I get asked this question by clients all the time. Best starting point is the current MMIS contract report put out by CMS. It will show you the expected procurement schedules by CMS Region and state. Generally speaking, whenever the larger MMIS is up for bid will be the best time to expect a state to test out a modular procurement. Screenshot below, full file attached.
Helping you consider differing viewpoints. Before it’s illegal.
Article 1:
Clay’s summary: Care’ and Caid’ blew $89B on improper payments in the last reporting year. I refuse to get my hopes up that anyone actually cares at this point.
Key Passage from the Article
The agency announced Tuesday that it is boosting audits to confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.
“This imbalance in the federal matching rate creates financial risks for taxpayers by incentivizing states to shift cost to the federal government,” CMS Administrator Seema Verma told reporters Tuesday. “This requires us to make sure that states are making accurate eligibility determinations.”
The CMS also said it will audit states found by HHS’ Office of Inspector General to be at high risk for enrolling ineligible people in Medicaid. California, Kentucky and New York have been cited by the OIG for doing this in the past.
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Article 2:
Clay’s summary: I know I feel better when I eat healthier. Some Philly MCOs are doing SDOH via good food. Cool.
Key Passage from the Article
Since 2015, Health Partners has joined a small group of insurers around the country to offer some members specially designed meals to improve their health. The company paid the full cost for 560,000 meals to be delivered to more than 2,100 of its members with various conditions such as diabetes, heart disease and kidney failure.
The Metropolitan Area Neighborhood Nutrition Alliance (MANNA), a Philadelphia-based nonprofit organization that provides medically appropriate food for people with serious illnesses, prepares and delivers the meals.
The service covers three meals a day and typically lasts six weeks, although members can renew for two additional six-week cycles. It also provides nutritional counseling. MANNA provides the meals to everyone in the household to help family members support patients who need to change bad diets. Health Partners, which serves Philadelphia and nearby counties, said its investment is paying off.
With the kick-start that comes from receiving these free meals and continued counseling to shop better and prepare healthy meals, the members are better able to control their diabetes, use the hospital less and reduce their medical costs, according to the health plan.
Article 3:
Clay’s summary: Related to the first one, but with info and link-outs on ramping up Medicaid provider background checks.
Key Passage from the Article
The Centers for Medicare & Medicaid Services should prioritize fingerprint-based criminal background checks and conduct site visits to high-risk providers to mitigate Medicaid fraud, a government watchdog official said Wednesday.
CMS has agreed with the HHS Office of Inspector General recommendations but has extended the deadline for implementing the background checks, Brian P. Ritchie, Assistant Inspector General for Audit Services, testified Wednesday before the Senate Committee on Homeland Security and Governmental Affairs. CMS announced a series of Medicaid fraud initiatives Tuesday in advance of Ritchie’s testimony.
Helping you consider differing viewpoints. Before it’s illegal.
Article 1:
Clay’s summary: You silly gooses. Geese.
Key Passage from the Article
Six states — Iowa, Massachusetts, Minnesota, Missouri, New Jersey and Washington state — have active legislation to establish a Medicaid buy-in program. In four others, bills were proposed but stalled. New Mexico has set up a task force to study a Medicaid buy-in program, and Connecticut may do the same.
According to experts, each state likely has a different reason for considering this option.
“States are still exploring what it would even mean,” says Heather Howard, director of State Health and Value Strategies. “For one state, it could be about addressing a bare county. For another, it could be an affordability issue. For another, it could be about expanding competition. In the absence of federal legislation on health care, states are asking: ‘What tools do we have?'”
For left-leaning lawmakers, Medicaid buy-in is considered a step toward single-payer health insurance. But conservatives are wary of expanding the government’s role in health care and of funneling more money into Medicaid, which is already a huge slice of state budgets.
New Mexico state Sen. Jerry Ortiz y Pino — who co-sponsored a bill to study the issue — says Medicaid buy-in makes sense there because the majority of residents (54 percent) already have Medicaid or Medicare. It’s the only state where more than half the population uses government health care.
“Besides Medicaid, we have a high Medicare population, high VA [Veterans Affairs] population and high numbers in the Indian Health Service,” says Ortiz y Pino. “So when we talk about non-governmental insurance, it’s a small number. That small population means it’s hard to attract private insurers, particularly in the marketplace.”
