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Thursday, February 28, 2019
December 2018 Medicaid & CHIP Eligibility and Enrollment Report
Who to Contact: Social Security or Medicare?
Sometimes it’s confusing to know who to contact and for what. Social Security and Medicare offer related services, so people aren’t always certain who does what. This “cheat sheet” can help.
Contact Social Security to:
- See if you’re eligible for Medicare;
- Create a my Social Security account to do things like request a replacement Medicare card and report a change of address, name, or phone number;
- Sign up for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance);
- Apply for Extra Help with Medicare prescription drug coverage (Part D) costs;
- Report a death; and
- Appeal an Income-Related Monthly Adjustment Amount (IRMAA) decision (for people who pay a higher Part B and/or Part D premium if their income is over a certain amount).
Find information on how to do all of this and more on Social Security’s Medicarewebsite.
Contact Medicare to:
- See what services Medicare covers;
- Get detailed information about Medicare health and prescription drug plans in your area, including costs and services;
- Choose and enroll in a Medicare health or prescription drug plan that meets your needs;
- Find a Medicare Supplement Insurance (Medigap) policy in your area;
- Find doctors, health care providers, and suppliers who participate in Medicare;
- Get information and forms for filing a Medicare appeal or for letting someone speak with Medicare on your behalf;
- Compare the quality of care provided by plans, nursing homes, hospitals, home health agencies, and dialysis facilities; and
- View Medicare publications.
Visit the Medicare website for more information on these services.
If you need to find out your claim status, find out deductibles, or get answers to premium payment questions, you can call 1-800-MEDICARE (1-800-633-4227; TTY: 1-877-486-2048).
Determining who to contact is the first step in getting the answers you need. Please share these lists with family and friends who need to know more about Social Security and Medicare.
https://blog.ssa.gov/who-to-contact-social-security-or-medicare/?utm_campaign=&utm_content=&utm_medium=email&utm_source=govdelivery
Find Resources to Improve Your Living Conditions
January 31, 2019
According to the U.S. Census Bureau, 12% of Americans, or almost 40 million people, are living in poverty. Benefits.gov offers information on a range of resources that can help improve the living conditions of individuals and their families. If you are facing challenges such as homelessness, poor health, or need financial support, you may be eligible for Federal assistance through the following programs.
Housing
If you need housing support, the U.S. Department of Housing and Urban Development (HUD) offers a Resource Locator Tool, where you can view housing resources offered in your state, from local shelter information to guidance on foreclosure prevention. If you have a low income and need help finding affordable rental housing, you may be eligible for HUD’s Housing Choice Voucher Program (Section 8)offered through your local Public Housing Authority.
If you need housing support, the U.S. Department of Housing and Urban Development (HUD) offers a Resource Locator Tool, where you can view housing resources offered in your state, from local shelter information to guidance on foreclosure prevention. If you have a low income and need help finding affordable rental housing, you may be eligible for HUD’s Housing Choice Voucher Program (Section 8)offered through your local Public Housing Authority.
Healthcare
Medicaid provides free or low-cost health coverage to eligible low-income adults and children. Medicaid programs and eligibility requirements vary from state to state, but Healthcare.gov allows you to search by state to find requirements. The U.S. Department of Health and Human Services (HHS)offers the Children’s Health Insurance Program (CHIP), providing health coverage to children in families that may not qualify for Medicaid. CHIP benefits and eligibility requirements are different in each state, but InsureKidsNow.gov provides information on the available programs by state.
Medicaid provides free or low-cost health coverage to eligible low-income adults and children. Medicaid programs and eligibility requirements vary from state to state, but Healthcare.gov allows you to search by state to find requirements. The U.S. Department of Health and Human Services (HHS)offers the Children’s Health Insurance Program (CHIP), providing health coverage to children in families that may not qualify for Medicaid. CHIP benefits and eligibility requirements are different in each state, but InsureKidsNow.gov provides information on the available programs by state.
Financial Assistance
HHS offers many programs with the goal of improving the well-being of individuals and families, including Temporary Assistance for Needy Families (TANF). TANF provides financial assistance to states to help families with things like childcare, employment services, housing, and other necessary expenses. The U.S. Department of Agriculture Supplemental Nutrition Assistance Program (SNAP)offers benefits to eligible low-income people and families. Use the SNAP Pre-Screening Tool to help determine if you are eligible to receive SNAP benefits.
