Supportive Housing Keeps People Healthy. Should Medicaid Pay?

With federal housing money in short supply, state and local authorities are looking to health dollars to help tackle homelessness.

#affordable-housing, #group-homes-and-supportive-housing, #health-insurance-and-managed-care, #homeless-persons, #internal-open-access, #medicaid

How South Dakota Voters Won a Power Struggle With G.O.P. Legislators

The state roundly rejected a proposal, meant to block Medicaid expansion, that would have reduced voters’ ability to direct policy. It was just the latest clash between voters and state legislatures.

#boudin-chesa, #caruso-rick-j, #internal-sub-only-nl, #law-and-legislation, #medicaid, #midterm-elections-2022, #referendums, #south-dakota, #united-states-politics-and-government

To Be Pro-Choice, You Must Have the Privilege of Having Choices

As we contend with the racial reckoning in this country, we must acknowledge the role that race plays in sexual and reproductive health outcomes.

#abortion, #health-insurance-and-managed-care, #medicaid, #minorities, #pregnancy-and-childbirth, #race-and-ethnicity, #roe-v-wade-supreme-court-decision

Americans on Medicaid Could Soon Lose Health Insurance

Millions of Americans may lose their Medicaid coverage.

#coronavirus-2019-ncov, #health-insurance-and-managed-care, #medicaid, #patient-protection-and-affordable-care-act-2010

Meet the Underdog of Senior Care

The Program of All-Inclusive Care for the Elderly, funded by Medicare and Medicaid, has quietly succeeded in enabling some older Americans to age in place.

#archcare, #elder-care, #elderly, #health-insurance-and-managed-care, #home-health-care, #jersey-city-nj, #medicaid, #medicare, #nursing-homes, #your-feed-healthcare, #your-feed-science

For Older Americans, Some Positive Health News

Three recent developments — incremental and undramatic but encouraging — are likely to improve the lives and health of seniors.

#california, #coronavirus-reopenings, #elderly, #health-insurance-and-managed-care, #hospitals, #medicaid, #medicare, #nursing-homes, #social-security-us, #social-security-administration, #your-feed-healthcare, #your-feed-science

How Being Sick Changed My Health Care Views

A chronic illness made me more left-wing and more libertarian at once.

#bankruptcies, #centers-for-disease-control-and-prevention, #food-and-drug-administration, #great-britain, #health-insurance-and-managed-care, #independent-payment-advisory-board, #innovation, #lyme-disease, #medicaid, #multiple-sclerosis, #patient-protection-and-affordable-care-act-2010, #united-states

Financial Planning for People With Chronic Diseases

Financial planning for people with chronic diseases is complicated and multifaceted. Start by building a team of people to help.

#chronic-condition-health, #content-type-service, #disabilities, #disability-insurance, #drugs-pharmaceuticals, #elderly, #medicaid, #medicare, #national-multiple-sclerosis-society, #pensions-and-retirement-plans, #personal-finances, #retirement

Biden Administration Rejects Medicaid Work Requirements in Georgia

The decision continued the administration’s rollback of the Trump-era policy, targeting the only remaining state with federal approval for the requirements.

#biden-joseph-r-jr, #centers-for-medicare-and-medicaid-services, #coronavirus-2019-ncov, #georgia, #health-insurance-and-managed-care, #medicaid, #states-us, #trump-donald-j, #united-states-politics-and-government

Obamacare Sign-Ups Reach Record as Virus Rocks Job-Based Coverage

Thanks to increased subsidies, new advertising, and a reshaped insurance landscape, 13.6 million Americans have enrolled in plans for 2022. Enrollment continues until Jan. 15.

#american-rescue-plan-2021, #health-insurance-and-managed-care, #insurance, #medicaid, #patient-protection-and-affordable-care-act-2010

The Medicaid Reentry Act Could Save Lives

The Medicaid Re-entry Act ought to become law, regardless of the fate of Build Back Better.

