New on the Web 50 (November 2008)
From Avalere Health: “Low-Income Medicare Beneficiaries Will Have Fewer Part D Options in 2009”
From the Center for Studying Health System Change: “Massachusetts Health Reform: High Costs and Expanding Expectations May Weaken Employer Support”
From the Columbia Mailman School of Public Health and the National Center for Children in Poverty: “Unclaimed Children Revisited: The Status of Children’s Mental Health Policy in the United States”
From the Commonwealth Fund: “Health Care Opinion Leaders’ Views on Payment System Reform,” “How Have Employers Responded to Health Reform in Massachusetts? Employees’ Views at the End of One Year,” “Medicare Advantage’s Private Fee-for-Service Plans: Paying for Coordinated Care without the Coordination”
From George Washington University: “Assessing the Effects of Medicaid Documentation Requirements on Health Centers and Their Patients: Results of a ‘Second Wave’ Survey”
From the Kaiser Commission on Medicaid and the Uninsured: “Emerging Health Information Technology for Children in Medicaid and SCHIP Programs,” “State Fiscal Conditions and Medicaid”
From the Kaiser Family Foundation: “2009 Medicare Part D Data Spotlights,” “The Medicare Health and Prescription Drug Plan Tracker,” “Medicare Part D Prescription Drug Plan (PDP) Availability in 2009”
From the Kaiser Family Foundation, the University of Florida, and the Urban Institute: “Florida’s Medicaid Reform: Informed Consumer Choice?”
From Mathematica: “How Do Employment Outcomes of Medicaid Buy-In Participants Vary Based on Prior Medicaid Coverage? An Example from Massachusetts”
From Avalere Health:
Low-Income Medicare Beneficiaries Will Have Fewer Part D Options in 2009 reports that the number of free-standing plans available for low-income beneficiaries who qualify for the low-income subsidy will decrease from about 500 this year to 308 in 2009. Approximately 1.3 million individuals will be automatically reassigned to new drug plans by the end of this year due to marketplace changes, continuing the trend of reassignment that has increased every year since the program began. (October 2008)
From the Center for Studying Health System Change:
Massachusetts Health Reform: High Costs and Expanding Expectations May Weaken Employer Support finds that, while the number of uninsured has declined significantly since the enactment of the state’s landmark health expansion, the high cost of the reform has prompted the state to seek additional financial support from stakeholders, including employers. Improved access to the individual insurance market, the availability of state-subsidized coverage, and the costs of increased employee take-up of employer-sponsored coverage and rising premiums could weaken employers’ motivation and ability to provide coverage. (October 2008)
From the Columbia Mailman School of Public Health and the National Center for Children in Poverty:
Unclaimed Children Revisited: The Status of Children’s Mental Health Policy in the United States reports that children with serious mental health problems do not receive adequate care in more than one in five states. The survey found that some federal and state policies prohibit Medicaid reimbursements for preventive or early mental health care for children. States identified federal fiscal barriers, including Medicaid, as the most critical policy challenge to addressing the mental health needs of children, youth, and their families. (November 2008)
From the Commonwealth Fund:
Health Care Opinion Leaders’ Views on Payment System Reform finds that respondents are fundamentally dissatisfied with the way health care is paid for in the U.S. More than two-thirds said that the fee-for-service system is not effective at encouraging high-quality, efficient care, and more than three-quarters would prefer a move toward bundled per-patient payment. A majority expressed support for the creation of a Medicare Health Board to make Medicare payment and benefit decisions. (November 2008)
How Have Employers Responded to Health Reform in Massachusetts? Employees’ Views at the End of One Year reveals that employers have neither dropped coverage nor restricted eligibility for coverage in the state’s first year of health reform. Despite initial concern from critics, researchers have found that employers made no changes to the scope of benefits, range of provider choices, or quality of care available under their plans. (October 2008)
