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Managed Care April 2000 Bob Carlson |
Many State Medicaid Agencies Use Financial Incentives To Boost Quality The days when state Medicaid agencies were bureaucratic establishments that paid claims and were unable to demand little better than institutional-style care are gone.... |
Managed Care October 2001 |
CMS Defends Plan To Let States Tailor Medicaid Benefits Centers for Medicare and Medicaid Services Administrator Thomas Scully has defended the Bush administration's plan to allow states to opt out of mandatory Medicaid-coverage requirements... |
Managed Care October 2001 Bob Carlson |
Trying To Get Control of Drug Costs, Florida Earns Kudos -- and a Lawsuit Pharmaceutical Research and Manufacturers of America (PhRMA) filed suit against Florida's Agency for Health Care Administration, challenging a new Medicaid formulary that requires manufacturers to pay supplemental rebates to have their drugs included... |
Managed Care August 2001 Bob Carlson |
States' Role as Policy Labs Tested as Resources Tighten State health-policy types point out that the State Children's Health Insurance Program (CHIP), the Health Insurance Portability and Accountability Act, the Patients' Bill of Rights and other federal initiatives came into existence only after states did the heavy lifting... |
Managed Care January 2001 Bob Carlson |
Ohio Struggles To Rescue Managed Medicaid Program Health plans and providers in Ohio's beleaguered Medicaid managed care program, OhioCare, welcomed its per-member, per-month payment increases of more than 25 percent over the last two years... |
Salon.com October 21, 1999 Dena Bunis |
Uninsured children A new report says there are still too many kids without health coverage. |
Managed Care August 2000 Carey Lee Straetz |
Managing Medicaid Rolls Often State-by-State Affair Despite the strong economy, Medicaid enrollment may be slowly rising after a three-year decline. The challenges for serving this population are huge. |
Salon.com October 13, 2000 |
Say what? Five Bush debate statements bear closer inspection... |
Managed Care April 2004 |
Medicaid DM To Get Boost From CMS The federal government plans to give Medicaid disease management a lift by matching the money states pay to run such programs. |
Managed Care April 2005 John Carroll |
Can Managed Care Programs Rein in Medicaid's Runaway Budgets? Cadillac or Yugo care for the poor? Fee-for-service or managed care? The states have a lot on their minds as the Medicaid monster grows and grows. |
Managed Care February 2006 |
Managed Care Offered to More Medicaid Enrollees A chart illustrates the percentage of medicaid enrollees in managed care, for the years 1996 to 2004. |
Managed Care April 2005 |
Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation. |
Managed Care February 2005 John Carroll |
Just What Can We Expect From New Head of HHS? How much will plans have to "be like Mike" -- Leavitt, that is. The influence of the secretary of health and human services reaches beyond the public sector. |
Managed Care July 2004 Martin Sipkoff |
Managed Medicaid Business Might Be Worth the Difficulties Financial, regulatory, and access problems continue. Still, this remains a growth industry and some have found a way to profit. |
Managed Care April 2002 Frank Diamond |
Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems? |
BusinessWeek February 21, 2005 Howard Gleckman |
The New Face Of Medicaid Seniors and the disabled are pushing the program to the breaking point. |
Managed Care October 2002 |
Though M+C Erosion Slows, Reimbursement Still an Issue The exodus of health plans from Medicare+Choice will moderate somewhat next year, offering hope that the struggling system can make a comeback. |
Managed Care December 2001 |
Economic Boom Over, State Health Budgets Besieged The National Association of State Budget Officers estimated that aggregate state shortfalls for fiscal 2002 could exceed $15 billion... |
Managed Care March 2002 Michael Levin-Epstein |
Illinois's Medicare Drug Program Called 1st Stab at National Reform The Illinois demonstration program gives the state permission to use federal and state Medicaid dollars to provide prescription drug coverage for 365,000 low-income, elderly Medicare beneficiaries... |
BusinessWeek August 8, 2005 Howard Gleckman |
Radical Surgery For Medicaid? South Carolina Governor Sanford has a plan to slash costs - but a political battle looms. |
Managed Care May 2002 Patrick Mullen |
Interview: Thomas Scilly In a candid, wide-ranging interview, the Centers for Medicare and Medicaid Services administrator counsels patience in solving the myriad problems of health care. A fix could take 20 years |
Managed Care July 2006 |
Education Concerns Push Back Florida's Medicaid Experiment The greatly anticipated meeting between Medicaid and managed care that's expected to take place in Florida has been delayed. |
Managed Care August 2002 |
24 States Hope Pharmacy Plus Helps Medicaid Twenty-four states may gamble that providing a prescription drug program to low-income elderly who do not qualify for Medicaid could save them money in the long run. |
Managed Care February 2005 |
Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players. |
Financial Planning February 1, 2005 DeFrancesco & Flory |
The Golden Years? As this country's baby boomers get closer to retirement, long-term care (LTC) will only grow in importance. Medicaid annuities may help clients preserve their assets, even if they're already in a nursing home. |
Managed Care January 2002 Michael Levin-Epstein |
HHS Seems To Soften Hard Line on Kickbacks Do two recent advisory opinions from the Health and Human Services Office of the Inspector General signal some moderation in federal policy on what constitutes a kickback? Maybe. Or then again, maybe not... |
