What We’re Reading, July 15, 2016: What can the 7 remaining co-ops do to survive; CMS projects increased Medicare spending per enrollee by 2025; and experts call for policy changes to support the health of prisoners at high risk for HIV.
With the rapid failure of the health insurance co-ops—with 4 more announcing there are shutting doors in just the past 2 weeks—only 7 of the initial 23 will still be operational when enrollment begins in fall of this year. Survival will be the bottom line for the remaining consumer operated and oriented plans, as they are called under the Affordable Care Act, since all of them posted losses in 2015, according to Kaiser Health News. According to Timothy Jost, a law professor at Washington and Lee University in Virginia, co-ops are an important alternative to commercial insurers.
According to the CMS Office of the Actuary, the government will be spending over $10,000 a person. The study, which was published in Health Affairs, says healthcare spending will be 20% of the economy by 2025. With 1 in 5 Americans on Medicare, CMS will spend nearly $18,000 annually per member. The lead author on the study, Sean P. Keehan, an economist at the actuary’s office at CMS, told The New York Times that a significant amount of this spending would be the result of high drug prices and greater use of specialty medications.
A series of articles published in The Lancet by experts from the infectious disease field are appealing for policy changes to improve access to treatment, prevention, and care of prisoners post release—especially for those prisoners who are at a high risk of HIV infections. The articles propose solutions such as harm-reduction and drug treatment programs to reduce disease transmission.
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
Listen
Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and Cost
May 9th 2024For patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
Read More