Medicaid

Hospitals Concerned About Medicaid State-Directed Payment Changes

December 5, 2023 - Eight leading healthcare industry groups are urging CMS to abandon proposed restrictions on provider-based Medicaid funding sources, citing coverage and cost consequences if the proposals are finalized. The American Hospital Association (AHA), Association of American Medical Colleges (AAMC), and Federation of American Hospitals (FAH) were among the...

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Value-Based Payments in Medicaid Tied to More Behavioral Health Visits

by Victoria Bailey

Medicaid value-based payment reform was associated with an increase in behavioral health visits for patients with mental health conditions, a study published in JAMA Health Forum found. As of 2020, 12...

As Hospitals Consolidate, Medicaid Patients Have Fewer Options

by Jacqueline LaPointe

Access to care for Medicaid patients declines as hospital markets become more concentrated following mergers and acquisitions, a new research brief from the National Institute for Health Care...

As Medicaid Unwinds, Hospitals Seek Relief from DSH Payment Cut

by Jacqueline LaPointe

Hospital and health system advocates are calling on lawmakers to stop an $8 billion cut to Medicaid Disproportionate Share (DSH) payments to safety-net hospitals. A letter sent to Congressional...

CMS Proposes to Implement Changes to Medicaid DSH Calculations

by Jacqueline LaPointe

CMS has proposed a rule to update the regulatory requirements of the Disproportionate Share Hospital (DSH) program in response to the Consolidated Appropriations Act of 2021, including implementing...

Higher Spending on Nursing Home Staff is Not Tied to Better Staffing Levels

by Victoria Bailey

Nursing homes with higher shares of Medicaid residents directed more revenue toward workers but had lower staffing levels, indicating that a minimum nursing staff expenditure regulation would not...

Two-Thirds of People Evade Coverage After Medicaid Disenrollment

by Jacqueline LaPointe

In a year after Medicaid disenrollment, about two-thirds of people had a period of uninsurance, according to a recent analysis from Kaiser Family Foundation (KFF). The Families First Coronavirus...

CMS Urges States to Tie Nursing Home Medicaid Payment to Quality

by Jacqueline LaPointe

CMS is pushing for more value-based reimbursement, this time for nursing home Medicaid payment. The federal agency has sent an informational bulletin to states urging them to tie Medicaid payments for...

How Healthcare Spending, Utilization Varies by Payer, Region

by Victoria Bailey

There is substantial variation and low correlation in healthcare spending across Medicare, Medicaid, and private insurance plans within different US regions, a study published in JAMA Network Open...

CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

by Jacqueline LaPointe

A COVID-19 vaccine mandate for healthcare workers will be tied to Medicaid and Medicare Conditions of Participation (CoP), the Biden-Harris Administration recently announced. The announcement made via...

Medicaid Expansion Associated with Less Medical Debt Collections

by Jill McKeon

States that expanded Medicaid in 2014 saw a 45 percent decline in the mean flow of medical debt collections compared to states that chose not to expand Medicaid or those that expanded after 2014,...

NIH Awards Grant to Study Effects of ACOs on Child Asthma Care

by Jill McKeon

The National Institutes of Health (NIH) awarded a $3 million grant to Sarah Goff, MD, PhD, a health services researcher at the University of Massachusetts Amherst, to study the effects of accountable...

Chiquita Brooks-LaSure Becomes Next CMS Administrator

by Jacqueline LaPointe

The Senate has confirmed Chiquita Brooks-LaSure to lead the Centers for Medicare & Medicaid Services (CMS) by a vote of 55 to 44. Brooks-LaSure is the first Black woman to lead the agency...

Hospital Uncompensated Care Costs Down After LA Medicaid Expansion

by Jacqueline LaPointe

After Medicaid expansion in Louisiana, hospital uncompensated care costs decreased by about a third—significantly more compared to some other expansion states—with public and rural...

Medicaid Physician Reimbursement Rates Lag Medicare

by Jacqueline LaPointe

Medicaid physician reimbursement is significantly lower than commercial payer and even Medicare payments for the same services despite growing enrollment in the public healthcare program, reveals a new...

Seema Verma Resigns as CMS Administrator Ahead of Biden Inauguration

by Jacqueline LaPointe

Seema Verma announced on her Twitter today that she is resigning as CMS Administrator in preparation for a new Medicare and Medicaid leader coming in next week under the Biden...

Medicaid Expansion Still Boosting Hospital Finances

by Jacqueline LaPointe

A study coming out of the Urban Institute shows that hospitals continue to reap the financial benefits of Medicaid expansion. The study recently published in Health Affairs found that hospitals in...

Multi-Payer Alignment Key to Advancing Value-Based Care in Medicaid

by Jacqueline LaPointe

In a new letter to Medicaid directors, CMS called for multi-payer alignment in value-based care arrangements run by the state healthcare programs. The Sept. 15th letter providers guidance to the...

Medicaid Enrollment Grew by 2.3M People at Start of the Pandemic

by Jacqueline LaPointe

In the first several months of the COVID-19 pandemic, Medicaid enrollment increased by at least 2.3 million Americans, according to researchers from the University of Minnesota. For more coronavirus...

TX Hospitals to Receive $1B Boost in Medicaid Reimbursement

by Jacqueline LaPointe

The gap between what hospitals actually spend to treat Medicaid patients and the Medicaid reimbursement amount for that care will get about $1 billion smaller in 2021. Texas Governor Greg Abbott...

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