Managed Care May 2002 Frank Diamond |
Medicare+EvenMoreChoice: U.S. Encourages PPO Option The government offers financial incentives that include $100,000 in seed money, risk-sharing deals, and higher payment rates |
Pharmaceutical Executive April 1, 2007 Jill Wechsler |
Washington Report: Medicaid Sets the Pace for Pharma Pricing Forget Medicare price negotiations. Pending changes in Medicaid drug-pricing formulas will put even more pressure on pharmaceutical prices. |
American Family Physician June 15, 2005 Carrie A. Morantz |
Newsletter Medicaid Expected to Top States' Health Care Agendas in 2005... NRMP Rules Out Second Residency Match... CMS Proposes New Rule on Hospice Care for Medicare Patients... Congressional Bill Encourages Use of Health Information Technology... etc. |
Managed Care July 2002 |
Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1. |
BusinessWeek February 17, 2011 |
Taking a Scalpel to Medicaid A look at eight key states whose governors want to cut costs for Medicaid. |
Registered Rep. September 18, 2013 Kevin McKinley |
Having Money and Getting Medicaid Clients who want to have both their money and Medicaid may want to purchase a specific type of long-term care insurance known as a "partnership" policy, currently available to residents in 31 states. |
Pharmaceutical Executive May 1, 2006 Huang, Pesile & Mozeson |
Medicare Part D: D for Doomed? New drug coverage plans cost more money and serve fewer patients than the government expected. What if things get worse? Here are two scenarios for disaster. |
BusinessWeek February 21, 2005 |
Mooching Off Medicaid The state-run medical-care programs originally designed to help poor mothers and their children now increasingly pay for nursing-home care for seniors. While many of those seniors are genuinely poor, others are not. The rules should be tightened. |
Financial Planning September 1, 2008 Donald Jay Korn |
Pleading Poverty Few things can play havoc with a thoughtful financial plan as surely as a long stay in a nursing home. Therefore, "Medicaid planning" has become a prime concern for many seniors and their younger relatives. |
Managed Care June 2003 |
For-profit, not-for-profit enrollment holding about steady While HMOs seemed to be losing enrollees to PPOs, the ratio of enrollees in for-profit and not-for-profit HMOs stabilized in the late 1990s, according to data collected by the Centers for Medicare and Medicaid Services. |
Managed Care March 2007 John Carroll |
Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split. |
Managed Care February 2002 |
Hospital costs lead way in health care expenditures The share of the gross domestic product attributed to health care increased slightly more than overall GDP growth from 1999 to 2000 -- the first time that's happened in nine years... |
Managed Care July 2002 |
CBO Weighs Effect of Growing Deficit on Fed Programs Health care programs such as Medicare and Medicaid figure to suffer, thanks to a growing federal budget deficit, according to a report by the Congressional Budget Office. |
American Family Physician January 15, 2007 |
Newsletter Congress Passes Legislation That Prevents Medicare Payment Cut... Congress Approves Extension of Physicians for Underserved Areas Act... HHS Unveils Four Cornerstones of Value-Driven Health Care System... etc. |
Managed Care February 2006 Martin Sipkoff |
Don't Bet That Problems With Part D Are Over Medicare Part D enrollment snags could be just the start of political and regulatory headaches facing health plans and pharmacy benefit managers. |
Reason February 2009 Ronald Bailey |
E.R. Crowding A study blames a rising population, a falling number of emergency departments, and understaffing that prevents stabilized patients from being admitted to other parts of the hospital. |
American Family Physician November 15, 2006 Liz Smith |
Newsletter AAFP adopts new physician workforce policy to counter family physicians shortage... Medicare and Medicaid services propose allowing use of part D data for research initiatives... etc. |
Registered Rep. November 5, 2012 Mark Miller |
Lawsuit Settlement Is a Game-Changer for Long-Term Care Coverage Medicare recipients will find it easier to get coverage. |
Managed Care March 2005 |
'This Country Cannot Continue With the System We Now Have' As a vice president of Pfizer Health Solutions, a major disease management company, John Sory knows how difficult it is to bring systematic care to the chronically ill. He discusses Pfizer's work with Florida's Medicaid program. |
Managed Care August 2004 |
Medicaid Fees Rise, But Still Below Medicare A recent study reports that 30 states raised their Medicaid fees at or above the rate of inflation, including 10 that raised physician fees by more than 35%. |
Managed Care February 2002 |
Computer Glitch Blocks Too Many Prescriptions Pharmacists in Massachusetts were hopping mad when a new computer system designed to help process prescriptions for Medicaid enrollees malfunctioned during its launch... |
Managed Care May 2005 Martin Sipkoff |
Health Plans Undaunted By Medicare Part D Despite the seeming Gordian knot of regulations associated with Medicare Part D, health plans figure the benefit-to-risk ratio is squarely in their favor. |
BusinessWeek May 10, 2004 John Carey |
Drug Prices: A New Covenant? The states' growing negotiating clout with Big Pharma raises crucial questions |
Registered Rep. March 1, 2006 Janet Arrowood |
The Medicare and Medicaid Minefield As the population ages and life expectancy rises, so does the likelihood that more people will be needing long-term care and your financial advisory clients should know the hard facts about paying for it, because the costs can be staggering. |