HHS offers many programs with the goal of improving the well-being of individuals and families, including Temporary Assistance for Needy Families (TANF). TANF provides financial assistance to states to help families with things like childcare, employment services, housing, and other necessary expenses. The U.S. Department of Agriculture Supplemental Nutrition Assistance Program (SNAP)offers benefits to eligible low-income people and families. Use the SNAP Pre-Screening Tool to help determine if you are eligible to receive SNAP benefits.
To find additional housing, healthcare, or financial resources, visit our Browse by Category page. We also encourage you to take our Benefit Finder questionnaire to find out what additional assistance you may be eligible to receive.
https://www.benefits.gov/compass/article/364?utm_source=govdelivery&utm_medium=email&utm_campaign=dr344
Health care spending is more than just the parts you see
Drew Altman, Kaiser Family Foundation
February 28, 2019
People
focus on the health costs that are most tangible and sometimes outrageous to
them: their deductibles, and drug costs, and surprise medical bills, and the
annual increase in the share of the premium they pay. But there's more that
gets less attention because it's not as visible to them.
Why it
matters: To really understand how Medicare for All or any other big
change in health care financing would affect them, people need to understand
how they would impact their overall family health budgets. Few people think
about the other health costs they pay: their taxes to support health care, or
what their employers are paying towards premiums (which is depressing their
wages).
Between
the lines: Consider this hypothetical example of a total family health
“budget”:
- The Browns, a family
of four with at least one member in poor health and
a $50,000 income, have standard employer coverage much like
156 million other Americans. They spend $9,250 per year (19% of
their income) on health.
- This includes $3,950 (8% of
their income) in out-of-pocket health
spending, $3,900 (8% of their income) in health insurance
premiums, and, although they are almost certainly not aware of it,
approximately $1,400 (3% of their income) in state and federal
taxes that fund health programs.
- The Browns are
not taxed on
the contributions their employer makes toward health insurance premiums,
which economists generally say offset wages. Their employer is contributing
an additional $13,050 to their health insurance premiums, as
well as $750 in Medicare payroll taxes.
- When combined, the
Brown’s spending on health care and the money spent by their employer on
their behalf totals a considerable $23,050. And remember, they make
$50,000.
A few
ideas that could help people learn more about their health total
care spending and how reform proposals might affect their health spending:
- The IRS and
states could
include a simple pie chart on everyone’s tax forms, showing taxpayers
where their tax dollars go today.
- Along with estimating the impact
of health reform legislation on the federal budget, or the number of
uninsured, the CBO could estimate its impact on typical family budgets,
taking into account all of the forms of health spending families have
today. Organizations like ours could do this as well.
What to
watch: This could be particularly important when analyzing Medicare for
All proposals, since they would so significantly alter the financing of health
care by shifting it from premiums and out-of-pocket costs to taxes.
- A Medicare for
All plan would
likely reduce what the nation spends on health care by lowering payment
rates to providers and creating administrative efficiencies. The average
family would likely pay less, but how much is hard to say without more
details.
- However, by changing the financing so significantly,
there would likely be both winners and losers. Low-income people and sick
people might pay less, and higher-income people and those who are healthy
could pay more.
The
bottom line: We can only get a clear picture of how family finances would be
affected by Medicare for All, or any other significant overhaul of the health
care system, by looking at the totality of what they pay now.
https://www.axios.com/understanding-health-care-spending-46e21c47-79ee-474b-80ff-778a705cdcae.html?utm_campaign=KFF%3A%20Drew%27s%20Columns&utm_medium=email&_hsenc=p2ANqtz-8LC489zrRwouoPFZbp5bDc1uOFXrYJKZQMe6-MYzKaEy9QNKlre8MFeqqGgV2cBYqULGF6lV_fgdFduHoa2Tn5iQyS3w&_hsmi=70342486&utm_content=70342486&utm_source=hs_email&hsCtaTracking=66083bbc-90fb-439a-a527-852ede240988%7Ca5ccaddb-8634-4d8a-95c0-17d0775a9d86
CMS updates hospital star ratings but seeks feedback on more changes
MARIA CASTELLUCCI February 28, 2019 10:10 AM
The CMS
is seeking comments from stakeholders on suggested changes to the hospital star
ratings even as the agency updates the Hospital Compare website with the newest
ratings after a nearly 15-month hiatus.
