Significant Decline in Employment Based Health Benefits Resulted from the Great Recession

by John W Rodat on March 21, 2012

Employment based health benefits have been declining steadily, but significantly for a long time. But the recent “Great Recession” accelerated that decline much more than my pessimistic self anticipated.

From the National Institute for Health Care Reform (a non-profit established by the International Union, UAW; Chrysler Group LLC; Ford Motor Company; and General Motors):

Between 2007 and 2010, the share of children and working-age adults in the United States with employer-sponsored health insurance dropped 10 percentage points from 63.6 percent to 53.5 percent, according to a new national study by the Center for Studying Health System Change (HSC). The key factor driving the sharp decline was the enormous loss of employment during the Great Recession, which officially started in December 2007 and ended in June 2009. The proportion of the population younger than 65 with no workers in the family spiked 10 percentage points between 2007 and 2010, from 21.6 percent to 31.6 percent. The decline in employer coverage disproportionately affected young adults, people with a high
school education or less, and people employed in small firms.

Even when employment rebounds to pre-recession levels, a return to previous levels of employer-sponsored health insurance is unlikely. Well before the start of the recession, a steady decline of employer health coverage was underway with fewer firms offering coverage and fewer workers taking up coverage—likely because of rising health care costs. Both of these trends continued during the recession and contributed to the decline in employer coverage between 2007 and 2010. The core threat to employer health coverage is health care costs increasing faster than wages, which makes employer coverage unaffordable for a larger share of the workforce, particularly low-wage workers. For example, among children and working age adults with incomes below 200 percent of poverty—$44,100 for a family of four in 2010—the proportion with employer coverage dropped from 42 percent in 2001 to 24 percent in 2010.

Many people who lost employer coverage during 2007-2010 obtained public health coverage. National health reform, with its major expansion of Medicaid and new subsidies to purchase nongroup insurance, will further extend coverage to the growing ranks of Americans without employer health coverage.

There’s lots of interesting data in the study. Among the elements that interested me were these:

Declines in coverage being offered and declines in coverage being taken up were generally not statistically significant but were generally in the same direction and with a couple of exceptions were pervasive across all firm sizes and governmental employers. The exceptions were:

  • Within firms with between 100 and 999 employees, access to employer coverage among working families increased, but coverage take up by families with access declined.
  • Within firms with 1,000 and more employees, access to employer coverage declined from 94.6 percent to 92.4 percent. However, take up by families with access increased from 89.9 to 90.4 percent.

The decline that was statistically significant and perhaps least surprising was employer coverage enrollment in firms with fewer than 100 employees. There the decline was from 50.9 to 45.2 percent.

Don’t expect economic recovery to generate a significant rebound.

Tagged as: Economics, Health Benefits, Health Insurance

{ Comments on this entry are closed }

New Health Plan Deliberately Excludes High Cost Hospitals & Other Providers

by John W Rodat on March 21, 2012

By Robert Weisman from the Boston Globe:

Harvard Pilgrim Health Care is teaming up with more than 50 hospitals and 16,500 doctors across the state to offer Massachusetts employers and their workers a 10 percent savings on health insurance by forming what they call a “focused network’’ of medical care groups that excludes Partners HealthCare System Inc. and other high-priced providers.

The goal is to contain costs by giving businesses, municipalities, consumers, and other insurance buyers a new choice for coverage. While the new network limits where patients can receive care, it boasts a broad coalition of more moderately priced Boston teaching hospitals, such as Tufts Medical Center, Boston Medical Center, and Beth Israel Deaconess Medical Center; regional providers that include Lahey Clinic in Burlington and Baystate Medical Center in Springfield; and community hospitals such as Beverly Hospital, Cambridge Hospital, and St. Elizabeth’s Medical Center in Boston.

By requiring providers in the network to keep the cost of their services below a certain level, Harvard Pilgrim hopes to pressure more expensive hospitals to cut their own rates to compete – or risk losing market share to lower-priced rivals.

“It’s a blunt instrument,’’ said Eric H. Schultz, chief executive of Harvard Pilgrim. “But it’s getting to the point where cost is a barrier to some services, and for some patients.’’

This is interesting in its own right, but even more because it’s happening in Massachusetts. Why is that extra interesting? Because the system back pressure is occurring in a state that has a universal coverage mechanism. In the past, excessive insurance premium levels led employers and individuals to make decisions that led to more people falling out of the private insurance system or losing coverage entirely.

The article goes on:

While Harvard Pilgrim is stressing the wide range of hospitals and medical services that are part of the new network, just as significant to many health care market watchers is who was excluded: many hospitals identified by the state attorney general’s office as the highest-priced. Among them are Massachusetts General and Brigham and Women’s hospitals in Boston and others owned by Partners, the state’s largest hospital and physicians group. Also left out are hospitals that enjoy geographic monopolies, such as Cape Cod Hospital in Hyannis and Cooley Dickinson Hospital in Northampton.