#ex-convicts, #health-insurance-and-managed-care, #house-of-representatives, #manchin-joe-iii, #medicaid, #prisons-and-prisoners, #senate, #tonko-paul-d, #united-states-politics-and-government

Build Back Better Act Would Patch Holes in Health Coverage

Taken together, the provisions in the social policy bill represent the biggest step toward universal coverage since the passage of the Affordable Care Act.

#drugs-pharmaceuticals, #health-insurance-and-managed-care, #law-and-legislation, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010

Democrats’ Bill Would Cover Poor Uninsured Adults, Up to a Point

The $1.85 trillion social policy bill would provide free private health insurance for more than two million adults locked out of coverage, but only for four years.

#federal-budget-us, #georgia, #health-insurance-and-managed-care, #medicaid, #patient-protection-and-affordable-care-act-2010, #united-states-politics-and-government, #warnock-raphael-g

Biden Promised to Fix Home Care for Seniors. Much More Help May Be Needed.

The latest Democratic proposal would funnel $150 billion toward subsidized home and community-based care. Experts worry that may not be enough to ease the severe shortage of workers.

#biden-joseph-r-jr, #democratic-party, #elderly, #health-insurance-and-managed-care, #home-health-care, #medicaid, #nursing-homes, #united-states-politics-and-government, #wages-and-salaries, #your-feed-healthcare

Home Care Is Broken. Can Congress Fix It?

The latest Democratic proposal would funnel $150 billion toward subsidized home and community-based care. Experts worry that may not be enough to ease the severe shortage of workers.

#biden-joseph-r-jr, #democratic-party, #elderly, #health-insurance-and-managed-care, #home-health-care, #medicaid, #nursing-homes, #united-states-politics-and-government, #wages-and-salaries, #your-feed-healthcare

Health coverage would be expanded under the Democrats’ spending plan.

The insurance expansion would offer free private plans to many low-income adults and financial assistance with premiums to higher earners.

#american-families-plan-2021, #democratic-party, #drugs-pharmaceuticals, #elderly, #health-insurance-and-managed-care, #law-and-legislation, #medicaid, #medicare, #united-states-politics-and-government

Biden and Democrats Push for Budget Deal This Week as Rifts Remain

Negotiators were closing in on a deal that could spend around $1.75 trillion, but lawmakers were still haggling over critical disagreements on the sprawling social policy bill.

#alternative-and-renewable-energy, #american-families-plan-2021, #american-jobs-plan-2021, #biden-joseph-r-jr, #democratic-party, #drugs-pharmaceuticals, #federal-budget-us, #global-warming, #high-net-worth-individuals, #house-of-representatives, #manchin-joe-iii, #medicaid, #medicare, #paid-time-off, #schumer-charles-e, #senate, #united-states-politics-and-government

Long Hours, Low Pay, Loneliness and a Booming Industry

The ranks of home health aides are expected to grow more than any other job in the next decade. What kind of work are they being asked to do?

#americare, #coronavirus-2019-ncov, #dessin-yvette, #elder-care, #home-health-care, #labor-and-jobs, #medicaid, #monah-helen, #regulation-and-deregulation-of-industry, #working-hours, #workplace-hazards-and-violations

Medicare Expansion Clashes With Health Care for the Poor as Budget Bill Shrinks

Under pressure to cut the bill’s cost, Democrats disagree over whether to offer more benefits to older Americans or to cover more of the working poor.

#democratic-party, #health-and-human-services-department, #health-insurance-and-managed-care, #house-committee-on-ways-and-means, #medicaid, #medicare, #united-states-politics-and-government

Babyscripts secures $12M to roll out its virtual maternity care model

Obstetrics virtual care company Babyscripts raised $12 million in the first round of a Series B investment that will enable the company to accelerate the roll out of its virtual maternity care tool platform to providers.

MemorialCare Innovation Fund led the investment and was joined by Philips Ventures and the CU Healthcare Innovation Fund. The new round of funding gives Babyscripts around $26 million raised to date, Babyscripts co-founder and president Juan Pablo Segura told TechCrunch.

We last checked in on Washington, D.C-based Babyscripts two years ago when Phillips led a $6 million investment into the company. A lot has happened since 2019, Segura said.

