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Medicaid Primary Care Pay: The Next SGR?
Reid Blackwelder, MD, a family physician in Kingsport, Tenn., said primary care physicians in his state would benefit immensely from a federal proposal raising Medicaid payments to equal what Medicare pays for the same services.
TennCare, the state’s Medicaid program, currently pays him only 60% of Medicare rates, Dr. Blackwelder said. If TennCare had paid 100% of Medicare rates for the previous 10 months of billing, from July 2011 through April 2012, “we would have made an additional $400,000 in our three residency programs,” said Dr. Blackwelder, a professor of family medicine at East Tennessee State University Quillen College of Medicine. Medicaid beneficiaries make up nearly 40% of the residency programs’ patient base.
Read the full story: http://hcp.lv/JyxcZA
Source: amednews.com
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
April 4th 2025This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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