I'm a research associate at Duke University Margolis Center. I used to be Richard Mayhew, a mid-level bureaucrat at UPMC Health Plan. I started writing here and have not found a reason to stop.
We’ve talked about the Copper plans being proposed by Senator Begich (D-Alaska) and others earlier this year. The basic thrust of the policy is the following: Right now, minimal essential coverage for people over the age of 29 and those not facing a hardship is a Bronze plan. That plan covers 60% of the average […]
If we were not engaged in a systemic freak out about a disease that has not killed anyone infected on US soil yet, we would be aggressively vaccinating for the flu right now. The flu is a disease that kills thousands in a good year, and tens of thousands in an average year. Its early […]
Back in 2008, there was an excellent study on the cost of losing health insurance and then regaining it for people with chronic conditions. RESULTS: Overall total program expenditures were higher for post-lapse periods compared with pre-lapse periods. Total expenditures were estimated to increase by $239 per member per month for the 3-month period. The […]
Just a few good ideas that I saw this morning: Question: if there’s no medical reason for the quarantine tent in New Jersey, would the nurse’s insurance company fight the bill? — Niels Lesniewski (@nielslesniewski) October 27, 2014 Really good question. Medical insurance tends to pay for “medically necessary” care and little else above and […]
Utah had been on my list of highly probable Medicaid expansion states for a while now. They’ve been in talks with Health and Human Services (HHS) for a 1115 waiver and their discussions have been wide ranging. Last Friday, it looks like the outlines of a deal have been agreed to: “They are giving us […]
Now that I’ve gotten your attention, it is actually a Forbes writer who wants to block grant Medicaid and allow states to conduct explicit cost effectiveness decisions for what treatments Medicaid will fund. Those decisions will lead to numerous early deaths. an advisory board recommended that Arkansas’s Medicaid program cover Kalydeco, a cystic fibrosis drug […]
Last week, a major specialty practice in the east suburbs of my central city announced that they had agreed to be bought out by Big City Medical Group. BCMG will now control 85% of the orthopedists, 100% of the dermatologists, 90% of the nephrologists, 75% of the oral surgeons and 50% of the cardiologists who […]