California Health Care Foundation’s Post

👀 👀 👀 L.A. Care Health Plan, the largest public health plan in the nation, serving nearly 3 million people in Los Angeles County, made a major move today... nixing nearly a quarter of its prior authorization requirements. CEO John Baackes said the change is aimed at reducing administrative burdens for providers, shortening discharge times and avoiding care delays. Read more about it here in reporting out today from Hayley DeSilva for Modern Healthcare. #Medicaid #Medicare #priorauthorization #PriorAuth #managedcare

The Healthcare Labyrinth is here! Chapter 18 of my book, The Healthcare Labyrinth, tells you about dual eligibles. These are folks who are enrolled in both Medicare (because of age or disability) and Medicaid (usually due to low income). These individuals number about 12 million in the U.S. and have large medical expenses due to their frailty as well as social determinant barriers. #healthcare #healthinsurance #healthcarereform The Healthcare Labyrinth Marc S. Ryan 🇺🇦 https://lnkd.in/gvmEKfNF

The Healthcare Labyrinth is here! Chapter 18 of my book, The Healthcare Labyrinth, tells you about dual eligibles. These are folks who are enrolled in both Medicare (because of age or disability) and Medicaid (usually due to low income). These individuals number about 12 million in the U.S. and have large medical expenses due to their frailty as well as social determinant barriers. #healthcare #healthinsurance #healthcarereform The Healthcare Labyrinth Marc S. Ryan 🇺🇦 https://lnkd.in/euBT8JTs

The Healthcare Labyrinth is here! Chapter 18 of my book, The Healthcare Labyrinth, tells you about dual eligibles. These are folks who are enrolled in both Medicare (because of age or disability) and Medicaid (usually due to low income). These individuals number about 12 million in the U.S. and have large medical expenses due to their frailty as well as social determinant barriers. #healthcare #healthinsurance #healthcarereform #healthcarelabyrinth Marc S. Ryan 🇺🇦

The Healthcare Labyrinth is out! Chapter 35 of my book, The Healthcare Labyrinth, covers the "Aging of America Time Bomb." I tell you that America desperately needs an aging policy and investment in aging infrastructure. America is aging by the minute and costs for both long-term care and concomitant medical care will go up dramatically. An aging policy would help soften the increase in costs and help people live with dignity in the community. A combination of public investment and individual means-tested buy-in to government programs can be used. #healthcare #healthinsurance #healthcarereform #aging #aginginplace #longtermcare #longtermcareinsurance #medicare #medicaid #medicareadvantage #aca #exchanges #obamacare #universalhealthcoverage #healthcarelabyrinth Marc S. Ryan 🇺🇦

The Healthcare Labyrinth is out! Chapter 35 of my book, The Healthcare Labyrinth, covers the "Aging of America Time Bomb." I tell you that America desperately needs an aging policy and investment in aging infrastructure. America is aging by the minute and costs for both long-term care and concomitant medical care will go up dramatically. An aging policy would help soften the increase in costs and help people live with dignity in the community. A combination of public investment and individual means-tested buy-in to government programs can be used. #healthcare #healthinsurance #healthcarereform #aging #aginginplace #longtermcare #longtermcareinsurance #medicare #medicaid #medicareadvantage #aca #exchanges #obamacare #universalhealthcoverage #healthcarelabyrinth Marc S. Ryan 🇺🇦

The Healthcare Labyrinth is here! Chapter 18 of my book, The Healthcare Labyrinth, tells you about dual eligibles. These are folks who are enrolled in both Medicare (because of age or disability) and Medicaid (usually due to low income). These individuals number about 12 million in the U.S. and have large medical expenses due to their frailty as well as social determinant barriers. #healthcare #healthinsurance #healthcarereform #healthcarelabyrinth Marc S. Ryan 🇺🇦

The Healthcare Labyrinth is out! Chapter 35 of my book, The Healthcare Labyrinth, covers the "Aging of America Time Bomb." I tell you that America desperately needs an aging policy and investment in aging infrastructure. America is aging by the minute and costs for both long-term care and concomitant medical care will go up dramatically. An aging policy would help soften the increase in costs and help people live with dignity in the community. A combination of public investment and individual means-tested buy-in to government programs can be used. #healthcare #healthinsurance #healthcarereform #aging #aginginplace #longtermcare #longtermcareinsurance #medicare #medicaid #medicareadvantage #aca #exchanges #obamacare #universalhealthcoverage #healthcarelabyrinth Marc S. Ryan 🇺🇦

After reading The Price We Pay by Marty Makary M.D., M.P.H., the way that I view healthcare, payments, insurance, and how we deliver care to patients in the US has radically changed. [https://amzn.to/42x5oQg] So this article regarding prices of care in my neighboring state of New Jersey caught my eye: https://lnkd.in/eXCJiMnj - Hospitals in New Jersey and across the nation have been required since 2021 to list prices for all procedures, to give patients the ability to shop around and possibly lower health care costs through open market competition. So, do you think that price transparency will lead to decreased costs for the patient?

"The largest source of long-term services and supports (LTSS) is unpaid caretakers, who are often elderly spouses or children themselves and soon to reach retirement age. Medicaid is the second source and the largest source of LTSS expenditures. Thus, even after the completion of the PHE unwind, the cost of Medicaid will once again continue to grow. Achieving sustainability will require states to manage the growth rate within the overall state budget, requiring transformative measures. Enforcing price controls won’t work in the long-run, as they often limit access, and poor quality of care is typically the most expensive over time. The next big transformations in Medicaid will center on where and how services are delivered." One of the reason's I joined HORNE was our unique position to help states with their next steps with Medicaid in the post-PHE world. Mississippi and other states are looking at not just new sources of funding, but new programs and operating models to better serve our communities and improve outcomes while being good stewards of taxpayer dollars. HORNE specializes in the execution and monitoring of these types of programs, and I'm looking forward to connecting with several states in the coming months to see where we can help drive success!