At the time, the company had one product and was working with hospitals and healthcare providers to distribute a medical device and mobile app to expecting mothers for monitoring blood pressure and providing neonatal care information.

Today, the company has multiple kits that can be targeted to patients, including blood pressure monitoring, weight and captured blood sugars. Babyscripts can automate 40% to 50% of prenatal care and alert doctors as health problems occur so that both mother and baby are healthy. At one physician site, use of Babyscripts helped open up close to 1,000 appointments in a year so obstetricians there could focus on higher-risk patients, Segura said.

It also has larger population health focuses — driven mainly by the pandemic — to help higher-risk expecting mothers with remote patient monitoring and virtual care, as well as work to solve health inequity issues.

More than 70% of patients using Babyscripts are on Medicaid, which may be the only safety net provider in the patient’s geography, Segura said. As a result, the company began forming partnerships with public health departments, managed Medicaid plans and providers, like Priva Health, so that Babyscripts could be paid for at the local level.

“Right now, one of the biggest challenges for a pregnant patient on Medicaid and working an hourly job is asking moms to choose between prenatal care and putting food on the table,” he added. “Fifty percent of maternal complications can be avoided, but a lot of these issues come from the fact that the model of delivery care hasn’t changed in 40 years. About 12% to 15% of deaths come from blood pressure complications. If we could monitor via Babyscripts or more coordinated care to get intervention faster, we could eliminate massive swaths of delivery events in maternity and reduce mortality events in this country.”

Amid the pandemic, Babyscripts saw enrollments grow 10x. Segura decided to go after a new round of funding to meet that need and opportunities that could be addressed. Babyscripts’s program is now being used by 75 health systems in 32 states, and the company is monitoring 250,000 women each year.

The company continues to receive inquiries from markets and payers that are looking to do more for pregnant patients, so Segura wants to be able to grow to meet that demand and invest in a go-to-market strategy to get its kits into as many hands as possible.

The new funding will also enable the company to release new features. It recently launched a mental health product and is developing a substance use disorder experience amid others, he said. Babyscripts is also working on a national level with payers and is building an infrastructure around that as well.

The company has 45 employees currently, and Segura expects to double that in the next 12 to 18 months in the areas of product, payer growth, clinical expertise, implementation and customer success. Babyscripts is also working toward being available in all 50 states and bringing in more public health departments and payers as partners to get more health systems working together, he added.

Meanwhile, Caleb Winder, managing director of MemorialCare Innovation Fund, said he was attracted to both Babyscripts’ outcomes data and addressing the high rates of complications in pregnancies. It also not only eliminates waiting for hours at the doctor’s office just to be seen for five minutes, but also closes some gaps in care, he added.

“One of the problems in this space is that providers, as much as they want to help, are stretched thin,” Winder said. “There are also access problems. Something like 50% of counties in this country lack one OB, so in-person care is difficult. Babyscripts can help patients anywhere be monitored and their health managed virtually. It can also alert a clinician when there is a real problem. We saw their data, for example, that showed preeclampsia was diagnosed 13 days faster than the standard of care.”

#babyscripts, #caleb-winder, #femtech, #funding, #hardware, #health, #health-systems, #juan-pablo-segura, #maternity, #medicaid, #obstetrics, #phillips, #physician, #recent-funding, #startups, #tc

For Tribal Members in Oklahoma, Medicaid Expansion Improves Access to Specialty Care

Medicaid expansion is expected to improve not just access to care for low-income Native Americans who had previously been shut out of health insurance, but the finances of the Indian Health Service.

#health-insurance-and-managed-care, #indian-health-service, #medicaid, #muscogee-creek-nation-okumlgee-okla, #native-americans, #oklahoma

When the New Covid Surge Struck, Mississippi Was Uniquely Unprepared

Poverty and politics have left the state with fewer doctors and nurses than it needs and hospitals on the brink of shutdown.

