Medicare’s new hospital payment experiment, which it calls TEAM (Transforming Episode Accountability Mode), may have profound effects on patients, their families, and providers such as nursing homes and home health agencies. While the acronym signals the virtues of collaboration and shared goals, its outcomes are far less certain. At its best, TEAM will encourage hospitals to improve the quality of the [...]
Our deeply fragmented health system is especially dangerous for older adults, younger people with disabilities, and their families. In an effort to improve their care, the federal Centers for Medicare and Medicaid Services is rolling out several experimental payment models aimed at better coordinating care and, perhaps, saving Medicare money. The demonstrations, described by a growing cacophony of acronyms, work [...]
While Congress and President Trump fruitlessly debate how much the government should subsidize certain health insurance premiums, they are missing a far more important question: How could the US rationalize our eight (at least) completely separate health insurance systems? This maze-like complexity comes at a price. Dividing Americans into multiple risk pools increases health care costs. It means patients lose [...]
One of the many lessons we should have learned from the Covid-19 pandemic is the cost to older adults of loneliness and social isolation. While nearly 900,000 older adults died from the virus, tens of thousands were sickened and may have died from the isolation the pandemic caused. But what have we learned from that tragic experience? Whether older adults [...]
US District Judge Reed O’Connor’s Friday night decision to strike down the entire Affordable Care Act would damage the well-being of older adults, those 50-64 nearing Medicare, and frail elders and younger people with disabilities who are receiving long-term care benefits under Medicaid. Many lawyers believe the ruling is poorly reasoned and likely would be reversed on appeal. However, it [...]
President Trump’s multi-pronged administrative attack on the Affordable Care Act would sharply increase premiums for middle-aged people who purchase insurance in the individual market, likely driving many to drop coverage. Most would not feel the effects until 2019, though some will face sharply higher premiums in 2018—rate hikes they’ll see when the open enrollment season begins next month. The President [...]
The still-evolving Senate Republican replacement for the Affordable Care Act could make health insurance unaffordable for more than 50 million middle-aged Americans by allowing insurers to raise premiums for those with pre-existing conditions. Other provisions would allow carriers to boost insurance costs for even health people aged 50-64. The bill would give states federal dollars to help subsidize those rate [...]
Senate Majority Leader Mitch McConnell’s health care plan would substantially increase costs for people age 50-64 who buy insurance in the individual market and for the frail elderly and younger people with disabilities who receive Medicaid long-term care benefits. In some ways, the Senate plan would be marginally better than the House-passed health bill. In others, it would be much [...]
The Senate’s version of the House-passed American Health Care Act will almost certainly include a fundamental change in the way the federal government contributes to Medicaid. Over time, that new structure would result in deep cuts in the federal contribution to Medicaid and ultimately reduce long-term care benefits for frail older adults as well as younger people with disabilities. These [...]
The House-passed health bill could further batter the already-beaten down market for long-term care insurance. And drive even more middle income seniors into impoverishment and onto Medicaid long-term care. Here’s why: The House bill, called the American Health Care Act (AHCA) would significantly raise health insurance premiums and out-of-pocket medical costs for buyers aged 50-64. And that is exactly the [...]