Study: Medicaid Expansion Leads to Increased Use of Health Services

Low-income adults in states that have expanded Medicaid feel as though their health insurance options have improved, and their use of healthcare services has also increased, according to new research discussed in an editorial published in the Annals of Internal Medicine.  (FierceHealthPayer)

Researchers at University of Michigan and the University of California-Los Angeles who did the study said it provides the first evidence of low-income adults’ increased use of health services in states that expanded Medicaid. (Kaiser Health News)

In the pre-expansion era, from 2010-2013, about 33 percent of people had no insurance in states that ultimately expanded Medicaid, compared to about 42 percent in states that opted out of expansion. (Reuters)

CMS Drops Two-Midnight Rule

CMS has released its fiscal year 2017 Medicare Inpatient Prospective Payment System proposed rule, which does away with the two-midnight rule’s inpatient pay cuts.(Becker’s Hospital CFO)

Under the two-midnight rule, hospital stays spanning less than two evenings are considered outpatient visits and paid accordingly. Those lasting two nights or longer are compensated as inpatient care.(Healthcare Dive)

Under the new rule released Monday, hospitals will get a one-time 0.6 percent payment in 2017 to make up for the 0.2 percent reduction that has been imposed over the last three years.(Healthcare Finance)

What is the Two-Midnight Rule?

Despite Losses on ACA Plans, UnitedHealth Reports Higher 1Q Profit

UnitedHealth Group Inc. will drop out of government-organized health insurance markets in at least 16 states as the U.S. industry leader tries to stem losses from participating in Obamacare, the healthcare overhaul that has brought coverage to millions of people.(Bloomberg)

“We will be down to a handful of states that we will be actively participating in the exchanges,” Stephen J. Hemsley, chief executive officer of UnitedHealth Group said in an earnings call, noting that the small market size and greater expense of patients insured through the marketplaces led the insurer to make the decision. (The Washington Post)

UnitedHealth has a pretty good earnings track record with the company delivering positive earnings surprises in each of the last four quarters with an average surprise of 3.1%. (Zacks)

(Read all about UnitedHealth’s exit from Obamacare)

Is the Affordable Care Act Unsustainable?

Insurers warn losses from ObamaCare are unsustainable – The Hill

Insurers Losing Money on Obamacare Plans: ‘Something Has to Give’– NewsMax

Insurers step up threats to drop out of Obamacare market, fearing death spiral -Insurance Business America

CMS sets sights on stabilizing Affordable Care Act exchanges –  FierceHealthPayer

Study: More approve of ACA’s effects, but political divisions skew overall opinions -FierceHealthPayer

The Trouble With Grandmothered Health Plans and Bidding Low – Morning Consult

News About Obamacare Has Been Bad Lately. How Bad? – The New York Times

Concerns Raised Over Medicare Part B Reform

Medicare reform prompts backlash – Benefitspro.com

Drug plan hit with backlash – The Hill

Medicare’s flawed Part B drug experiment could harm patients– Morning Consult

Feds consider exemptions to controversial Medicare Part B payment model – FierceHealthPayer

Medicare change: ‘Perverse’ incentive or ‘perverse’ reform? – CNN

Medicare plan on payment for Cancer drugs stirs battle – ABC News

Related articles and CMS proposal

Affordable Care Act Testing New Ways to Deliver and Pay for Health Care

How to think about Medicare’s new primary care plan –  Politico

IT central to Medicare’s medical home model – Politico/Morning eHealth

CMS unveils plan for new payment model – Medical Economics

(Read  the CMS Comprehensive Primary Care Plus (CPC+) Fact Sheet)

New CMS primary-care payment model would affect 20K doctors –  Modern Healthcare

CMS unveils new risk-based primary care model: 13 things to know -Becker’s Hospital CFO

Feds’ new plan to wean some doctors off ‘fee-for-service’ – CNBC