In a
press release Thursday morning, the CMS said a public comment page has opened
for stakeholders to provide feedback on the possibility that the agency will
separate hospitals into "peer groups" when comparing how they perform
on the 57 measures used to assign star ratings. The agency said hospitals could
be separated by bed-size and status like community or teaching. A CMS agency
official said the new comment period is in response to feedback from
stakeholders that the star ratings methodology needs to be changed in order to
better assess quality of care at hospitals.
"We
are putting out (this comment period) to get a greater breath of input on any
potential future changes that we might continue to make to the program,"
she added. But even as the CMS acknowledges opportunities to improve the
ratings system, the CMS official said she stands by the current star ratings as
a helpful tool for consumers.
The CMS
has been in hot water over its hospital star ratings since they first published
on Hospital Compare in July 2016. Hospital groups argue that the ratings
inaccurately depict quality of care at hospitals. The pushback hit a peak last
year after a preview of the July 2018 update had some hospitals seeing drastic changes to
their star ratings in just six months. The controversy led the CMS to withhold a new release
of the star ratings since December
2017.
The
suggestion to separate hospitals into peer groups addresses a common sticking
point for teaching hospitals who say they get low ratings because their
performance on measures is compared to specialty and small community hospitals
that don't have the same case mix, including patients with socioeconomic
challenges.
A Modern
Healthcare analysis last year
found that specialty hospitals receive disproportionately higher ratings than
teaching hospitals.
The
public comment period will end March 29.
The
latest star ratings update to Hospital Compare didn't see any changes from the
preview report the CMS released to providers in December, an agency official
said. At the time, hospital stakeholders expressed disappointment
that the February star ratings won't have substantial changes to the
methodology.
The one
change the CMS made to the February star ratings was how the
healthcare-associated infections measures used in the methodology were
weighted, which allowed those measures to have a greater impact on a hospital's
overall rating. The CMS also will remove measures that have statistically
significant negative loading from the star ratings, but that didn't happen in
the February star ratings release, the CMS official said.
Senate Drug Hearing Produces Few Fireworks
Merck's CEO said sick patients are subsidizing healthy patients'
insurance premiums.
By Timothy Annett
and Anna Edney | February 26, 2019 at 06:54 PM
A highly anticipated Senate hearing on surging
drug prices that was billed as a replay of a decades-ago public reckoning for the
tobacco industry produced few memorable fireworks.
Instead, what emerged was a broad recognition
that the U.S. health care system is complex, and that easy fixes are in short
supply.
Lawmakers from the Senate Finance Committee
largely refrained from bashing seven senior pharmaceutical executives who came
to Capitol Hill to explain why medicines cost so much. Many of the techniques
the industry has used to preserve its profits from blockbuster drugs came in
for criticism, but company officials were able to place much of the blame on a
patchwork of incentives that culminates in high out-of-pocket costs for
patients.
“I feel like I need a Ph.D. in prescription
drug-pricing to understand how the heck this industry works,” said Senator
Maggie Hassan, the New Hampshire Democrat.
The hearing marks the start of what is likely
to be a prolonged bipartisan push to tackle soaring health costs that could
extend far beyond drugmakers. Republicans and Democrats have been largely in
agreement on the need to address an acute source of strain for many American
families. The Trump administration has proposed new rules and approved a slew
of new generic drugs, and has signaled openness to more ambitious changes.
Iowa Republican Chuck Grassley, the
committee’s chairman, said it wasn’t yet clear which issues the Senate would
act on first. Grassley has previously pushed legislation that would do away
with various moves branded drugmakers have used to thwart generic competition.
“They realize there’s a problem and I think
every one of them is going to help us solve it,” Grassley said to reporters
after the hearing concluded.
Investors appeared relieved that the industry
was spared a pointed public thrashing. The S&P 500 Pharmaceuticals Index,
which includes heavyweights such as Bristol-Myers Squibb Co. and Pfizer Inc.,
was modestly higher in midafternoon trading, bucking a slide in the broader
U.S. stock market.
