One of the bigger articles in this issue covered the Kaiser Family Foundation survey on employer health benefit plans. (HA Issue) I am dealing with that in some separate posts. One article talks about using artificial intelligence to improve care management for people with complex chronic diseases. Not discussed is why we produce so many patients like this, who don’t work and are totally dependent on the taxpayers. It is usually due to a lack of responsibility for one’s health. Can AI help with that?
Medicaid has a lot of fraud. So one article suggests a way to make it even more fraudulent–automatically renew people’s coverage and lessen checking of whether they are really eligible. I am sure the taxpayers appreciate that. Another article is more of the same, but in regard to children’s Medicaid eligibility. Another cost-raising measure discussed favorably in a study–laws banning prior authorization for medications treating opioid abuse.
Private equity and venture capital ownership of providers has attracted a lot of negative press recently, somewhat deservedly. But one study in this issue finds that when these firms buy substance abuse treatment centers, the centers are more likely to accept Medicaid and Medicare patients.
Physicians are economic creatures, like all of us. Give them a financial incentive and they will take advantage of it. So when Medicare started paying for remote monitoring of patients at home, physicians started both making money doing the monitoring and having the patients come in for more outpatient visits. No evidence that this additional spending improved outcomes.
UnitedHealth pays the providers it owns more than those it doesn’t own. Well, duh! Anyone who watched this trend of plans buying providers knows that it was largely driven by the ability to increase overall profitability by evading the loss ratio restrictions imposed by federal and state laws.
The federal government provides some funding for what are called federally qualified health centers, usually located in low-income areas. When these centers were switched to value based payments, which condition the level of payment on certain health quality measures, performance on those measures improved.