New Mexico’s marketplace has four insurers covering the state, which is actually more than many part of the country. About half of Americans only had one or two insurers last open enrollment season. Still, like most other states, New Mexico’s marketplace is facing increased premiums and possible insurer dropouts this year.
…
Article 2:
Clay’s summary: Very important annual report that covers lots of insights from state budgets. Medicaid is always a big part of the analysis- starts on page 73 of this years report.
Key Passage from the Article
In fiscal 2017, states reported total spending for Medicaid expansion of $87.7B, $6.7B in state funds, and $81.1B in federal funds. In fiscal 2018, states are estimated to spend $91.2B in all funds, $10.3B in state funds, and $80.9B in federal funds.
Article 3:
Clay’s summary: Things are heating up for MCOs in the LoneStar state after a reporter decided to look into Medicaid managed care.
Key Passage from the Article
Part of the investigation focused on twins D’ashon and D’asia Morris, who were born with severe birth defects and were placed in foster care after they tested positive for drugs at birth. While D’ashon Morris was a foster child under Superior HealthPlan — a managed care program for foster children — he was denied 24-hour nursing care that would prevent suffocation, according to The Dallas Morning News’ report.
The report said providing that care would have cost Superior Health as much as $500 a day. One day, when D’ashon was in temporary foster care while his foster mother, Linda Badawo, was traveling outside the country, he started choking. After nurses and medics performed CPR for 40 minutes, D’ashon was taken to the hospital, where doctors concluded that he had gone too long without oxygen to his brain — he would be brain dead for the rest of his life.
“Superior is 100 percent responsible,” Badawo, who has since adopted D’ashon, told lawmakers Wednesday, her voice shaking. “I strongly believe that they don’t have any passion for what they do.”
It wasn’t until after the accident that Superior gave D’ashon 24-hour care, the Morning News reported.
“So my question to you was: ‘Was this a matter of life and death?'” state Rep. Mark Keough, R-The Woodlands, asked Superior’s representatives regarding 24-hour care for D’ashon.
David Harmon, Superior’s chief medical director, said his company did not believe so, based on the information it had. “If we did, we would not have authorized to continue” with 17 hours a day of care instead of 24, he said.
The story, Harmon said, “misrepresented the facts in all of these cases to make us look very bad.”
David McSwane, one of the Morning News reporters who wrote the investigative series, defended the reporting.
“The data, docs and patients in the stories tell the story,” McSwane tweeted during the hearing.
Mark Sanders, CEO of Superior HealthPlan, said Superior proposed using a “soft splint” to prevent D’ashon from pulling out a tube that helps him breathe. Badawo said she was horrified because state regulations bar her from using physical restraint on foster children in many situations.
Sanders, who showed an example of the soft splint to lawmakers, said the device was “in no way shape or form” like a restraint.
State Rep. Richard Peña Raymond, D-Laredo, told representatives from Superior that the company needed to become more aware that there were going to be members and patients who would need more attention than others.
“We’re going to stay on you,” Raymond warned. “We don’t want these things to happen. But if we don’t do it right, these things will bubble up.”
Representatives of private companies that manage Medicaid in Texas slammed the newspaper report for what they said were inaccuracies. LeAnn Behrens, west region president of AmeriGroup Medicaid, took issue with the report’s assertion that AmeriGroup is withholding care from patients in order to make a profit.
“As you all know, the state of Texas has set up a system that restricts the amount of profits that a managed care can make,” Behrens said. “Members get the best care, they get the right care at the right place — and you have confidence that I am being wise with taxpayer money.”
The article below originally appeared in the Baltimore Sun. Reprinted with kind permission from the author Dr. Dan Morhaim (whom I had the good fortune of working with years ago in Maryland – Clay F)
– Dan K. Morhaim
On March 27, in a House Judiciary Committee hearing, I asked Baltimore County State’s Attorney Scott Shellenberger what percentage of crime in Baltimore County was due to drugs. His answer: “Upwards of 85 percent.” I then asked Baltimore City Police Major Byron Conaway the same question, and his answer was “90 percent.”
As an E.R. doctor, I ask my patients who are substance abusers where they get the $50 a day needed to sustain their habit. Many get others hooked because then those new users become paying customers. There’s also petty crime, prostitution and the major crimes that plague our streets and neighborhoods.
If we are to be serious about reducing crime, then the focus must be on preventing and treating substance abuse. New multi-faceted policies are needed, both in the criminal justice system and in health care.
