jane Sarasohn-Kahn

First published 5/11/11 on Health Populi

Health care costs have doubled in less than nine years for the typical American family of four covered by a preferred provider health plan (PPO). In 2011, that health cost is nearly $20,000; in 2002, it was $9,235, as measured by the 2011 Milliman Medical Index (MMI). To put this in context,

  • The 2011 poverty level for a family of 4 in the 48 contiguous U.S. states is $22,350
  • The car buyer could purchase a Mini-Cooper with $20,000
  • The investor could invest $20K to yield $265,353 at a 9% return-on-investment.

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Medicaid: Busting the Budget Buster with Real Innovation or Re-Arranging the Deck Chairs on the Titanic?

David Harlow

First published 3/3/11 on HealthBlawg

Medicaid has been front and center this week as President Obama addressed the National Governors Association, and several governors testified before the House Energy and Commerce Committee.  Obama told the governors that he supports the Wyden-Brown bill, which would accelerate the availability of waivers under the Affordable Care Act (from 2017 to 2014), so that states would not have to first create health insurance exchanges under the law, and then only later have the right to dismantle them and replace them with other mechanisms to achieve coverage goals of the law without additional cost to the federales.  (See Wyden-Brown fact sheet)  The law as it stands hurts the early adopters.  Without the change, the sponsors’ home states, Oregon and Massachusetts would have to dismantle parts of their own health reform efforts in order to align with the federal mandates, only to potentially change things up agian three years down the road.  (Wyden has been a longer-term proponent of experimentation and innovation in health reform than Brown, and the opportunity to innovate three years down the road is in the ACA because of him.)

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Republicans Had Better Get Organized On Health Care

Robert Laszewski

First published 3/3/11 on Health Policy and Marketplace Review

If the past week is any indication, the Republicans will have real trouble come 2012 trying to convince voters they have a plan to fix the American health care system.

Last weekend, President Obama endorsed the Wyden-Brown bill that would give the states the opportunity, in 2014, to take their share of the almost $1 trillion the new health law collects and use it to craft an alternative health care plan to their liking.

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