Medicaid redetermination may result in a favorable payer mix for some providers if people switch to ACA and employer-based coverage that has higher payer rates. But that is a pretty big if.
The Kaiser Family Foundation has estimated that 17 million people could lose Medicaid coverage as result of Medicaid redetermination and the end of the automatic re-enrollment into the public payer programs that was part of the government’s response to the COVID-19 pandemic. If people losing Medicaid coverage don’t switch to other kinds of coverage, the consequences could be dire for their access to healthcare. A growth in the number of uninsured Americans could also put a strain on health systems and providers, Axios reports this morning (full text available). But the news brevity website also mentions an alternative scenario whereby substantial number of people losing Medicaid coverage switch to employment-based and ACA coverage, which pay providers at a higher rate than Medicaid programs. “Redeterminations could change the payer mix in a revenue-positive way if patients for from Medicaid to employer-sponsored or ACA plans,” writer Axios’ Arielle Dreher.
Sen. Bernie Sanders maybe hasn’t given up on Medicare for all. But in the meantime, he is preparing to push for major funding boost for community health centers and efforts to increase the healthcare workforce, Politico is reporting this morning. The Vermont independent’s plan calls for $200 billion in healthcare spending, including $130 billion for community health centers over a five-year period and $60 billion in programs and projects designed to increase the healthcare workforce. As chair of the Senate Health, Education, Labor and Pensions Committee, Sanders has sway and a bully pulpit on healthcare matters. However, the ranking member, Sen. Bill Cassidy, a Louisiana Republican, told Politico that there was a little chance of Sanders’ plans becoming law. “This proposal to increase funding for health centers by 550% at a time when Congress is deadlocked trying to negotiate spending and a debt ceiling increase is not setting up a path for success for legislation that can pass the Senate with 60 votes and make it through the House to be signed into law,” Cassidy is quoted as saying. “Let’s just be realistic.”
Elisabeth Rosenthal has a provocative piece about AI and apps and mental health care this morning on KFF Health News. Rosenthal, who was editor in chief of the health news website for many years and is now a senior contributing editor, mentions the gaping supply-and-demand gap in U.S. mental healthcare and the “marketing juggernaut” to fill it. But she pours cool-to-cold water on the enthusiasm apps and AI. “Unfortunately, in the mental health space, evidence of effectiveness is lacking. Few of the many apps on the market have independent outcomes research showing they help; most haven’t been scrutinized at all by the FDA,” she writes.
The Centers for Disease Control and Prevention announced on Monday that it is investigating a cluster of cases in the Chicago area that includes 12 confirmed cases and one probable one.
“Spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events,” the agency warned.
The CDC’s alert notes that vaccine-induced immunity is not complete but that the two-dose JYNNEOS does reduce the risk of severe symptoms.