Indeed, the network’s provider directory may symbolize a new cost-conscious alliance that seeks to challenge the dominance of Partners and other higher-priced competitors.

“This really feels like a partnership in many ways,’’ said Kevin Tabb, the new chief executive of Beth Israel Deaconess. All of the hospitals will continue to operate independently, however, and have separate payment contracts with Harvard Pilgrim.

The insurance company said it developed the network using a formula that calculated hospital prices and total medical expenses for doctors. Before applying to the insurance division for permission to sell the plan, Harvard Pilgrim sent letters to all providers, including those who were excluded, giving them a chance to negotiate lower reimbursements. If they do so in the future, they will be welcomed into the network, the insurer said.

Reinforcing the point above, assuming the State approves this plan, within it there would be the incentive and mechanism for increased price competition in a state with a universal coverage mechanism.

That’s worth watching.

Tagged as: Health Benefits, Health Insurance, Healthcare, Hospital, Massachusetts, Physicians

{ Comments on this entry are closed }

Feckless Chapter 2: Albany County Legislature is Clumsy or Slick?

by John W Rodat on March 20, 2012

You have got to be kidding me! Well, you could be kidding me or you could be kidding me. Or us.

The leadership of the Albany County Legislature has rushed past feckless to either a clumsy attempt at deception or a really slick effort at self-defeat. Or perhaps they really can’t see past the next step.

One perspective: Shawn Morse and the Albany County Legislative Leadership are fumbling and desperate. As so often happens in such circumstances, one blunder leads to another, “Oh! what a tangled web we weave When first we practice to deceive!”

Or another perspective: Shawn Morse and the Albany County Legislative Leadership are really subtle. They now realize that they’re on the verge of a catastrophic financial error and by grossly and repeatedly over-promising a new nursing home, as well as deceiving their own colleagues, they’ve already made a catastrophic political error. So by disowning their own numbers and attacking the very State agency, public officials (including not incidentally the Commissioner of Health, and by implication the Governor) and private citizens who must approve a new nursing home, they are increasing the odds that the State will deny their application, simultaneously taking them off the hook and giving them someone else to blame.

Or another perspective: Shawn Morse and the Albany County Legislative Leadership really believe what they’re saying. Then Morse and his allies are even more inattentive to what’s necessary to get things done and even more clumsy than we thought. Whatever the case, they’re even more likely to get the same result as above, namely rejection or financial disaster.

Whatever the reason, by disowning the financial projections and by saying that the projections are false, Shawn Morse and the leadership of the Albany County Legislature have just about guaranteed that their certificate of need application to build a new nursing home will be disapproved.

The Albany County Legislature submitted paperwork to New York State projecting that a new nursing home would lose over $26.5 million per year. The $26 million was prepared by their consultants, reviewed and approved by their Nursing Home Facilities Committee, signed by their Chairman and submitted by them to the New York State Health Department. Had they not included a projection, the Department would not even have begun a review of the application. But they did. And that projection was for revenue of $24,327,915 against annual expenditures of $50,813,787 for an annual loss of $(26,485,872.00) (-52.1%).

Being of sound minds, the State questioned whether they really wanted to go ahead with such an expensive project, especially in light of the property tax cap. Instead of answering the question honestly, on the floor of the Legislature this past week, they denied the numbers were correct; they denied where they came from; they even denied knowing about them.

And yesterday, claiming their own numbers to be the State’s rather than their own, they said the numbers were “simply false.” And then they tried a very clumsy deception not by dealing with projections or offering concrete ideas on how they would reduce the losses, but with data from several recent years. The State is asking a question about projections. They answer by pointing in a different direction, namely backwards. Hey guys, projections are about the future. Your numbers are about the past. Didn’t you notice? Didn’t you think we might notice?

And in saying that the numbers are “simply false,” Shawn Morse, the Chairman of the Albany County Legislature has said that the certificate of need application submitted by the County itself is false. Thus, the State Department of Health no longer has a valid application in front of it. It has two choices, rejecting the application either because it has been falsified or rejecting it because the County’s governing body has not made the necessary (though hollow) commitment required to meet the financial feasibility test required by the Public Health Law. At an absolute minimum, the Department would have to return the application back to the County to start over. Were it to do so, it would need to subject any new application to exceptional scrutiny.

Albany County’s application is not on the next agenda of the State Public Health and Health Planning Council, probably because the State did not receive a timely response to its request. Now it doesn’t make any difference because the Chairman of the Legislature has said that the application the County submitted to the State was and is “false.”

