This Week in Managed Care: November 7, 2015

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This week in managed care Kentucky elected a new governor who could bring big changes to the state's Medicaid program, researchers reported that costs of dementia in the last 5 years of life surpass even cancer, and the latest Hospital Safety Score report was released.


Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care, from the Managed Markets News Network.

New Kentucky Governor Could Change State's Medicaid

The presidential election is still a year away, but important state elections just took place, and in Kentucky a new governor could mean big changes for the state’s Medicaid program. Republican Matt Bevin claimed victory and will succeed Democrat Steve Beshear, who embraced the Affordable Care Act and expanded Medicaid during his tenure.

While Bevin had originally vowed to repeal Medicaid expansion, he has backed off that position. Instead, he wants a waiver to impose cost and eligibility limits on recipients. And he plans to shut down the state-level exchange, Kynect, and ask enrollees to move onto the federal exchange.

Outgoing Governor Beshear spoke to AJMC about how he came to the decision to expand Medicaid in Kentucky.

High Cost of Dementia

During the last 5 years of life, the cost of dementia eclipses other diseases. A report from the National Institute on Aging found that total expenditures for people with dementia in the last 5 years of life were 57% greater than the costs associated with death from cancer and heart disease.

Researchers from the NIA analyzed data from the Health and Retirement Study and linked Medicare and Medicaid records for more than 1700 Medicare fee-for-service beneficiaries over the age of 70. The report found that out-of-pocket spending for people with dementia was $61,522 compared with $34,068 for people without dementia.

NIA Director, Dr. Richard J. Hodes, said that this study “…provides an important picture of the risks that families face, particularly those with dementia and those who may be least able to bear major financial risk. Such insights are critically important as we examine how best to support the aging of the U.S. population.”

Hospital Safety

The latest Hospital Safety Score report from The Leapfrog Group found some progress but a lot of room for improvement. Of the 28 measures used to calculate patient safety grades, 8 increased on average and 8 decreased, while the rest remained mostly flat.

The twice-yearly report did show a number of positive trends for certain hospital-acquired conditions and safety measures. However, hospitals are performing worse on critical measures like foreign objects left in patients after surgery. Of the 2540 hospitals included in the report, only 773 earned an A rating and for the 4th time in a row, Maine had the highest percentage of A-rated hospitals.

Leah Binder, president and CEO of The Leapfrog Group, recently discussed the organization’s hospital survey and hospital safety score initiatives.

Patient-Centered Oncology Care

Finally, there is still time to register for Patient-Centered Oncology Care, which will be held November 19-20 in Baltimore, Maryland. The keynote speaker is ASCO President Dr. Julie Vose. Learn more and secure your seat.

For the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.