Expanding Medicaid to Low-Income Adults Improves Health, Saves Lives

Wednesday, August 1st, 2012
This post was written by Cheryl Miller

The Medicaid population is the big winner this week, given the results of a new study from the Harvard School of Public Health. In the first published study since the Supreme Court’s ruling on the effect of recent state Medicaid expansions on mortality among low-income adults, the findings suggest that expanding coverage to the uninsured may save lives. The groups that benefited from the expansion the most are those that traditionally had higher mortality rates and faced greater barriers to care. States now have the option to expand their Medicaid coverage, and researchers hope this study will help state policymakers in their decisions.

The CMS also scores big, with provisions that have saved over 5 million Medicare beneficiaries nearly $4 billion on prescription drugs. In the first six months of this year alone, over 1 million seniors and people with disabilities have saved an estimated $687 million on prescription drugs in the “donut hole” coverage gap. CMS officials predict that coverage for both brand and generic drugs in the gap will continue to increase in time until 2020 when it will be closed.

Cigna is a contender, as its collaborative care programs continue to grow throughout the country. The health provider’s widening roster of initiatives, which aim to expand patient access to healthcare, improve care coordination, and achieve the gold standard of healthcare, the “triple aim” of improved health outcomes, affordabiity and patient satisfaction, are now based in six new states, including California, Ohio and Maine. Cigna now has 32 collaborative initiatives in 16 states servicing more than 300,000 customers. Key to the programs is the use of RNs as clinical care coordinators, and a PFP reimbursement structure.

And small employers are trying to stay in the race by looking into self-insurance as a way to protect themselves against potentially catastrophic medical claims, reports a new study from the Center for Studying Health System Change. Researchers say that increasingly competitive markets for stop-loss insurance and third-party administrators are making self-insurance attractive to more employers, particularly small firms with fewer than 100 workers. But the trend may pose challenges for policy makers, researchers add.

Read all of these stories in their entirety in this week’s Healthcare Business Weekly Update.

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