At a minimum, it’s a two month delay. Alternatively, it’s a much longer delay or an outright rejection.

Here are a couple theories about what Morse and his colleagues are actually doing:

  • Trying to sandbag the whole effort to build a new nursing home so they can blame the State. Think that’s unlikely? More than one member of the Legislature and someone’s who’s been deep in the middle of the nursing home debate has said privately he would be just as happy if the State rejects the application. He will have been a hero to Nursing Home employees and someone else will get the blame. He’ll even have more opportunities to grandstand!
  • Having arrived at school without their homework, they’re trying to confuse things or compounding one set of lies with another.
  • They truly are that inattentive and/or don’t understand what’s happening outside their narrow little universes. One leading Legislator told me a couple years ago, he never even reads the budget summary, much less the budget. Why should we expect him to read any background material on a $70 million capital project?
  • They are paying attention, but they don’t understand. (Was that worded generously enough?)

Clearly they haven’t done their homework and now they’re caught. So at a minimum, we’re seeing pervasive carelessness followed by attempts to shift attention elsewhere. But why are they doubling down now?

Clearly, they’re desperate enough to be attacking the very organization and people whose approval they need to actually proceed with a new nursing home.

And clearly, at least one of these characters is such an incompetent blowhard that it’s really hard to tell whether he remembers what he’s said from one minute to the next.

But the patterns are getting very regular and very pervasive.

Whatever the reason, the Albany County Legislature is becoming a laughingstock. Either the leadership is lying and it knows it or it’s lying and it doesn’t know it.

Now to the specifics. Here’s a press release that Shawn Morse, the Chairman of the Albany County Legislature issued today:

FOR IMMEDIATE RELEASE

Albany County Legislative Leaders Say State’s Numbers on Nursing Home Inaccurate

MARCH 19th 2011 (Albany, NY) Albany County Legislative Chairman Shawn Morse, along with Majority Leader Frank Commisso and Deputy Majority Leader Sean Ward are disputing a recent claim by the New York State Department of Health that the Albany County Nursing Home has an annual operating deficit of 26.3 million dollars.

The claim was made by Charles Abel, the Deputy Director of the New York State Department of Health’s Facility Planning in a letter to the Legislature.

According to Legislative Chairman Shawn Morse, the State’s numbers do not accurately reflect the County’s annual contribution to the operation of the nursing home. “The numbers from the State are simply false,” said Morse. “The fact of the matter is this. We have applied for a certificate of need with the State to construct a new nursing home. We believe that a state of the art facility will not only save the taxpayers of Albany County in the annual contribution rates, but also provide a vital service to our seniors, many of which have no place else to go for care.”

According to the Legislature, County contribution rates to the nursing home over the last four years are as follows; 10.4 million in 2009, 12.3 million in 2010, 11.9 million in 2011 and 7.2 million for 2012.

Morse says that while an A to Z overhaul of the nursing home is needed, the County should not relinquish its duty to those seniors most in need. “We have a duty as a County government to make sure that those seniors who need a high level of care, a level of care they may not be able to receive anywhere else, receive that care and keep them close to their families.”

Legislative leaders believe that with a new facility, the county contribution to the nursing home could be reduced up to 3 million dollars.

For more information, contact Chairman Shawn Morse: 518-447-5695

Morse’s letter was a response to the letter sent in January by the State Department of Health. Did Morse really need a week after the legislative debate on the very same letter letter to actually prepare a response, however misleading? Or is he responding to the fact that he and his colleagues got caught?

In its entirety, here is the letter sent by the New York State Department of Health to Albany County’s County Executive. It was subsequently transmitted to the County Legislature, by Michael Perrin, the Deputy County Executive

January 26, 2012

Mr. Daniel P. McCoy
Albany County Executive
112 State Street, Room 200
Albany, New York 12207

Re: Project # 102376 Albany County Nursing Home – Construct a 200 bed replacement facility and certify a 30 slot adult day health care program

Dear Mr. McCoy:

The Certificate of Need application (CON) noted above is under review by the New York State Department of Health. The project was advanced to the November 17, 2011 meeting of the Public Health and Health Planning Council’s (PHHPC) Committee on Establishment and Project Review. At that meeting, Committee members questioned the financial feasibility of this project given the substantial operating deficits, the Department’s imminent release of a new nursing home pricing rate methodology, and the two percent property tax cap legislation. Based upon these factors, the Council deferred the project from the PHHPC agenda to allow the County time top reassess the project.

