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Morning Briefing

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Monday, Jul 20 2015

Full Issue

State Highlights: Florida's Medicaid Managed Care Model Achieves Cost-Cutting Goals; Iowa Soon To Launch Computerized System To Track Available Mental Health Beds

Health care stories are reported from Florida, Iowa, D.C., Pennsylvania, California, New Mexico and Texas.

In less than a year, Florida鈥檚 switch to privately managed healthcare for more than 3 million poor, disabled and elderly residents has achieved one of its primary goals: cutting costs for Medicaid, the public health insurance program for low-income people that accounted for roughly one-fifth or about $9.5 billion of state spending last year. But the savings may be short lived after the private companies that took over insuring Florida鈥檚 Medicaid patients asked for a mid-year raise of nearly $400 million. (Chang, 7/17)

State administrators will soon launch a computerized system designed to track the availability of psychiatric beds throughout Iowa. The registry is supposed to allow emergency department staffers, social workers and other professionals to see if any of the approximately 700 psychiatric beds in Iowa are open. (Leys, 7/19)

Medicaid recipients in Washington, D.C., may be entitled to an explanation and written notice of their right to request a hearing whenever their claim for prescription-drug coverage is denied, the D.C. Circuit Court of Appeals ruled on Friday. The decision revives part of a potential class action that was filed five years ago in U.S. District Court in Washington, D.C. The nine named plaintiffs said they had tried to fill prescriptions at area pharmacies, but the District of Columbia and its third-party Medicaid administrator, Xerox, refused to authorize payment, did not tell them why or that they could request a hearing to challenge the denial. (Grzincic, 7/17)

Consumer advocates worry that merging Aetna and Humana into the country鈥檚 second-largest health insurer might encourage near monopolies, regional hot spots where the companies could dominate pricing and access to care. But the opposite could be true in Western Pennsylvania, where the proposed merger could help control costs and deliver new coverage options for more than 400,000 senior citizens on Medicare Advantage, industry observers said. (Smeltz, 7/19)

After suffering major cuts during the last recession, Sacramento County鈥檚 mental health programs are finally bouncing back with an influx of state money that will more than double the number of beds for people needing crisis mental health care. (Caiola, 7/18)

The 19-month saga of the struggling Daughters of Charity Health System took an unexpected turn Friday after the nonprofit hospital chain announced that it will be financed by an East Coast hedge fund. (Seipel, 7/17)

Bernalillo County officials learned that 58 percent of inmates at the Metropolitan Detention Center were enrolled in Medicaid during a one-day 鈥渟napshot鈥 of the jail鈥檚 population last month, said Tom Swisstack, deputy county manager for public safety. The finding is good news for the county, which is developing a pilot program to enroll all eligible inmates in Medicaid, he said. The ultimate goal is to prevent inmates from returning to jail by enrolling them in medical, mental health and substance abuse services from the day they leave custody, Swisstack said. (Uyttebrouck, 7/20)

Sensing a new vein of potential profits to be mined in the multibillion-dollar health care industry, a small but growing number of private equity firms is seeking to buy into primary care practices, interviews with doctors and financial analysts suggest. Policy shifts in the way public programs like Medicare pay for care, financial factors such as low interest rates and changing employment preferences among young doctors are aligning to intrigue investors, experts said. (Walters, 7/18)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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