Category: MM Curator

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Monday Morning Medicaid Must Reads: July 1st, 2019

Helping you consider differing viewpoints. Before it’s illegal.
other MMRS – http://bit.ly/2T7CP7K
In this issue…

Article 1:       Trump’s Medicare chief, in Chicago, slams ‘Medicare for All’ plan: ‘We’re not going to see savings. It’s actually going to cost more. Chicago Tribune, June 11, 2019. Lisa Schencker

Clay’s summary:     Bbbbbut- Bernie! He promised me it’ll work.
Key Excerpts from the Article:
Q: The doctors who support Medicare for All say it would allow doctors and hospitals to spend less money on administration because they wouldn’t be dealing with multiple insurance companies. What are your thoughts on that argument?
A: One of the things I hear a lot is we should go to Medicare for All because of the lower administrative costs. The reality is we’re not spending enough on administration within Medicare. There’s a lot of bureaucracy that goes on with the Medicare program in terms of access to technology, protecting taxpayers against fraud and abuse and it’s because we haven’t made those investments in administering the program like you would see in the private sector.
The main issue with Medicare for All and having the government take over the entire program, is that we’re not going to see savings. It’s actually going to cost more, which means taxpayers are going to pay more, and when they’re paying more, that’s going to lead to rationing of care and problems with access to care.
Read full article in packet or at links provided

Article 2:

Puerto Rico has a post-Maria Medicaid crisis — and Congress and the White House refuse to do anything about it, RawStory

Clay’s summary:     We now have this in regular rotation in Medicaid news cycles. The key factors all center around statehood status (which ties back to the secondary issue of the federal match). Why does no one point out that the path forward on this either involves another star on the flag or independence?
Key Excerpts from the Article:
Puerto Rico has its own definition of what constitutes poverty level and that, it turns out, is much lower than the federal level.  In order to qualify for Medicaid, a family of four in Puerto Rico must show a yearly income of under the amount set as the poverty level on the island, or $10,200. That’s $850 or less a month on an island where the cost of living is higher than in most of the continental U.S. If Puerto Ricans were to qualify for Medicaid under federal poverty guidelines, they would do so as long as their income (for a family of four) did not exceed $25,750, or a little over $2,000 a month.
This means that a large number of Americans living in Puerto Rico can qualify for Medicaid if they leave the island and move to the 50 states even if their income more than doubles. Puerto Rico government officials are well aware of the problem, but lack resources to address it.
Luz E. Cruz, Medicaid director for the government of Puerto Rico acknowledged that the federal cap on Medicaid funds gives Puerto Rico limited funds and if the poverty level was raised to the level in the 50 states, more people would qualify for the program. “And that would mean that the matching portion from the government of Puerto Rico would be higher and that’s money that we don’t have right now,” she said during a brief telephone interview.
Read full article in packet or at links provided

Article 3:       Requiring People To Work To Get Medicaid Went Really Well In Arkansas Until A Judge Stopped It, The Federalist, June 10th, Victoria Eardley

Clay’s summary:     Not what you wanted to hear, I know.
Key Excerpts from the Article:
 
Since 2000, the number of able-bodied adults using Medicaid quadrupled nationwide. The program is one of the chief costs for state governments, squeezing other priorities.
When last summer Arkansas became the first state to require Medicaid recipients to work in exchange for taxpayer-provided health care, welfare advocates would have had you believing the world was ending: health coverage for the needy was being slashed, the reporting process was too complex, and those who lost coverage didn’t even know about the requirement. On and on the hysteria went.
 
But those apoplectic claims were far from reality. Arkansas’ work requirement was a big step towards restoring the state Medicaid program to its objective. It was saving taxpayers money, freeing up resources for the truly needy, and—notably—changing people’s lives for the better.
 
What critics of the requirement neglected to disclose were the thousands of people who found work as a result of the reform—some for the first time in years. These folks went from a life of government dependency to a life of independence, an undeniably better future for both themselves and their families. These are real people, with real stories, reported by the Arkansas Department of Workforce Services in late 2018.
 
