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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
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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Insurance Gaps Threaten Cancer Treatment Success
July 7th 2025Access to and affordability of immune checkpoint inhibitors, which can be lifesaving if patients receive them on time and under optimal circumstances, continue to top the list of reasons behind outcomes disparities for patients who have private insurance vs those who remain uninsured.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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