States Finding It Hard To Coordinate Care For People Who Have Medicare And Medicaid
A report to CMS looks at difficulties encountered by states running demonstration programs. Also in the news, Medicare officials are weighing opioid abuse efforts and advocates are pressing for coverage of genetic sequencing of tumors.
Modern Healthcare:
States Find It Hard And Expensive To Coordinate Care For Duals
States say it's harder and more expensive than initially predicted to coordinate care for the roughly 9 million people who are dually eligible for Medicare and Medicaid. ... Many in this population have severe chronic conditions and physical or behavioral disabilities. ... CMS hired research firm RTI International to perform an independent analysis of the state demonstrations aimed at better aligning the coverage and services of American who are so-called dual-eligibles. The audit would help find ways to cut costs. RTI's initial report (PDF) was completed in October 2015 but was published on the CMS' website just last week. (Dickson, 1/25)
Modern Healthcare:
Opioid Abuse Discussions Include Medicare Program
There's growing attention and support for the inclusion of a patient review and restriction program in Medicare to help prevent opioid overuse and addiction.In a congressional hearing last week on a separate topic, the CMS Acting Administrator Andy Slavitt lauded such programs. (Muchmore, 1/25)
STAT:
Calls Intensify To Get Medicare To Pay For Genetic Sequencing Of Tumors
The Obama administration is facing growing calls to allow Medicare and Medicaid to pay for advanced gene-sequencing of tumors, a step proponents say will help both cancer patients and scientific research. The appeals have grown louder since Vice President Joe Biden announced his “moonshot” to cure cancer, and top researchers said they raised the issue in a private meeting recently with Biden’s staff. (Scott, 1/26)
Meanwhile, a newspaper examines the cost of insulin for patients —
The Philadelphia Inquirer:
Patients Shocked As Insulin Prices Climb Higher
Injectable insulin, which keeps some diabetics alive and keeps others out of serious health crises, has soared in price in the past few years. “It is out of control,” said Carol Hammond, 72, a Philadelphia diabetic who survives on Social Security. “My rent isn’t too bad, but after paying for insulin, I don’t have much left.” Hammond said she skips buying or taking doses because her Medicare and Medicare Advantage health-insurance plans don’t always cover the cost of her insulin at the pharmacy counter. Her doctor helps her find it cheaper and gives her an occasional sample. (Sell, 1/24)
Related KHN article: You Can Buy Insulin Without A Prescription, But Should You? (Tribble, 12/14)