Removing Barriers to Exchanging Electronic Health Records Would Help Consumers

  Over the past five years, taxpayers have doled out over $30 billion in bonus payments to push hospitals and doctors’ offices to switch from paper to electronic medical records. Now nearly all hospitals and over half of all office-based doctors have gone digital; but much of that electronic information doesn’t flow freely between health care providers because their separate software systems do not communicate — and consumers are losing out. Consumers win when electronic health records (EHR) systems talk …

Covering Low-Income Midlife Adults Through Medicaid: Making Progress, but More States Need to Take the Plunge

The Affordable Care Act — as interpreted by the U.S. Supreme Court — gives states the option to expand Medicaid. Access to Medicaid significantly reduces the number of uninsured in this country. Since the expansion began, millions of individuals are receiving coverage through Medicaid or the Children’s Health Insurance Program. Yet, 19 states have not expanded Medicaid coverage, potentially leaving almost 2 million low-income midlife adults (ages 45-64) without access to insurance coverage. Being uninsured is especially hard on adults …

Food Insecurity and Older Adults: What States Can Do to Help

En español | Food insecurity is a significant public health problem for older adults. In 2014, nearly 8 percent (3.47 million) of Americans age 65 and older were living in food insecure households, meaning they did not have balanced meals or enough to eat because they could not afford it. According to current estimates, the share of food-insecure older adults will increase 50 percent by 2025. Many low-income older adults who suffer from food insecurity are often forced to use …

Is Observation Status Substituting for Hospital Readmission?

Since October 2012, the Medicare program has penalized hospitals when too many patients in traditional Medicare are re-hospitalized within a month of discharge. This policy appears to be having unintended consequences for patients in Medicare and in the commercial market. Hospitals with readmission rates above the national average now receive lower payments across-the-board from Medicare; the higher the rate of “excess” readmissions, the greater the penalty. The fines are intended to push hospitals to provide better care for their patients …

New Medicare Program May Be Reducing Hospital Readmissions for Joint Replacement Patients

Lately you may have noticed a growing number of commercials filled with people happily touting the benefits of their new joints. Experts expect such procedures to become increasingly popular as the active boomer population continues to age. However, the commercials typically gloss over the fact that joint replacements do not come without risk: Implant-related complications are common and can lead to unplanned hospital readmissions. While many hospital readmissions are unavoidable, experts believe hospitals can reduce readmissions for certain conditions. Accordingly, …

It’s a Shame: Low-Income Medicare Beneficiaries Continue to Be Plagued With Balance Billing

Federal law prohibits traditional Medicare and Medicare Advantage providers and suppliers from billing people who are qualified Medicare beneficiaries (QMBs) for Medicare deductibles, coinsurance and copayments — a practice known as balance billing. Qualified Medicare beneficiaries (QMBs) are people with Medicare who have incomes at or below 100 percent of the federal poverty level — or a higher level set by their state — and very few resources. In spite of the prohibition, many QMBs are receiving and, out of …