There is no point in saddling people arrested with small amounts of drugs with a misdemeanor conviction. Instead, users should be provided treatment instead of a criminal record that will haunt them for the rest of their lives. (The small number of people convicted of repeat violent crime felonies, however — especially with firearms — need to be vigorously prosecuted and incarcerated for extended periods.)
Substance abuse treatment ought to be immediately available, 24/7/365, and one of the best places to initiate this is in hospital emergency rooms. Persons with substance abuse disorders already show up in E.R.s for a wide variety of health issues, so why not routinely include drug treatment as part of the care? Treatment plans should be individualized, just as is done for all other medical conditions. Some patients may need long term care, others medicated assistance treatment (e.g. methadone, buprenorphine) and others faith-based approach. One size does not fit all.
Supervised consumption facilities also have been shown to work, reducing deaths, addiction, discarded needles and crime. It may seem to some that this idea condones substance abuse, but the data showing success cannot be denied. It is shortsighted to dismiss this option without seriously considering it first.
Among other efforts we should make: find ways to dispose of all medications safely, especially opioids; make naloxone more available to at least avoid some overdose deaths; allow people go to fire or police stations when they need help without fear of penalty; use methods other than narcotics to treat pain unless absolutely necessary; continue public education regarding substance use, especially in schools.
How can we afford to do this? The real question is how can we afford not to? There are about 30,000 daily drug users in the Baltimore metro area. At an average cost of $50 per day to sustain a habit, that means that $1.5 million per day — or $547 million per year — is spent solely to buy drugs. Statewide, Marylanders spend about $800 million per year on illegal drugs. Then there all the other costs in health care; the criminal justice system; and harm to families, victims, businesses and neighborhoods.
Where does all that money go? Ultimately, it goes to dangerous and violent overseas drug cartels and terrorist organizations, like ISIS and al-Qaida. We’ve been on a policy trajectory that is destroying our society from the inside while shipping vast sums of money to those who would destroy us from the outside.
The economics of the drug war now define the economic activity of many communities. Re-directing “drug money” to legitimate businesses and education would bring jobs, income and safety.
Imagine if only 10 percent or 20 percent of daily users got into treatment today, an achievable goal. Overnight the health care and criminal justice system would be decompressed because those now in treatment would tomorrow not be seeking money for drugs.
Of course, there’s a deeper question that must be confronted: Why do so many of us turn to drugs? Perhaps our focus on material wealth, our endless distractions via media, the daily stress most people endure, hurtful behaviors spanning generations and the emphasis on the individual over community leave too many of us feeling isolated, angry and unfulfilled. As author Johann Hari observed: “The opposite of addiction isn’t just sobriety; it is connection.”
But we’ve got to start somewhere.
Dan K. Morhaim is a physician and Democrat representing Baltimore County in the Maryland House of Delegates. His email is dan.morhaim@house.state.md.us.
Copyright © 2018, The Baltimore Sun, a Baltimore Sun Media Group publication | Place an Ad
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Helping you consider differing viewpoints. Before it’s illegal.
Article 1:
Clay’s summary: TPL is hard, and so is not overpaying cap to plans. But hey – what’s $1.3B?
Key Passage from the Article
Thanks to a lack of oversight, the state Health Department doled out $1.3 billion in six years in Medicaid premiums for people who were already enrolled in other comprehensive health plans, according to a new report from state Comptroller Thomas DiNapoli.
The report found that the state Health Department is not quick enough to disenroll people when they sign up for coverage with another insurer. The overwhelming majority of those funds—about $1.2 billion—are not recoverable.
“Glitches in the state Department of Health’s payment system and other problems led to over a billion dollars in unnecessary spending,” DiNapoli said. “The department needs to improve its procedures and stop this waste of taxpayer money.”
The waste in question, while considerable, accounts for a fraction of the annual Medicaid budget. New York’s Medicaid program, which is funded by federal, state and local governments, spent $58 billion for services for some 7.4 million members in fiscal 2017 alone.
The majority of Medicaid members in New York are enrolled in mainstream Medicaid managed-care plans, which are run by private companies or nonprofit organizations that receive monthly payments for each member from the government. The state Health Department is responsible for disenrolling members from those Medicaid plans as soon as it learns they have enrolled in another comprehensive health plan.