Read full article in packet or at links provided
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Medicaid Job Hunter: 07/01/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Johnston County Income Maintenance Caseworker III- Long Term Care Medicaid Job in NC
  2. Iowa Department of Administrative Services hiring Medicaid Program Manager in Des Moines, IA, US
  3. Humana hiring Behavioral Health Medical Director – Louisiana Medicaid in Metairie, LA, US
  4. State of Ohio Jobs hiring Medicaid Health Systems Administrator 2 in Columbus, OH, US
  5. Manager, Actuarial Services (Medicaid)
  6. State of Missouri hiring Medicaid Specialist in Jefferson City, MO, US
  7. State of Florida hiring 68064849 – MEDICAL/HEALTH CARE PROG ANALYST in Tallahassee, FL, US
  8. Medicaid / Managed Care Billing Coordinator in Lombard, IL, US
  9. Market Medical Director, Vivida Health Plan in Alturas, FL, US
  10. VP, Medicaid Chief Medical Officer in Atlanta, GA, US

Medicaid Industry Jobs Hunter 7.1.19

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Medicaid Job Hunter: 06/24/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Jobs @ TheJobNetwork hiring RN Case Manager Medicaid Phoenix Tucson AZ in Tucson, AZ, US
  2. State of Illinois hiring Medicaid Management Analyst in Sangamon, IL, US
  3. Health Plan President – Jacksonville, FL
  4. Spectrum Health hiring Business Intell Analyst Medicaid Full Time (Priority Health) in Grand Rapids, MI, US
  5. HCA Healthcare hiring Medicaid Eligibility Advocate in Kansas City, MO, US
  6. Iowa Department of Administrative Services Medicaid Program Manager Job in Independence, IA
  7. Magellan Health Senior Director-Medicaid Health Plan for Florida – Remote Opportunity Job in Glen Allen, VA
  8. Colorado State University hiring Medicaid Director, Department of Health Care Policy & Financing in Denver, CO, US
  9. Centers for Medicare & Medicaid Services hiring Health Insurance Specialist (Program Policy) in Woodlawn, MD, US
  10. CFO, Health Plan (Medicare – Medicaid) – Virtual / Travel

Medicaid Industry Jobs Hunter 06.24.19

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Medicaid Job Hunter: 06/17/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Centers for Medicare & Medicaid Services hiring Health Insurance Specialist in Washington, D.C., DC, US
  2. Ross Center for Health and Rehabilitation Medicaid/HMO Coordinator Job in Brentwood, NY
  3. UPMC Health Plan hiring CHC Service Coordinator, Central (Erie) in Erie, PA, US
  4. UPMC Health Plan hiring Medicaid Clinical Coordinator (Child Health / EPSDT Coordinator) in Pittsburgh, PA, US
  5. Medicaid Eligibility Advocate Jobs in Snellville, GA – Parallon
  6. Coastal Medical Medicaid Program Manager Job in Providence, RI
  7. VP, Medicaid Chief Medical Officer in Los Angeles, California, United States
  8. Magellan Health hiring Health Plan President, Magellan Complete Care of Virginia in Glen Allen, VA, US
  9. Medicaid Representative III – Little Rock, AR
  10. State of Mississippi hiring DOM-Medicaid Program Nurse III in Montgomery, AL, US

Medicaid Industry Jobs Hunter 06.17.19

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Medicaid Job Hunter: 06/10/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

 
  1. University of Utah Health Care Psychiatry Medical Director – University of Utah Health Plans Job in Murray, UT
  2. Fidelis Care hiring Actuary (Medicaid) in Rego Park, NY, US
  3. Sr Director-Medicaid Plan CFO at Aetna in Princeton
  4. Syrainfotek hiring Business Analyst with Medicare/Medicaid with Syrainfotek in Norfolk, VA, US
  5. Meridian hiring Fraud, Waste and Abuse Investigator in Detroit, MI, US
  6. Shriners Hospitals for Children hiring Health Plan Liaison in Tampa, FL, US
  7. WellCare Health Plans hiring Licensed Health Insurance Agent in Memphis, TN, US
  8. Molina Healthcare hiring VP, Government Contracts in Midvale, UT, US
  9. DOM-Medicaid Program Nurse III
  10. Health Insurance Specialist Special Assistant Job in NEW YORK, NY

