Arizona Proposes Medicaid Fat Fee
Arizona's governor on Thursday proposed levying a $50 fee on some enrollees in the state's cash-starved Medicaid program, including obese people who don't follow a doctor-supervised slimming regimen and smokers.
The plan, if approved by the Republican-dominated legislature, would mark the first time the state-federal health-care program for the poor has charged people for engaging in behavior deemed unhealthy.The most important health-care reform story people aren’t talking about
In one of those stories that seems boring but is actually really important, the Department of Health and Human Services released the rules (PDF — and a long one) that will govern Accountable Care Organizations going forward. Centers for Medicare and Medicaid Services Director Don Berwick summarizes here. The bottom line is that ACOs are the new hotness in medicine. The idea is that rather than getting your care from one specialist after the other, each of whom is only responsible for their tiny slice of your treatment, you’ll get your care from one organization that’s responsible for coordinating all of your treatments and gets paid based on how well you do rather than how much they do to you.
When I say things like “controlling health-care costs is about treating sick people,” ACOs are the sort of thing I’m talking about. If they work as well as their advocates hope, costs could go down and quality could go up. If they don’t, it’s back to the drawing board. But most people don’t know much about them, even as their success or failure is ultimately the sort of thing that will determine whether the Medicare cuts can stick.
For more on ACOs, NPR has a good explainer. But if you’re the type of person who could do the explaining yourself, head over to the Incidental Economist, where they’re trying to crowdsource their way through the new regulations. Getting that done would be a real service.Obama administration offers rules for delivering care to older Americans
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Vast Gene Study Yields Insights on Alzheimer’s
The two largest studies of Alzheimer’s disease have led to the discovery of no fewer than five genes that provide intriguing new clues to why the disease strikes and how it progresses.
Researchers say the studies, which analyzed the genes of more than 50,000 people in the United States and Europe, leave little doubt that the five genes make the disease more likely in the elderly and have something important to reveal about the disease’s process. They may also lead to ways to delay its onset or slow its progress.
“The level of evidence is very, very strong,” said Dr. Michael Boehnke, a professor of biostatistics at the University of Michigan and an outside adviser on the research. The two studies are being published Monday in the journal Nature Genetics.Nine alternatives to the individual mandate
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Cuts Leave Patients With Medicaid Cards, but No Specialist to See
“How can an already overtaxed Medicaid system handle such a huge influx of people?” asked Dr. Michael A. Felton, a family doctor in Church Point, La., near Lafayette.
It is a question being asked in many states. With the expansion of Medicaid to cover nearly all people under 65 with incomes up to 133 percent of the official poverty level (up to $29,330 a year for a family of four), Medicaid will soon be the nation’s largest insurer. It accounts for almost half of the increase in coverage expected under Mr. Obama’s health law, but has received less attention than other parts of the law regulating private insurance.
The Congressional Budget Office predicts that average monthly Medicaid enrollment, now 56 million, will rise to 71 million by 2016, with another five million people added to the rolls in the five years after that.
Like many states, Louisiana has been struggling with a fiscal crisis. To hold down costs, it has cut Medicaid payments to doctors, dentists, hospitals and other health care providers several times in the last two years. Many providers report that the cuts, taken together, total 15 percent to 20 percent.
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