…
Article 2:
Clay’s summary: WellCare continues the acquisition march and buys a stake in the hot mess that is the IL Medicaid market.
Key Passage from the Article
WellCare Health Plans has agreed to acquire Medicaid insurer Meridian Health Plan for $2.5 billion, it announced Tuesday.
The insurers expect the deal to close by the end of 2018. Tampa, Fla.-based WellCare said the acquisition will bolster its Medicaid business by boosting membership in several states. WellCare will also benefit from adding Meridian’s in-house pharmacy benefit manager MeridianRx to its portfolio.
The deal “will grow and diversify our Medicaid and Medicare Advantage businesses” and “add new and enhance existing capabilities,” WellCare CEO Kenneth Burdick said on Tuesday.
WellCare’s announcement comes amid rampant consolidation in the health insurance industry, as health plans pair up with other insurers, ambulatory care providers and PBMs. Anthem last week bought Aspire Health, a Nashville-based palliative care company. Humana has struck deals to buy stakes in home health services provider Kindred Healthcare and hospice operator Curo Health in recent months.
While MeridianRx is a relatively small operation serving mostly Meridian members, bringing a PBM in house could give WellCare a foundation to grow its pharmacy management capabilities as fellow insurers Aetna and Cigna Corp. pair up with PBM giants CVS Health and Express Scripts, respectively.
Article 3:
Clay’s summary: Let’s start the protest music. Here we go again…
Key Passage from the Article
Agency for Health Care Administration Secretary Justin Senior is meeting with 12 managed-care companies that filed petitions with the state last week, as he tries to dissuade them from legal fights over the state’s decisions to award five-year Medicaid contracts that could be worth up to $90 billion.
Mallory McManus, an AHCA spokeswoman, forwarded a schedule to The News Service of Florida that showed Senior, Medicaid director Beth Kidder and three other staff members expected to meet with three companies on Wednesday: Aetna Better Health, which is challenging the state’s decisions in eight Medicaid regions; Magellan, which is challenging decisions statewide; and Prestige Health Choice, a plan that is partially owned by insurance company Florida Blue and is challenging decisions in nine Medicaid regions.
Senior kicked off the meetings with managed-care companies on Monday, talking with Lighthouse Health, a provider-sponsored plan hoping to get managed-care contracts in Medicaid regions 1 and 2.
GAO got intrigued by the amazingly low Payment Error Rate report for MCOs (0.3%) vs fee for service (10%). A report released in early May suggests the calculations for FFS and Managed Care are not comparable. Further- the managed care calculation does not go into much detail at all in reviewing charts or even data from MCOs to see if benefits were reimbursed in accordance with policy. We touched on this report in the 6/11/2018 news show.
Summary from report –
What GAO Found
The Centers for Medicare & Medicaid Services’ (CMS) estimate of improper payments for Medicaid managed care has limitations that are not mitigated by
the agency’s and states’ current oversight efforts. One component of the Payment Error Rate Measurement (PERM) measures the accuracy of capitated
payments, which are periodic payments that state Medicaid agencies make to managed care organizations (MCO) to provide services to enrollees and to cover
other allowable costs, such as administrative expenses. However, the managed care component of the PERM neither includes a medical review of services
delivered to enrollees, nor reviews of MCO records or data. Further, GAO’s review of the 27 federal and state audits and investigations identified key
program risks.
• Ten of the 27 federal and state audits and investigations identified about $68 million in overpayments and unallowable MCO costs that were not accounted
for by PERM estimates; another of these investigations resulted in a $137.5 million settlement.
• These audits and investigations were conducted over more than 5 years and involved a small fraction of the more than 270 MCOs operating nationwide as
of September 2017.
To the extent that overpayments and unallowable costs are unidentified and not removed from the cost data used to set capitation rates, they may allow inflated
MCO payments and minimize the appearance of program risks in Medicaid managed care.
Here’s the actual report –
2018 05 GAO rpt on MMC PERM 691618
Learn more about what we do to help health plans – Mostly Medicaid Health Plan Solutions Page
Helping you consider differing viewpoints. Before it’s illegal.
Article 1:
Clay’s summary: Medicaid advocates may be acting foolish to oppose work requirements- a small group of people are affected, and it may be the grease that makes non-expansion states expand.
