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It’s no secret that the response to the HIV epidemic domestically has not kept pace with the response to the global epidemic. And in an earlier column called America Has Gone Quiet on HIV/AIDS I wrote about the growing complacency towards the domestic epidemic revealed in our recent survey of the American people. Last Friday, we released a new study with the National Alliance of State and Territorial AIDS Directors that documents the level of…
This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring the average payment closer to the costs of traditional fee-for-service Medicare, while rewarding plans with high-quality ratings. The brief also describes new benefit requirements for…
This analysis examines the potential costs and savings that the health reform law may generate for state budgets, a topic of great interest at a time when states continue to struggle with tight budgets in the wake of the recession. The analysis seeks to explain why recent state estimates of the likely impact of health reform on their budgets vary widely, and discusses the major expected sources of costs and savings as the new law…
A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. These decisions will have enormous consequences for health coverage for the low-income population. This analysis uses the Urban Institute’s Health Insurance Policy…
The nation's primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions. This report provides an overview of long-term care users and their acute and long-term care service spending. The report finds that although the individuals who rely on long-term care…
This study, published in a Health Affairs Web exclusive, provides the first national and state-by-state update of Medicaid physician fees since 2003. Medicaid has historically reimbursed physicians under fee-for-service at levels below what Medicare and private health insurers would pay for the same services. The study finds that Medicaid fees grew by more than 15 percent from 2003 to 2008, but fell in real terms because the gains did not keep pace with inflation. Medicaid…
One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…
To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents This report explores factors that appear to drive relatively high rates of hospitalizations, based on interviews with doctors, nursing home staff and families in four cities. Key factors include liability concerns, limited onsite staff capabilities, difficulty reaching residents' physicians for care instructions on nights and weekends, better and more timely access to diagnostic tests in hospitals, and patient preferences. Physicians with patients…
About eight of 10 of the 2.6 million people who died in the US in 2014 were people on Medicare, making Medicare the largest insurer of health care provided during the last year of life. These Frequently Asked Questions explain Medicare’s role in or coverage of end-of-life care, advance care planning, advance directives, and hospice care. They also provide information on Medicare spending on end-of-life care, changes to the physician fee schedule, and how related issues arose…
This budget analysis reviews U.S. funding for global health programs included in the fiscal year 2016 Budget Request released on February 2, 2015.
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