Medicaid Industry Jobs Hunter 06.10.19

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Medicaid Job Hunter: 06/03/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Metroplus Health – Social Worker Job in New York, NY
  2. Cook County Government hiring DIrector of Finance, Medicare and Medicaid- County in Chicago, IL, US
  3. Metroplus Health – Registered Nurse (RN) Job in New York, NY
  4. Recruiting International hiring Health Plan Account Mgr CHC in Houston, TX, US
  5. Capgemini hiring Medicare/Medicaid/ Claims( Healthcare) – Supervisor/Lead in El Paso, TX, US
  6. Ivy Exec hiring Senior Director-Medicaid Health Plan in Scottsdale, AZ, US
  7. United Healthcare Health Insurance Sales Job in Knoxville, TN
  8. Independent Care Health Plan hiring Contract and Network Development Specialist – Family Care Partnership in Madison, WI, US
  9. Income Maintenance Caseworker II- Adult Medicaid Processing
  10. Eligibility Specialist, Medicaid/Medicare Jobs in Scottsdale, AZ – Centauri Health Solutions, Inc. 

Medicaid Industry Jobs Hunter 6.3.19

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Medicaid Job Hunter: 05/28/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Independent Care Health Plan Medicare Benefits Consultant in Green Bay, WI, US
  2. State of Florida 68064589 – CHIEF OF MEDICAID QUALITY Job in Tallahassee, FL
  3. IlliniCare Health Provider Network Specialist II in Chicago, IL, US
  4. Analytica International State Medicaid Program Director in Baltimore, MD, US
  5. Physicians Health Partners Senior Member Support Specialist (Medicaid) in Colorado Springs, CO, US
  6. IlliniCare Health Community Health Services Representative I in Carbondale, IL, US
  7. Fallon Health Registered Nurse Case Manager in Berkshire, MA, US
  8. WellCare Health Plans State President – Ohio in Columbus, OH, US
  9. Molina Healthcare Sr Program Specialist, Medicare in Long Beach, CA, US
  10. Medical Director (Aetna Better Health of Maryland) in Linthicum, Maryland, United States

Medicaid Industry Jobs Hunter 05.28.19

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Monday Morning Medicaid Must Reads: May 27, 2019

Helping you consider differing viewpoints. Before it’s illegal.
other MMRS – http://bit.ly/2T7CP7K
In this issue…

Article 1:      A First Look at North Carolina’s Section 1115 Medicaid Waiver’s Healthy Opportunities Pilots, KFF, May 15, 2019

Clay’s summary:     $600M to address SDoH for about 25,000 to 30,000 members. May seem steep, but its our first real attempt to measure this concept we’ve all been yapping about for 5 years.
Key Excerpts from the Article:
Medicaid funds typically cannot be used to pay for non-medical interventions that target the social determinants of health. However, in October 2018, CMS approved North Carolina’s Section 1115 waiver which provides financing for a new pilot program, called “Healthy Opportunities Pilots,” to cover evidence-based non-medical services that address specific social needs linked to health/health outcomes. The pilots will address housing instability, transportation insecurity, food insecurity, and interpersonal violence and toxic stress for a limited number of high-need enrollees.
Read full article in packet or at links provided

Article 2:      Block Granting Medicaid is Still a Terrible Idea, Suzanne Wikle, CLASP, May 15, 2019

Clay’s summary:     Op-ed writer may not realize that what she thinks is a bug is the key feature (reducing spending). Good one to have bookmarked if you are anti-block grants, though.
Key Excerpts from the Article:
While the promise of increased flexibility can sound enticing, the reality is that so-called flexibility pits funding choices against one another and ultimately leads to cuts. Medicaid already has the flexibility it needs to respond to economic downturns or public health crises, and capping funding for the program makes these responses more difficult. Block grants have not worked in the Temporary Assistance for Needy Families (TANF) program. What we know from 20 years of experience with TANF is that funding has not increased with inflation or in response to poverty and need. Moreover, states have used TANF funds to support alternative programs and have significantly decreased the aid going directly to families. Despite assurances they would fund key supports like affordable child care, policymakers haven’t been able to deliver on their promises.
Read full article in packet or at links provided

Article 3:      Medicaid could save $2.6 billion if 1% of smokers quit, Stanton Glanz, JAMA, April 17, 2019

 
Clay’s summary:      Ain’t nobody gonna tell Medicaid bennies they have to stop smoking. So we all just keep paying…
Key Excerpts from the Article:
 “Medicaid recipients smoke at higher rates than the general population … suggesting that investments to reduce smoking in this population could be associated with a reduction in Medicaid costs in the short run,” Stanton Glantz, PhD, of the Center for Tobacco Control, Research and Education at University of California, San Francisco, wrote. He noted that in fiscal year 2017, Medicaid costs totaled $577 billion. Glantz evaluated Medicaid expenditures and the economic response between changes in smoking prevalence and health care costs. All data were from 2017 and came from all 50 states and Washington, D.C.
 
