Medicaid Changes Under the ACA Will Simplify Enrollment, Reduce Number of Uninsured in Michigan

Monday, August 6th, 2012
This post was written by Cheryl Miller

The coverage on the games continues, with Americans winning two more gold medals and…oops, wrong story.

The coverage on Medicaid expansion continues, with a new study from the University of Michigan’s Center for Healthcare Research & Transformation, which finds that there are currently at least 40 different ways for Michigan residents to qualify for Medicaid, and each category has varying eligibility requirements. In 2014, the ACA will require states to streamline eligibility criteria and simplify enrollment, enabling more people to obtain coverage. All categories, mandated or optional, will be placed into three categories. Michigan has not declared whether it will opt-in to expand Medicaid as of yet.

General acute care and long-term care hospitals will receive payment increases under a final rule from CMS. The agency is projecting that total Medicare spending on inpatient hospital services will increase by about $2 billion in FY 2013 relative to FY 2012. Other related provisions in the final rule include a central line-associated bloodstream infecton measure that rewards hospitals for avoiding the kinds of life-threatening blood infections that can develop during inpatient hospital stays, and a hospital readmissions reduction incentive program.

Reducing readmissions is one of the goals of a new pilot program from Johns Hopkins, which finds specially trained nurse-pharmacist teams to be highly effective in preventing medication errors among those patients admitted to or recently discharged from the hospital. These teams are being used to find discrepancies between drugs patients are taking at home and those they are scheduled to take in the hospital, ultimately improving patient safety and reducing the high cost of avoidable readmissions.

Cost savings take center stage again in a new accountable care collaboration between Aurora Health Care and Aetna, that offers price guarantees to employers. In what is possibly the first of its kind among such healthcare models, say Aetna officials, employers could potentially get an average 10 percent reduction based on their past claims expenses. The plans are designed to provide more coordinated, personalized experience for patients and better healthcare outcomes.

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

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