We have public options now. Are they any good?
Filed under: Government, Health care reform, Hot Health Headline
ProPublica’s Sabrina Shankman reviews America’s existing “public options” for health care, finding mixed results and limited utility. In addition to Medicare and Medicaid, Shankman reviews a few less prominent institutions:
- The armed forces Tricare plan: Covers all active members of the military, retirees and their families, regardless of preexisting conditions. If you stick to military treatment facilities, it’s cheap.
- Veterans Health Administration: Veterans who meet its standards are guaranteed high quality care, but funding is tight at the VA right now.
- Indian Health Service: Allows American Indians and Alaska Natives free access to reservation clinics… until the service’s funding runs out, as it does about halfway through each year.
- Healthcare Group of Arizona: It was founded to provide afforable insurance to certain small businesses, but a lack of funds and climbing deductibles mean that many employers will be better off looking to the private market anyway.
Reuters has a handy summary of the key provisions of the latest bill likely to be considered by the House of Representatives.
Key CMS database unresponsive, inadequate
Filed under: Health data, Hot Health Headline, Public records, Studies
The Department of Health and Human Services’ Office of Inspector General released a memo (27-page PDF) detailing an investigation that found that the effectiveness of a key database used for detecting Medicaid fraud has been compromised by slow response times and inefficient data tracking.
The Centers for Medicare and Medicaid Services’ Medicaid Statistical Information System is “the only nationwide Medicaid eligibility and claims information source.” It aggregates Medicaid from states, and its data are relied upon by a number of other federal databases and agencies. MSIS is used as a source on everything from data releases to congressional inquiries.
And, as is most relevant to the OIG’s investigation, MSIS is used by Medicaid Integrity Program to detect fraud, waste and abuse in the system. In the course of the investigation, OIG agents evaluated MSIS for immediacy, accuracy and utility. Investigators found that, between 2004 and 2006, eligibility and claims files both took almost 600 days to complete their file submission and validation process, and that “states submitted nearly two-thirds of the initial MSIS file submissions after the CMS due dates.” Furthermore, 32 states didn’t even get their submissions in within six months of the deadline.
Investigators also faulted CMS for not reporting adjustments that would affect statistical error in the data and for not tracking categories that would be useful in detecting fraud.
(Hat tip to Peter Newbatt Smith of The Center for Public Integrity)
Health a factor in report card on homeless kids
The National Center on Family Homelessness has released a report card on child homelessness, with an estimate that more than 1.5 million children in the United States are homeless.
The report points out that:
“Children without homes are twice as likely to experience hunger as other children. Two-thirds worry they won’t have enough to eat. More than one-third of homeless children report being forced to skip meals. Homelessness makes children sick. Children who experience homelessness
are more than twice as likely as middle class children to have moderate to severe acute and chronic health problems.”
Health is one measure taken into account for the report’s child well-being score and the report has sections that deal with the health of children as well as policy initiatives, such as Medicaid and SCHIP.
The report has a state-by-state breakdown that shows the percentage of uninsured children, Medicaid expenditures and eligibility and other measures. It also includes rankings and an evaluation of each state’s policy and planning for homelessness.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
