All Articles In 'Health Plans'
Health Care Spending and Hypertension: The Cost of High Blood Pressure
Hypertension, or high blood pressure, is related to several major chronic diseases. Obesity and diabetes raise your chance of developing high blood pressure, which in turn makes you more likely to suffer from heart disease and [...]
Medicare and Medicaid Spending on Dual Eligible Populations: Analysis of Health Costs
Much of the story about rising health costs and spending has to do with relatively small groups of people with expensive health needs. For example, the Centers for Medicare and Medicaid Services (CMS) estimates Medicare beneficiaries [...]
Medicare Physician Sustainable Growth Rate: Repealing SGR
For over a decade, the sustainable growth rate (SGR) has been a source of financial worry for physicians who serve Medicare patients. Medicare’s physician payment rate is based on a composite measure of the cost of [...]
Medicaid Expansion Through Health Insurance Marketplaces: Unresolved Questions
The Centers for Medicare and Medicaid Services (CMS) has answered some questions about how Arkansas’s creative plan to expand Medicaid under the Affordable Care Act (ACA). The plan, which Gov. Mike Beebe put forward, would use [...]
Dual Eligibles and Medicare Cost Sharing: State Medicaid Payment of Medicare Premiums, Deductibles, and Co-Payments
State Medicaid programs will spend about $175 billion this year on health care for dual eligibles – low-income seniors and persons with disabilities who receive benefits from both Medicare and Medicaid. State spending on dual eligibles [...]
Employer Mandate and Penalties Under the Affordable Care Act: Understanding the New $130 Billion Tax
Under the new employer mandate imposed by the Affordable Care Act (ACA), employers will pay about $130 billion in penalties over the next 10 years. The ACA employer mandate is highly complex and employers have many [...]
Impact of ACA on Employer-Sponsored Insurance: Costs, Taxes, and Enrollment Effects
Employer-sponsored insurance (ESI) has been central to the U.S. health care system. The Affordable Care Act (ACA) adds many requirements and imposes many costs on employers that could change how – and if – they offer [...]
Chronic Care Management: CMS Multiple Chronic Conditions Dashboard
Many new care models in both the public and private sector focus on people with chronic diseases, particularly conditions like diabetes, congestive heart failure, and hypertension. The Veterans Health Administration (VHA) Care Coordination/Home Telehealth (CCHT) pilot program [...]
Impact of ACA on Health Premiums and Enrollment: Society of Actuaries Estimates of Health Reform Law
Love it or hate it, the Affordable Care Act is unprecedented in size, scope, complexity, and uncertainty. To project its impact, numerous policy, economic, competitive, and behavioral factors must be considered and assumptions made. From an [...]
Medicaid Prescription Drugs: Utilization in Medicaid Health Plans and Medicaid Fee-for-Service
What’s the impact on patient care, particularly prescription drug utilization, as Medicaid beneficiaries move from fee-for-service to Medicaid health plans? This year, state Medicaid programs will spend over $22.1 billion on pharmacy benefits. This will grow to [...]
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