#coronavirus-2019-ncov, #emergency-medical-treatment, #hospitals, #labor-and-jobs, #medicaid, #mississippi, #politics-and-government, #reeves-tate-1974, #rural-areas, #shortages, #states-us

Getting Old Is a Crisis More and More Americans Can’t Afford

The looming financial crisis for seniors.

#baby-boomers, #elderly, #health-insurance-and-managed-care, #long-term-care-insurance, #medicaid, #medicare

Obamacare’s Survival Is Now Assured, but It Still Has One Big Problem

Twelve states have refused to expand Medicaid, leaving millions of poor Americans without health coverage and Democrats divided over how to respond.

#democratic-party, #health-insurance-and-managed-care, #house-of-representatives, #medicaid, #patient-protection-and-affordable-care-act-2010, #states-us

Medicaid Enrollment Surpassed 80 Million, a Record, During the Pandemic

The increase points to the program’s growing role not just as a safety net, but also as a foundation of U.S. health coverage.

#coronavirus-2019-ncov, #coronavirus-aid-relief-and-economic-security-act-2020, #medicaid, #patient-protection-and-affordable-care-act-2010, #state-childrens-health-insurance-program-s-chip

On Medicare and Need Dental Work? Beware a Big Bill.

The traditional version doesn’t cover dental, vision or hearing care. Advocates hope for change under a Biden proposal.

#biden-joseph-r-jr, #ears-and-hearing, #eyes-and-eyesight, #health-affairs-journal, #health-insurance-and-managed-care, #medicaid, #medicare, #prices-fares-fees-and-rates, #teeth-and-dentistry, #united-states-politics-and-government

How a Nursing Shortage Affects Families With Disabled Children

A nursing shortage — driven by the pandemic — has made life miserable for parents with profoundly disabled children. “What if I’m so exhausted that I make a mistake?”

#children-and-childhood, #coronavirus-2019-ncov, #families-and-family-life, #home-health-care, #medicaid, #nursing-and-nurses, #parenting, #shortages

Covid Pandemic Forces Families to Rethink Nursing Home Care

Even with vaccines, many older people and their relatives are weighing how to manage at-home care for those who can no longer live independently.

#coronavirus-2019-ncov, #elder-care, #elderly, #families-and-family-life, #home-health-care, #medicaid, #nursing-homes, #your-feed-healthcare

Alexia’s Lifelong Nurse Has to Leave Her. Here’s Why.

For the most fragile New Yorkers and those who care for them, turning 23 brings enormous consequences.

#group-homes-and-supportive-housing, #health-department-nys, #home-health-care, #medicaid, #new-york-state, #nursing-and-nurses, #office-for-people-with-developmental-disabilities-nys, #savino-diane-j, #willowbrook-state-school

Biden Takes On Sagging Safety Net With Plan to Fix Long-Term Care

The proposal to spend $400 billion over eight years faces political challenges and a funding system not designed for the burden it has come to bear.

#biden-joseph-r-jr, #disabilities, #elder-care, #elderly, #health-insurance-and-managed-care, #home-health-care, #labor-and-jobs, #medicaid, #wages-and-salaries

Meet the New Cuomo. Same as the Old Cuomo.

We should have known who he was all along.

#cuomo-andrew-m, #democratic-party, #johnson-lyndon-baines, #labor-department-nys, #medicaid, #minimum-wage, #new-york-state, #politics-and-government, #sexual-harassment, #wages-and-salaries

Turning Away From Nursing Homes, to What?

Covid-19 has driven down Americans’ demand for senior care facilities. Building support for more elders to remain at home requires systemic changes.

#content-type-service, #coronavirus-2019-ncov, #elder-care, #elderly, #medicaid, #medicare, #nursing-homes, #retirement

Manufacturing Isn’t Coming Back. Let’s Improve These Jobs Instead.

Health care workers are crucial to our society, yet we reward them with low wages and dangerous conditions.

#centers-for-medicare-and-medicaid-services, #labor-and-jobs, #medicaid, #medicare, #wages-and-salaries

Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

Nursing homes have manipulated the influential star system in ways that have masked deep problems — and left them unprepared for Covid-19.

