Health Wonk Review – The Falling Leaves Edition


by Louise Norris

Source: Health Wonk Review

Welcome to the Falling Leaves edition of the Health Wonk Review!  Grab your pumpkin-flavored whatever and pull up a chair – we’ve got lots of good stuff from the health wonks this week.  The election is coming – don’t forget to vote! – and so is open enrollment, so there’s lots to talk about when it comes to the ongoing story of Obamacare.  And of course Ebola is on a lot of minds lately too.  But there’s also plenty of other interesting stuff going on in the world of health policy, and we’ve got a little something for everyone here.  Enjoy!

John R. Graham from the NPCA’s Health Policy Blog writes about health outcomes for people on Medicaid, and addresses ways that we can improve those outcomes going forward.  His piece is a fascinating look at the dichotomy that often pops up when people refer to studies on Medicaid outcomes:  One side says that Medicaid is worse than no coverage at all in terms of how patients fare, while the other side points out that Medicaid does a good job of managing numerous health conditions.  So how do we reconcile such diverse claims?  It appears that it’s mostly a factor of what groups are being studied.  The majority of elderly and disabled Medicaid beneficiaries (who account for most Medicaid spending and tend, not surprisingly, to have the worst health outcomes) are enrolled in the government-run fee-for-service Medicaid program.  But the majority of the rest of the Medicaid population (including pregnant women, children, and the newly-eligible non-disabled adults), are enrolled in coverage through private plans that contract with the government to provide Medicaid managed care (MCOs) or primary care case management (PCCMs).  Comparing the outcomes of those two groups isn’t particularly helpful.  But John suggests that increasing enrollment in private Medicaid plans and increasing focus on the needs of very ill Medicaid patients could help to improve the outcomes of the group that’s currently the subject of the claims that Medicaid is no better than no insurance at all (by the way, that’s a rallying cry for people who would prefer to simply leave millions of Americans with no insurance at all – it suits their needs to make such claims without digging further to find out more about the underlying causes).