Key Passage from the Article
Recent proposals for redesigning this part of Medicaid have identified this pervasive issue: work and policymakers’ attitudes toward it. Most Americans under age 65 at all income levels receive health insurance through their employment and are induced (through tax breaks and employer regulations) to take it as part of their compensation. Several states, including some that reluctantly implemented expansion and some contemplating it, have asked for federal permission to link Medicaid eligibility to labor force participation—working or looking for work.
As with everything in health policy these days, this idea is controversial, with disagreement even about the facts but more fundamentally about subjective social values. The factual questions are 1. how many people on Medicaid would be affected by this policy and 2. how many people who receive Medicaid would be able to work (or go to school) if they are not already, and how many would just choose not to?
The value question deals with the latter group—if some of them could find employment, but choose not to, would you as a taxpayer be willing to sacrifice some of your wages to pay for their health insurance? There can be no doubt that some politicians and the citizens who support them say no, while others say yes. There is no generally accepted principle that can tell analysts that one value system is better than the other.
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Article 2:
Clay’s summary: A Stanford Doctor tells us that government healthcare should be only for soldiers, and anything beyond that only increases costs and decreases quality.
Key Passage from the Article
The Great Society’s social engineers would not be satisfied until the government burrowed deeper into medical care. Thus Medicaid for all the “medically indigent” and Medicare for all seniors (aka middle class welfare) were born.
And since money grows on third-party and government trees, medical costs were ignored, and expenditures dramatically increased from 5.0 percent of GDP in 1960 to 17.9 percent in 2016. And at 28 percent, healthcare expenditures are the single largest piece of the federal budget pie.
The ACA’s justification for commandeering the remainder of the health insurance market was to rid our nation of the uninsured. Yet six years later, the nation’s uninsured dropped a mere 3.8 percent, and premiums have more than doubled. The number one reason the current uninsured did not buy insurance was because the cost was too high. Of course it was. The ACA’s mandated “free” benefits had to be paid for somehow. Worse yet, it now takes a Herculean effort to find individual health insurance; nationally, there are only 3.5 issuers in the ACA marketplace.
Medicare and Medicaid began the upending of the health insurance business. These programs became the siren call, enticing us to cede control over our health to disinterested third parties and middlemen. Government largesse led us to accept blind pricing as the norm. Where else do you buy something before you know what it costs? Freebies lured us into relinquishing our privacy to government data banks and now leave us longing for the comfort and simplicity of a computer-free doctor visit.
Article 3:
Clay’s summary:
Key Passage from the Article
What’s in the Scorecard?
Like Medicaid and CHIP beneficiaries, information in the Scorecard spans all life stages. This first version of the Scorecard includes information on selected health and program indicators. It also describes the Medicaid and CHIP programs and how they operate.
The Scorecard will evolve. Future iterations likely will allow year-to-year comparisons to help identify trends. The Scorecard will be flexible—CMS may add new areas of emphasis important to the Medicaid and CHIP programs or replace measures as more outcome-focused ones become available.
CMS worked with a subset of state Medicaid agencies to select measures for this first Scorecard. Many measures in the Scorecard come from public reports. For example, most measures in the State Health System Performance pillar come from the Child and Adult Core Sets. This approach allows CMS to align the Scorecard with existing reporting efforts.
Including measures from the Core Sets in the Scorecard builds on states’ investments in collecting and reporting these voluntary measure sets. While there are many reasons some states do not collect or report all Core Set measures, CMS hopes the Scorecard will draw attention to the importance of reporting on these measures. Core Set reporting methods also can vary among states. For example, some states have access to different data on populations covered under fee-for-service as compared to populations covered under managed care. This variation in data availability can impact measure performance. Readers should review the detailed measure notes located after the graph to better understand states’ reported rates.
The Scorecard also sheds light on important questions about the scope of Medicaid and CHIP. …
We look out for this one each year because of the high quality, unique insights contained year after year.
This report summarizes the calendar year 2017 experience for selected financial metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners annual statement. The primary purpose of this report is to provide reference and benchmarking information for certain key financial metrics used in the day-to-day analysis of Medicaid managed care organization financial performance.
Key findings from the analysis include:
Here’s a link to the report on the Milliman site –
www.milliman.com/medicaid-results-2017/www.milliman.com/medicaid-results-2017/
It’s also attached here, but if you visit the Milliman page you can learn more about the authors and find other analyses and publications.
Helping you consider differing viewpoints. Before it’s illegal.