#bed-sores, #brookdale-senior-living-inc, #centers-for-medicare-and-medicaid-services, #clove-lakes-health-care-and-rehabilitation-center-staten-island-ny, #coronavirus-risks-and-safety-concerns, #elder-care, #health-and-human-services-department, #infections, #life-care-centers-of-america, #manor-care-incorporated, #medicaid, #medicare, #nursing-homes, #united-states

At Last, Democrats Get Chance to Engineer Obamacare 2.0

The Biden administration is trying to make the health care law more generous and closer to its original design, but may disappoint progressive allies hoping for more.

#biden-joseph-r-jr, #health-insurance-and-managed-care, #law-and-legislation, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010

They Say They Are Attacking Abortion. They Are Really Hurting the Poor.

Deep in the heart of Texas, poverty means illness reigns.

#abortion, #health-insurance-and-managed-care, #medicaid, #planned-parenthood-federation-of-america, #texas

Biden Administration Moves to End Work Requirements in Medicaid

Reversing the Trump administration’s policy of allowing states to tether work to health insurance.

#biden-joseph-r-jr, #executive-orders-and-memorandums, #medicaid, #states-us, #verma-seema

Affordable Care Act Enrollment Reopens

The new three-month sign-up period begins Feb. 15, as millions of people have lost their jobs and insurance in the pandemic.

#biden-joseph-r-jr, #centers-for-medicare-and-medicaid-services, #content-type-service, #coronavirus-2019-ncov, #executive-orders-and-memorandums, #health-insurance-and-managed-care, #healthcare-gov, #medicaid, #patient-protection-and-affordable-care-act-2010, #unemployment

Burned by Low Reimbursements, Some Doctors Stop Testing for Covid

Some insurers pay pediatricians less than the cost of the test itself, jeopardizing a tool to help control the pandemic.

#children-and-childhood, #coronavirus-2019-ncov, #health-insurance-and-managed-care, #medicaid, #tests-medical, #unitedhealth-group-inc

How Rich Hospitals Profit From Patients in Car Crashes

Hospitals use century-old lien laws to bypass insurers and charge patients, especially poorer ones, the full amount.

#community-health-systems-inc, #compensation-for-damages-law, #emergency-medical-treatment, #hospitals, #medicaid, #parkview-health, #prices-fares-fees-and-rates, #suits-and-litigation-civil, #traffic-accidents-and-safety, #washington-mary-hospital-fredericksburg-va, #wellstar-health-system

An 11th-Hour Approval for Major Changes to Medicaid in Tennessee

The Trump administration’s move, which Biden could eventually reverse, would loosen program rules and cap the state’s funding as part of a block grant.

#health-and-human-services-department, #medicaid, #tennessee, #verma-seema

With New Majority, Here’s What Democrats Can (and Can’t) Do on Health Care

Senate control opens up new possibilities, but the party will still need to contend with arcane rules and the challenges of a narrow majority.

#health-insurance-and-managed-care, #law-and-legislation, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010, #united-states-politics-and-government

Obamacare, in Its First Big Test as Safety Net, Is Holding Up So Far

Job losses and the loss of insurance have typically gone hand in hand. This year, more Americans are staying covered.

#health-insurance-and-managed-care, #layoffs-and-job-reductions, #medicaid, #patient-protection-and-affordable-care-act-2010, #recession-and-depression

Becerra Supports ‘Medicare for All,’ and Could Help States Get There

Waivers can expand health care offerings without need for congressional approval, but the challenge will be how to pay for them.

#becerra-xavier, #biden-joseph-r-jr, #health-insurance-and-managed-care, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010, #states-us

Supreme Court to Hear Case on Trump’s Medicaid Work Requirements

The case, which could become moot if the Biden administration eliminates the requirements, will be scheduled to be heard early next year.

#federal-state-relations-us, #labor-and-jobs, #medicaid, #supreme-court-us, #trump-donald-j, #united-states-politics-and-government

After 4 Years of Trump, Medicare and Medicaid Badly Need Attention

Science and objective analysis need to be revived.

