A few years ago it struck the D.C. region's biggest medical insurer that the doctors who saw its members most often and knew them best got the smallest piece of the healthcare dollar. CareFirst BlueCross BlueShield spent billions on hospital procedures, drugs and specialty physicians to treat sick patients. Only one dollar in 20 went to the family-care doctors and other primary caregivers trained to keep people healthy. The company's move to shift that balance tells a lesser-known story of the Affordable Care Act and efforts to change the health system.
A campaign ad highlights Alexander's role as one of the chief GOP critics of President Obama's health-care law during a nationally televised "health-care summit" held on Feb. 25, 2010. The ad shows Alexander debating the president over whether the Congressional Budget Office predicted a rise in premiums because of the Senate version of the bill. Then the ad asserts that individual premiums have gone up more than 50 percent, citing 2010 and 2013 data from the Kaiser Family Foundation and the Department of Health and Human Services. Let's revisit this data.
A Thursday report casts a shadow over Medicare, raising new questions about fraud and mismanagement within the government insurance program for people who are retired or disabled. The inspector general of the Department of Health and Human Services (HHS) released a report that found Medicare made billions of dollars in suspect payments to clinical laboratories around the country in 2010, the most recent year for which data is available. The report follows a similarly damaging account from the Senate Special Committee on Aging, which said Wednesday that improper Medicare payments are at a record high.
A new software system for the state’s health insurance website passed its first key test this week, and a final decision on whether Massachusetts will run its own site or join the federal exchange will be made in early August, a top state official said. Maydad Cohen, special adviser to the governor, told the Massachusetts Health Connector board Thursday morning that the new software from hCentive performed every task required by federal officials, and then some, in a Washington, D.C., demonstration Monday. This success, he said in an interview afterward, leaves him increasingly but cautiously optimistic that the state will be able to employ the hCentive software when open enrollment starts Nov. 15.
Michigan Gov. Rick Snyder (R) announced Thursday that the state had reached its first-year goal of signing up 322,000 residents for the Healthy Michigan Plan eight months early. About 477,000 Michigan residents are eligible for the Health Michigan Plan, the state’s expanded Medicaid program for low-income residents. To be eligible, individuals cannot qualify for or be enrolled in Medicare or other Medicaid programs and must have income at or below 133 percent of the poverty level. Michigan also exceeded enrollment predictions for its individual marketplace, with 272,539 enrolling by March 31, according to the Detroit Free Press. The estimate was about 190,000.
A Vermont legislative committee on Thursday approved a lengthy set of provisions governing health care, despite an earlier objection from legal advocates. But work will continue to examine possible scenarios that might play out for Vermonters from the rules. The provisions on health benefits eligibility and enrollment are part of wider efforts for health care reform in the state, a major goal for Gov. Peter Shumlin and legislators. Vermont Legal Aid believed one section as written might exclude certain populations from long-term care benefits in a Medicaid-funded program called Choices for Care. It offers benefits for long-term care and is designed to assist people who require intensive assistance.