Article 1:
Clay’s summary: ACA has gone to the gallows several times. Last time it was saved under the “its still a tax so its ok” argument. Now that the IRS made then penalty zero, that doesn’t work anymore…
Key Passage from the Article
Ignore everything you have been told by the “news” media about Texas v. United States, the lawsuit recently filed by 20 states challenging the constitutionality of Obamacare. The Fourth Estate, in its all but official role as the public relations department of the Democratic Party, has generally downplayed the suit as yet another futile attempt by fanatical Republicans bent on destroying former President Obama’s “legacy.” Following their usual playbook for reporting constitutional challenges to the “Affordable Care Act” the media briefly sneered about its merits and then, to paraphrase David Burge, “covered the story with a pillow.”
It is nonetheless an important case and it’s useful to review the basis on which the plaintiffs actually base their case against the mandate: In 2012, a majority of the Supreme Court’s justices — including Chief Justice Roberts — rejected the government’s claim that Congress could impose the individual mandate pursuant to the Commerce Clause of the Constitution. Yet Roberts held that the mandate was still constitutional because its penalty was a tax collected by the IRS to raise revenue. The plaintiffs argue that this “saving construction” evaporated when Congress reduced the penalty to zero last year. Their complaint puts it as follows:
The Patient Protection and Affordable Care Act… as recently amended, forces an unconstitutional and irrational regime onto the States and their citizens. Because this recent amendment renders legally impossible the Supreme Court’s prior saving construction of the Affordable Care Act’s core provision — the individual mandate — the Court should hold that the ACA is unlawful and enjoin its operation.
In other words, because Congress has no authority to impose the individual mandate pursuant to the Commerce Clause, and it can’t be justified as a revenue-raising device (since enactment of the Tax Cuts and Jobs Act of 2017), the mandate must be struck down.
…
Article 2:
Clay’s summary: This is important. The need to do hub / spoke keeps a lot of services from not happening that could happen via very simple technology (facetime, skpe, etc) in the patient’s home. Expect new rounds of billions to be blow by private equity chasing the latest MIT grad who thinks they discovered the Medicaid telehealth opportunity for the first time and can code an app.
Key Passage from the Article
In its spring 2018 update of the State Telehealth Laws and Reimbursement Policies Report, the Center for Connected Health Policy reports that 10 states have amended their telehealth policies since August 2016 to specifically make the patient’s home an originating site for Medicaid-accepted telehealth and telemedicine programs. Those states are Delaware, Colorado, Maryland, Michigan, Minnesota, Missouri, New York, Texas, Washington and Wyoming.
Meanwhile, the report notes that six states have limited the geographic requirement altogether since 2013. And 16 states have added schools to the list of approved originating sites, though some are placing restrictions on those services.
According the CCHP’s sixth annual report, some 160 telehealth-related bills have been introduced during the 2018 legislative session in 44 states, continuing a digital health trend that saw more than 200 pieces of legislation introduced during the 2017 session. But not all of those bills are supportive of new healthcare services.
Article 3:
Clay’s summary: Lefties don’t like it when people float the idea that double Medicaid enrollments with promises of free federal magic money may put some hurt on state budgets. No way. No how. You are a TERRIBLE PERSON for even thinking it, let along examining it. Thoughtcrime! But hey – this segment is for all viewpoints so let’s run it anyway.
Key Passage from the Article
Contrary to claims that Medicaid expansion would make approximately 630,000 additional citizens eligible, most estimates are half that. Professor Hall’s data shows that enrollment “has either fallen short of or not substantially exceeded expectations.” There also is a study of 10 states that confirms providers have not been overwhelmed. Adult males have not crowded out women and children.
Since the program has been going for five years, predictions for costs rely on track records and have become progressively more accurate. No state has repealed Medicaid expansion. Governors of red states (including Arkansas, Arizona, Michigan, Nevada and Ohio) argued against repeal of the Affordable Care Act to preserve their Medicaid expansion.
The Menges Group puts out these great analyses and insights each month. And is kind enough to let us repost them for the MM audience. Check out themengesgroup.com to learn more about the work they do.
Attached is the February 2018 edition of our 5 Slide Series. This edition focuses on the 46 health care companies on the current Fortune 500 list, conveying their ranking in CY2016 revenues and profits, and their percentage profit margins. During CY2000, no health care companies were in Fortune’s top 25 – now there are seven.
v57 The Health Care Fortue 500
