Public Payers News

How ACA Insurer Participation May Perpetuate Care Disparities

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Insurer participation in the Affordable Care Act marketplace may contribute to a lack of health equity, at least in the early days of the Affordable Care Act individual marketplace, a study published...

How Medicaid Programs Provide Coverage for Maternal Health Services

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Most Medicaid programs offer coverage for basic maternal health services and many have initiatives planned to expand the scope of benefits, according to a report from the Kaiser Family Foundation...

AHIP Supports Using Texts, Calls for Medicaid Enrollment Processes

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AHIP has expressed its support for a request from the US Department of Health and Human Services (HHS) and CMS to the Federal Communications Commission, which seeks confirmation of the agencies’...

CMS Updates Medicare.gov To Simplify, Support Navigation

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CMS has updated its website, Medicare.gov, to include new features such as highlighting pages that answer popular questions and spotlighting key steps that consumers should take related to Medicare...

Health Plans Falter at Providing Medicaid Redetermination Info

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Member engagement may be lacking for Medicaid plans, as only 56 percent of beneficiaries reported receiving helpful information about Medicaid redetermination or re-enrollment, according to a survey...

Provider Acceptance High for Privately Insured, Medicare Patients

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Most office-based physicians accept both new Medicare patients and new privately insured patients, indicating that Medicare beneficiaries have similar access to physicians as individuals with private...

Payer Establishes Culturally Specific Alternative Payment Model

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CareOregon and the Alliance for Culturally Specific Behavioral Health Providers have developed an alternative payment model that seeks to empower culturally specific provider services. The newest...

Complaint Filed Against Alabama Medicaid for Hepatitis C Coverage

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Editor's Note 05/13/2022: This article has been corrected to indicate that AIDS Alabama and CHLPI filed an administrative complaint against Alabama Medicaid. A previous version said that the...

How Medicaid Can Address Youth Homelessness, Behavioral Health

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Medicaid can help reduce youth homelessness among individuals with behavioral health needs by expanding coverage, incentivizing cross-agency coordination, and increasing plan oversight and...

Rural Residents See Higher Premiums, More ARPA Premium Subsidies

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The premium subsidies under the American Rescue Plan Act (ARPA) provide significant financial assistance to individuals living in rural areas who were more likely to see higher health insurance...

How One Medicaid Program May Prevent Coverage Loss Post-COVID

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The Massachusetts Medicaid program can use a variety of strategies that it might implement in order to reduce coverage loss after the public health emergency lifts, according to a brief from the Blue...

Contracted Medicaid Managed Care Providers Treated Few Beneficiaries

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Around one-third of primary care and specialty physicians that contracted with Medicaid managed care plans saw fewer than ten Medicaid beneficiaries over a year, suggesting that network adequacy...

Telehealth Waiver Boosted Care Access for Medicare Beneficiaries

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The CMS telehealth waiver that expanded coverage for virtual care services during the COVID-19 pandemic helped increase access to virtual care for Medicare beneficiaries in disadvantaged neighborhoods,...

Trends in Medicare Savings Programs, Part D Subsidy Enrollment

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The number of Medicare beneficiaries enrolled in the Medicare Savings Programs and receiving Part D low-income subsidies varied by state, as states have the individual power to expand eligibility and...

CMS Introduces Health Equity Strategy for Public Payer Programs

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CMS has released its strategy for health equity, which is the first pillar in the agency’s strategic vision. “Advancing health equity is the core work of the Centers for Medicare &...

The Status of Uninsurance Among Immigrants, Barriers to Coverage

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Noncitizens are more likely to be uninsured, including immigrants who are lawfully present in the US, a Kaiser Family Foundation (KFF) issue brief determined. In 2020, 24 percent of the nonelderly...

Part D Out-of-Pocket Costs Pose a Barrier to Treatment Access

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Out-of-pocket costs may dissuade Medicare beneficiaries from initiating treatment with high-price Part D specialty drugs, as beneficiaries without low-income subsidies were less likely to fill a new...

Medicaid Expansion Boosted Coverage for Adults with Legal Involvement

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Medicaid expansion was associated with a significant increase in health insurance coverage for low-income individuals with recent criminal legal involvement, according to a study published in JAMA...

ARPA Tax Credit Expiration Will Increase Uninsured Population by 3M

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The uninsured population may increase by more than 3 million if policymakers do not extend the premium tax credits under the American Rescue Plan Act (ARPA), according to an Urban Institute issue...

LA Care Health Plan Tackles Provider Workforce Shortage

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LA Care Health Plan is combatting the provider workforce shortage and improving access to care by issuing provider recruitment grants, the payer announced. The payer is distributing $1.75 million...