#biden-joseph-r-jr, #centers-for-disease-control-and-prevention, #centers-for-medicare-and-medicaid-services, #drugs-pharmaceuticals, #elderly, #food-and-drug-administration, #health-insurance-and-managed-care, #medicaid, #medicare, #presidential-election-of-2020, #united-states

Springtide, an autism treatment center network, raises $15.6 million

With one in 54 children diagnosed with autism spectrum disorder in the US, the issue of how to treat patients diagnosed with the condition has become almost as acute as the prevalence of the condition itself.

That’s one reason why Jia Jia Ye and the team at the healthcare startup studio Redesign Health, were able to raise $15.6 million in a recent round of funding for the new startup, Springtide Child Development.

A longtime executive in the healthcare industry with previous stints at OneMedical and Oscar, Ye and Redesign Health’s team began talking two years ago about potential business ideas. The group settled on autism care because of what they saw as the clear need in the market, Ye said.

“Why this immediately clicked is that the supply and demand imbalance was super clear,” Ye said. 

Simply put, Springtide combines the concierge medical business model with early childcare and education businesses like Sylvan Learning to offer autism care through specialists and a team of registered behavioral technicians.

To ensure that as many people as possible can use Springtide’s services the company takes both private insurance and Medicaid.

So far, the company has one clinic set up in Connecticut providing both remote and in-person services, and it plans to launch several sites throughout the Northeast on the back of its $15.6 million in financing.

Joining Ye in designing the company’s facilities and treatment services is Dr. Tiva Pierce, who previously worked at Constellation Health Services, which provides behavioral and physical healthcare through schools.

Like many companies which had an in-person services model, Springtide had to pivot to delivering remote care as soon as the pandemic lockdowns hit the Northeast.

Image Credit: Thetaree Sarmkasat iStock / Getty Images Plus

The company charges Medicad $46 per hour and commercial payers will be charged between $50 and $60 per hour, but the company’s services will only cost families their typical co-pay and deductible.

Taking Medicaid was a priority, Ye said, to increase access for more people who need it.

Already, the families in the US spend about $17 billion on ABA therapy, according to Ye. And the overall spending on autism related issues is $68 billion, she said.

The financing, which came from Deerfield Management and Optum Ventures, will be used to expand the company’s footprint and staff, which currently numbers roughly 30 employees.

“The rapidly growing autism care market is highly fragmented and uncoordinated, which creates significant challenges for children and their families who deserve to have access to care that is consistently of exceptional quality,” said Julian Harris, M.D., Partner at Deerfield. “Springtide offers an interdisciplinary, in-center care experience with a tech-enabled wrap-around for families who want their children to get all of their care in one setting.  With an emphasis on outcomes measurement, we hope that Springtide can serve as a platform for care and research, ultimately establishing the gold standard in this field.

#autism, #connecticut, #executive, #getty-images, #healthcare, #healthcare-industry, #medicaid, #optum, #optum-ventures, #oscar, #tc, #united-states

Obamacare Enrollment Opens, With Costs Generally Lower

Millions lost their insurance, along with their jobs, during the pandemic. But many people are eligible for financial help.

#content-type-service, #coronavirus-2019-ncov, #health-insurance-and-managed-care, #healthcare-gov, #medicaid, #patient-protection-and-affordable-care-act-2010, #personal-finances, #unemployment

Obamacare Is Back in Court. The Stakes Couldn’t Be Higher.

This time, the issue is democracy, and the Supreme Court’s duty to leave political decisions to the elected branches of government.

#health-insurance-and-managed-care, #law-and-legislation, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010, #republican-party, #supreme-court-us, #trump-donald-j, #united-states

A Chance to Expand Medicaid Rallies Democrats in North Carolina

The legislature in this battleground state could flip to Democratic control, a prospect that is bringing out lower-income voters who stayed home in 2016.

#elections-state-legislature, #health-insurance-and-managed-care, #medicaid, #north-carolina, #politics-and-government, #presidential-election-of-2020, #states-us, #voting-and-voters