Medicare Advantage’s Private Fee-For-Service Plans: Paying for Coordinated Care without the Coordination examines the policies underlying the rapid increase in these plans and in their enrollment, the payments they receive, and the potential impact of recent Medicare legislation (MIPPA). Payments to PFFS plans in 2008 averaged 16.6 percent more than those for traditional fee-for-service Medicare. PFFS plans have concentrated their focus on counties with especially high levels of extra payments, resulting in an unequal geographic distribution of PFFS plan enrollment, with the majority centered in urban areas. (October 2008)
From George Washington University:
Assessing the Effects of Medicaid Documentation Requirements on Health Centers and Their Patients: Results of a “Second Wave” Survey finds that the citizenship documentation requirements for Medicaid beneficiaries have negatively affected patients at most community health centers, and the policies have been improperly applied to some enrolled in CHIP. Nearly half of health centers reported that Medicaid patients face longer application and enrollment times, as well as problems acquiring documents. This in turn affects the ability of health centers to refer patients to specialty care, begin services for new patients, and secure supplies and equipment. (October 2008)
From the Kaiser Commission on Medicaid and the Uninsured:
Emerging Health Information Technology for Children in Medicaid and SCHIP Programs highlights states’ innovative use of health information technology to improve their ability to reach and enroll eligible children, improve quality of care, increase communications with families, and modernize programs. Although states continue to face financing and other challenges to obtaining new health information technology, findings to date show improvements in access to care, care coordination, case management, and administrative efficiency. (November 2008)
State Fiscal Conditions and Medicaid analyzes the relationship between states’ budgets and their Medicaid programs, and it discusses the current fiscal situation in the states and how it is affecting Medicaid. The report found that declines in tax revenue inhibit states’ ability to meet rising Medicaid costs as enrollment grows, which presents state with tough choices when trying to balance their budgets. (November 2008)
From the Kaiser Family Foundation:
2009 Medicare Part D Data Spotlights is a collection of resources related to Part D drug plan options that will be available in 2009. Each spotlight focuses on one key aspect of the drug plans, including premiums, “doughnut hole” coverage, and the low-income subsidy. (November 2008)
The Medicare Health and Prescription Drug Plan Tracker is an updated, interactive, online resource with new 2009 data about Medicare Advantage and Medicare prescription drug plans, as well as 2008 enrollment data. It provides information on stand-alone prescription drug plans nationally and by state, and on Medicare Advantage plans by region and county. The resource can be used to monitor trends in Medicare Advantage plans since 1999 and in Part D plans since their inception in 2006. (November 2008)
Medicare Part D Prescription Drug Plan (PDP) Availability in 2009 is a two-page fact sheet that contains 2009 state-specific summary data on Part D plan options. It includes premium ranges, the number of stand-alone plans with coverage in the "doughnut hole," and the number of plans available at no cost to qualifying beneficiaries. (November 2008)
From the Kaiser Family Foundation, the University of Florida, and the Urban Institute:
Florida’s Medicaid Reform: Informed Consumer Choice? examines Florida’s Medicaid reform pilot program, which was designed to encourage “consumer choice” and “market competition” by allowing enrollees to choose among different plans and by giving health plans new authority to vary benefits. About three in 10 beneficiaries who participated in the pilot program were not aware that they were expected to choose a new health plan for themselves, 30 percent did not know that they were enrolled in the program, and 60 percent did not know that they could opt out of the program by using their Medicaid funds to purchase private coverage. (October 2008)
From Mathematica:
How Do Employment Outcomes of Medicaid Buy-In Participants Vary Based on Prior Medicaid Coverage? An Example from Massachusetts examines the Medicaid Buy-In Program, a key component of the federal effort to help people with disabilities work without fear of losing health coverage even if their income is otherwise too high for Medicaid. The brief looks at differences in post-enrollment rates, monthly hours worked, earnings, and private health insurance between new CommonHealth Working (CHW) enrollees who were previously covered under MassHealth and those without prior MassHealth coverage. The average employment rate among CHW participants rose sharply from 36 percent to 86 percent. (October 2008)
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