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On Medicaid Payment Amounts

5 Responses

1. Sally, on July 7, 2014 at 6:06 PM said:

   Annual Growth in Medicaid Enrollment, By Enrolled Population, 2007-2012

   Aged & Disabled Families Total:

   2007-08 2.7% 3.3% 3.1%
   2008-09 3.5% 9.5% 7.8%
   2009-10 3.6% 8.5% 7.2%
   2010-11 4.0% 5.0% 4.7%
   2011-12 3.1% 2.3% 2.5%

   Source: Kaiser Family Foundation

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2. Charles, on December 27, 2014 at 10:35 PM said:

   As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care

   Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care. The Affordable Care Act provided a big increase in Medicaid payments for primary care in 2013 and 2014.

   But, the increase expires on Thursday — just weeks after the Obama administration told the Supreme Court that doctors and other providers had no legal right to challenge the adequacy of payments they received from Medicaid.

   The impact will vary by state, but a study by the Urban Institute, a non-partisan research organization, estimates that doctors who have been receiving the enhanced payments will see their fees for primary care cut by 43 percent, on average.

   Source: Robert Pear
   New York Times [12/17/14]

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3. Sally, on January 27, 2015 at 8:32 PM said:

   KFF Survey: Median Medicaid / CHIP Income Eligibility Limits

   According to a January 2015 survey of eligibility, enrollment, renewal and cost-sharing policies by the Kaiser Family Foundation:

   Adopting Medicaid Expansion (28 states) Income Thresholds:
   – 305% FPL $60K (Children)
   – 138% $27K (Parents)
   – 138% $16K (Childless Adults)

   Not adopting Medicaid expansion (23 states) Income Thresholds:
   – 215% $43K (Children)
   – 45% $9K (Parents)
   – 0% $0 (Childless Adults)

   Source: Kaiser Family Foundation

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4. Ann Miller RN MHA, on March 3, 2015 at 7:05 PM said:

   Medicaid Acceptance by Healthcare Providers Drops in 2015

   HealthPocket examined government records on Medicaid acceptance for a broad cross-section of healthcare providers. Below are some findings:

   • 34% of the healthcare providers examined were listed as accepting Medicaid insurance.
   • 2015 results represent a 21% decrease compared to 2013 data for the same provider categories.
   • Medicaid typically pays 61% of what Medicare pays for the same outpatient physician services.
   • Medicare itself typically pays 80% of what commercial health insurers pay.

   Source: Insurance News Net

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5. Douglas B. Sherlock CFA, on August 27, 2015 at 8:23 PM said:

   On Medicaid

   A friend of Sherlock Company suggested that plans with a heavy focus on Medicaid, all other factors being equal, tends to operate at lower administrative costs in their commercial business. He believes that states are very sensitive to costs and also favor benefit designs that are simple and remain relatively stable over time. This creates a corporate culture that emphasizes low cost administrative processes in health plans.

   Using the Sherlock Benchmarks, we’ve tested his theory. While we can’t confirm the causation, a focus on Medicaid does in fact seem associated with low administrative costs in commercial products. So, our friend may have a point. The P-Value is 11.5%, which is often interpreted as the chance of there being no relationship between the variables.

   Douglas B. Sherlock CFA
   [Senior Health Care Analyst]
   Sherlock Company

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