Read full article in packet or at links provided
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Medicaid Job Hunter: 05/20/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. IlliniCare Health – Referral Specialist I in Westmont, IL, US
  2. Pharmacy Provider Liaison at Centene Corporation
  3. MetroPlus Health Plan – MLTC Marketing Representative in New York City, NY, US
  4. Humana – Medical Management Coordinator – Louisiana Medicaid in Metairie, LA, US
  5. State of Colorado – Medicaid Director, Department of Health Care Policy & Financing in Denver, CO, US
  6. Mid West Apply – Supervisory Health Insurance Specialist with Centers for Medicare & Medicaid Services in Chicago, IL, US
  7. President, Medicaid Health Plan – New York City, New York, United States
  8. Centers for Medicare & Medicaid Services – Health Insurance Specialist. in Woodlawn, MD, US
  9. Licensed Behavioral Care Advocate Mississippi Medicaid Telecommute Field Based job at UnitedHealth Group
  10. President Medicaid Health Plan Jobs in Woodbridge Township, NJ

Medicaid Industry Jobs Hunter 5.20.19

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Monday Morning Medicaid Must Reads: May 20, 2019

Helping you consider differing viewpoints. Before it’s illegal.
other MMRS – http://bit.ly/2T7CP7K
In this issue…

Article 1:     Medicaid Demonstrations: Approvals of Major Changes Need Increased Transparency, GAO, 5/17/2019

Clay’s summary:    Now that Medicaid waiver requests are asking for something besides “more,” we may see an interest in actually doing the 1115 “demonstration” reviews.
Key Excerpts from the Article:
 About a third of Medicaid spending is for demonstrations, which allow states to test new approaches to delivering services. States and the federal government are supposed to be transparent about the demonstrations that are proposed and give the public a chance to weigh in. Is that happening?
The short answer is sometimes. Transparency has improved, but there are still significant gaps. For example, the federal government doesn’t always require states to share the projected effects of proposals, even when they could significantly affect beneficiary eligibility.
Read full article in packet or at links provided

Article 2:     The inconvenient truths of Louisiana’s Medicaid expansion, The Advertiser, Chris Jacobs, May 17, 2019

Clay’s summary:     All that “free” federal money? Federal funding still comes from taxpayers like you and me. And expansion may just be killing people on waiting lists.
Key Excerpts from the Article:
Second, the truly vulnerable continue to get overlooked due to Medicaid expansion. Secretary Gee claimed that her “top priority is to ensure every dollar spent [on Medicaid] goes towards providing health care to people who need it most.” But Louisiana still has tens of thousands of individuals with disabilities on waiting lists for home and community-based services—who are not getting the care they need, because Louisiana has focused on expanding Medicaid to the able-bodied.
Since Louisiana expanded Medicaid in July 2016, at least 5,534 Louisiana residents with disabilities have died—yes, died—while on waiting lists for Medicaid to care for their personal needs. Louisiana should have placed the needs of these vulnerable patients ahead of expanding coverage to able-bodied adults—tens of thousands of whom already had private health insurance and dropped that insurance to enroll in Medicaid expansion.
Read full article in packet or at links provided

Article 3:     Why Medicaid carriers are wary of joining the ACA marketplace, BenefitsPro, Scott Woolridge, May 13, 2019

Clay’s summary:     Making money on the exchanges is hard. Just stick with the safe bet of Medicaid capitation revenues, and invest in carving out hard stuff.
Key Excerpts from the Article:
 The analysis by the Robert Wood Johnson Foundation (RWJ) notes that in areas where Medicaid insurers compete with other carriers in the ACA individual market, premiums for that market tend to be lower overall. Of the 31 states that had Medicaid buy-in programs for at least some state residents, 18 states reported premiums that were priced lower than the national average.
“This suggests that convincing more Medicaid insurers to sell marketplace plans could lower marketplace premiums,” the report said. “Participating in marketplaces can benefit consumers as well as insurers: several large Medicaid insurers are turning a profit on marketplace plans. Yet many other Medicaid insurers have chosen not to sell marketplace plans.”
Read full article in packet or at links provided