“The only way things could have gone sideways
is if a CEO got baited into losing their cool and going off script,” said Rob
Smith, an analyst at Capital Alpha Partners, a Washington-based research firm.
“They’ve stuck to the same talking points we’ve heard for years.”
Familiar Argument
The most intractable issue in crafting any new
legislation is likely to be determining which part of the drug-supply chain is
most responsible for increasing prices and which part of the industry can
withstand major changes without destroying jobs or profits.
At Tuesday’s hearing, pharmaceutical
executives stuck to their oft-rehearsed argument that rebates for drug-plan
middlemen have clouded the true price of prescription drugs. Most of them said
that they would lower list prices for their drugs if rebates were to disappear
— a proposal that would upend the pharmacy-benefit management business.
Last year, the three largest PBMs — CVS Health
Corp., UnitedHealth Group Inc.’s OptumRx and Cigna Corp.’s Express Scripts unit
— processed 76% of U.S. prescriptions, according to preliminary estimates by
the Drug Channels Institute.
Lawmakers had warned drugmakers not to blame
others for higher costs. Oregon Senator Ron Wyden, the ranking Democrat on the
panel, called the idea that rebates and other fees are to blame for high drug
costs “window dressing,” suggesting pharmaceutical companies bare the bulk of
responsibility for high patients costs for lifesaving medicines.
But Wyden also indicated PBMs and health
insurers would have their turn before the panel. Indeed, shares of prominent
pharmacy-benefit managers declined more deeply than most drug stocks on
Tuesday. Cigna saw its shares slide by as much as 1.8% as of 2:20 p.m. in New
York, while CVS fell by as much as 1 percent.
Economic Handcuffs
Merck & Co. Chief Executive Officer
Kenneth Frazier said that rebates force drug companies to set a high price for
their medicines. In prepared remarks to the committee, he said the current
system is designed to keep insurance premiums low, which means “sick patients
are essentially subsidizing healthy patients.”
Frazier said those economics handcuff
drugmakers. “If you bring a product to the market with a low list price in this
system you get punished financially,” he said during the hearing.
Lawmakers also probed the executives on patent
protections that shield many blockbuster therapies from competition — in some
cases, for years past when the original patent for the medications lapsed.
Senators pushed AbbVie Inc. CEO Richard Gonzalez on the fortress of 136 patents
the company has erected around arthritis drug Humira, one of the
biggest-selling medicines in the world.
“That patent portfolio evolved as we
discovered and learned new things about Humira,” Gonzalez said. The main
patent, known as the composition-of-matter patent, expired in 2016, but AbbVie
was able to continue to protect the drug with patents for new uses.
Senator John Cornyn, a Texas Republican, said
he would suggest the Judiciary Committee on which he also sits look into
patents.
—With assistance from Riley Griffin and Bailey Lipschultz.
Copyright 2019
Bloomberg. All rights reserved. This material may not be published, broadcast,
rewritten, or redistributed.
https://www.thinkadvisor.com/2019/02/26/senate-drug-hearing-produces-few-fireworks/?slreturn=20190128101916
What a Complete Blood Count Says About Your Health
December 12, 2017 / Family Medicine
The CBC can explain
fatigue, bruising, swelling and more
Your complete blood count (CBC) is a quick,
easy and practically painless blood test. “It gives your doctor an overview
of your health,” explains family medicine physician Daniel Allan, MD. Tap
or click to learn more:
One of the most common
blood tests
The CBC is typically part of your regular
checkup. "I also order a complete blood count for patients who are
weak or tired; have swelling, bruising or bleeding; or who may have an
infection,” Dr. Allan. explains. "This test also can help me check how a
patient’s body is responding to medication.”
What if your test results are abnormal?
Don't worry. They don't necessarily mean you’re sick.
Diet, menstrual cycle, medication and other
factors can affect your scores. Talk to your doctor about your CBC
results. He or she will explain any areas of concern and help you determine
next steps.
https://health.clevelandclinic.org/what-a-complete-blood-count-says-about-your-health/?utm_campaign=cc%20posts&utm_medium=social&utm_source=facebook&utm_content=1902018%20cbc&cvosrc=social%20network.facebook.cc%20posts&cvo_creative=1902018%20cbc
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