Hospitals more likely to admit children with private insurance

http://www.fiercehealthcare.com/payer/hospitals-more-likely-to-admit-children-private-insurance?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTXpNd1lqZGlNR0U1WkRJeCIsInQiOiJLOWhzWGhXZ2FrUHdBMEg5d1VNTnppNTR6TEh5XC9tQjI1bDgxcVlUUWNcL1wvSWt0SkRUck9vYm90K1VuSlZJUGFpQ3RubDhPdjFFTWZFUEF1S3RDTUlpZ0VQbmtJRmYyOVg5ZHk0T3RiUUZYRT0ifQ%3D%3D

Medicaid on paper and a stethoscope Medicaid on paper and a stethoscope

New research shows hospitals are more likely to admit children with private insurance over those with publicly funded plans, particularly during times when there are limited inpatient beds, an indication that reimbursement rates play a role in how hospitals manage pediatric patients in the emergency room.

Researchers from the National Bureau of Economic Research studied billing patterns for children in New Jersey that visited an emergency room between 2006 and 2012. The economists found that children with Medicaid or Children’s Health Insurance Program that presented to the ER with flu symptoms were 10 percent less likely to be hospitalized than those with private plans, according to the Washington Post.  During peak flu season, when there was a shortage of inpatient beds, children between 2 and 10 years old on Medicaid and CHIP were 20 percent less likely to be admitted.

To Improve Medicaid, Measure Everywhere

 

http://altarum.org/health-policy-blog/to-improve-medicaid-measure-everywhere

Image result for data

“In God we trust. All others must bring data.”

So said W. Edwards Deming, a management consultant widely regarded as one of the most influential figures in quality management of the 20th century.

One would think that in the data-driven 21stcentury, we’d have come a long way in applying that dictum to health care. To some degree, we have—Medicaid and CHIP programs that contract with managed care entities include provisions around quality measurement and reporting in state contracts and make use of the Healthcare Effectiveness Data and Information Set. This reporting serves as the foundation of targeted quality improvement projects in states and helps inform consumer choice through products such as the state-published report cards and annual rankings of health insurance plans set out by the National Committee for Quality Assurance.

But this kind of systematic, comprehensive reporting is largely and notably absent from fee-for-service Medicaid and CHIP. We can’t afford to go without it. It’s imperative that we know what works well in Medicaid and CHIP and what areas of the program need attention or improvement. These programs combine to cover more than one in four Americans and command more than half a trillion dollars in federal and state spending per year.

With this in mind, Safety Net Health Plan members of the Association for Community Affiliated Plans (ACAP) have come together to support a suite of legislation on Capitol Hill. This legislation would extend the benefits of quality measurement and reporting to all Medicaid and CHIP delivery systems—including areas such as fee-for-service that have typically not provided regular, systematic quality data.

The good news is that lawmakers in Washington have taken the first steps toward bringing quality measurement forward into the 21st century by introducing two bills.

In Annual Baseline Budget Projections, CBO Decreases Marketplace Enrollment Estimates (Update)

http://healthaffairs.org/blog/2016/03/25/in-annual-baseline-budget-projections-cbo-decreases-marketplace-enrollment-estimates/

Tim-ACA-slide

Medicare Payments to Doctors

http://www.c-span.org/video/?325041-1/nathaniel-weixel-doc-fix-bill&elq=ea1be2ae832b4329b9acdc028078e686&elqCampaignId=453&elqaid=787&elqat=1&elqTrackId=ffc6f2bd41f34a1bb43a157db564c343

House Chamber