Article 1: AAFP Objects to Planned End of Medicaid Access Rule, AAFP

Clay’s summary: The rule is intended to show whether docs get paid enough to “encourage” them to provide Medicaid services, but it takes a good bit of effort to report on that info. And docs don’t like the idea of removing anything intended to make sure they get paid.

Key Excerpts from the Article:

In the rule,(www.govinfo.gov) published in the July 15 Federal Register, CMS noted its intention to ease some of the administrative burden that states currently face in trying to document whether Medicaid payments in fee-for-service systems are high enough to encourage physicians and other health care professionals to provide services to Medicaid beneficiaries.

The proposed rule outlines CMS’ contention that by compelling states to collect specific information, the agency “excessively constrains state freedom to administer the program in the manner that is best for the state and the Medicaid beneficiaries in the state.”

The AAFP noted its shared commitment to reducing administrative burden for states and clinicians, but argued that the proposed rule, as written, would likely negatively affect Americans in rural areas, as well as some of the country’s most vulnerable patient populations that depend on Medicaid for health care services.

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Article 2: Walmart’s First Healthcare Services ‘Super Center’ Opens, Bruce Japsen, Forbes

Clay’s summary: Amazon is creating empty shelves / space in those huge Walmart buildings. So far Bezos hasn’t figure out how to do 2 day shipping on a doctor’s visit, so Walmart is opening clinics. CVS, too…

Key Excerpts from the Article:

The retailers see 10,000 baby boomers aging into Medicare coverage each day and are also looking to fill emptying space in their brick and mortar stores in the face of changing consumer shopping habits driven by online retail giant Amazon, which is also exploring new ways to get into the healthcare business but has yet to offer face-to-face personalized healthcare services for customers…

This year, CVS has said its new health hub concept store will reach four U.S. metropolitan areas and 50 locations by the end of this year as part of a major expansion. CVS said the HealthHub rollout will grow to 1,500 locations by the end of 2021, or about 500 HealthHubs a year, CVS chief executive officer Larry Merlo told analysts on the company’s second quarter earnings call.

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Article 3: Medicaid expansion increased ED use, study shows, Modern Healthcare

Clay’s summary: A Medicaid card provides immunity to medical debt, so ED visits went up. You don’t say?

Key Excerpts from the Article:

Patients under Medicaid don’t have to fear debt collection, removing one big barrier that could deter someone from a hospital visit. Those visits may be perceived as more convenient than a regular doctor’s office visit even if they’re more expensive to Medicaid, since the patient doesn’t have to find a physician who accepts his or her plan…”This pattern of estimates is intuitive,” they wrote. “Medicaid expansion effectively lowers the price of an ED visit for the patient, and so we would expect for an increase in visits for those that are discretionary.”In general, people who qualified for Medicaid under the expansion went to doctors or hospitals at higher rates than the people who didn’t qualify. The authors said that suggests basing the expansion on income rather than specific categories of need “successfully targeted” the people most in need of medical care.

That suggestion held in non-expansion states as well. The people in those states who bought plans on the individual market exchanges with the aid of income-based subsidies were also those who most needed medical care.

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2019 10 14 MMMR