The new rate methodology has now been released and an examination of the Albany County Nursing Home’s CON budget, adjusted for projected rates, shows an projected annual operating deficit of $26,316,572. With the incremental revenue produced from the adult day health care program, the combined operational loss is projected to be $26,266,769. Obviously the loss will have to be addressed by Albany County. Before the Department again advances this project to the PHHPC for its consideration, we are requesting your written commitment to meet the projected financial deficits for this nursing home project, recognizing that the two percent property tax cap presents a significant challenge to the financing of the facility.

If you have any questions, you can reach me at (518) 402-0967

Sincerely,

Charles P. Abel
Acting Director
Division of Health Facility Planning

My bet? Nah, these guys don’t know subtle. They may be able to bully some people but they can’t bully facts. They can’t bully reality. They’ve created a mess for themselves and they tried desperately to get out. But in doing so, they undercut their own application. Of course, that’s not to say that they wouldn’t be relieved were the State to take them off the hook.

And by the way, you can bet heavily that the numbers Morse used do not count over $4.25 million buried in the budget of the County Department of Social Services for both 2011 and 2012 that is there for one reason and one reason only. That’s to buy extra reimbursement and reduce the loss at the Nursing Home.

Boy, was my first post of the week on target. Political language is designed to make lies sound truthful …

Tagged as: Albany County, Certificate-of-Need, Nursing Home, Orwell

{ Comments on this entry are closed }

Interest Costs. Just a Reminder

by John W Rodat on March 20, 2012

If you have ever had a mortgage to pay, you know painfully well how much you pay in interest costs over the life of the mortgage. With interest, total acquisition costs often come close to doubling the purchase price.

A new Albany County Nursing Home project (by their own numbers) will require borrowing $70.842 million. Over 30 years at 4.0 percent, adding in the interest costs will bring the total capital costs to $122.942 million. So the Albany County Nursing Home is really a $122.942 million project.

Because, Albany County’s design is so expensive, it exceeds the State’s allowable per bed limit. Of the $70.8 million cost, only $55.8 million will be allowable for reimbursement. When the interest on the difference is factored in, even under the best of circumstances, of the $122.942 million, the maximum allowable reimbursement would be for $96.715 million. Thus, of capital cost alone, $26.227 million would never be reimbursable. (Interesting coincidence that the number $26 million keeps coming up.)

Translating these figures into annual budget implications, the new mortgage alone would add about $4.1 million to the current annual budget. At best … optimistically … only $3.2 million would be reimbursed.

Tagged as: Albany County, Capital Costs, Nursing Home

{ Comments on this entry are closed }

Aww. C’mon

by John W Rodat on March 20, 2012

Such a beautiful day for a two-wheeled vehicle …

But our friends at the Albany County Legislature just won’t let us go play. More on that shortly.

Tagged as: Albany County

{ Comments on this entry are closed }

Fitch Credits Sale of Ulster County Nursing Home in Reaffirming County’s Bond Rating

by John W Rodat on March 20, 2012

From the Mid-Hudson News Network:

Fitch reaffirms Ulster County’s bond rating, cites ‘sound’ financial profile

NEW YORK – Fitch Ratings Service supports the sale of the Golden Hill Health Care Center by Ulster County government.

The revelation comes in the rating agency’s latest report on the county’s finances and its reaffirmation of the county’s AA- bond rating. Selling Golden Hill “would significantly decrease the county’s future liabilities,” its new report states.

Shocking, I know, but there you have it.

Tagged as: Bonds, Nursing Home, Rating, Ulster County

{ Comments on this entry are closed }

Orwell on Political Language

by John W Rodat on March 19, 2012

Something tells me that this will be a good week to start with a reminder from Orwell:

Political language is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.

George Orwell, Why I Write, 1946

Tagged as: Orwell, Politics, QOTD

{ Comments on this entry are closed }

Inflation Adjusted Earnings Declined in February

by John W Rodat on March 16, 2012

From the Bureau of Labor Statistics this morning:

REAL EARNINGS FEBRUARY 2012

All employees

Real average hourly earnings for all employees fell 0.3 percent from January 2012 to February 2012,
seasonally adjusted, the U.S. Bureau of Labor Statistics reported today. A 0.1 percent increase in the
average hourly earnings was more than offset by a 0.4 percent increase in the Consumer Price Index for
All Urban Consumers (CPI-U).

Real average weekly earnings fell 0.3 percent over the month due to the decline in the real average
hourly earnings combined with an unchanged workweek. Since reaching a peak in October 2010, real
average weekly earnings has fallen 1.2 percent.

Real average hourly earnings fell 1.1 percent, seasonally adjusted, from February 2011 to February 2012.
The decrease in real average hourly earnings combined with a 0.6 percent increase in average weekly
hours resulted in a 0.4 percent decrease in real average weekly earnings during this period.

Production and nonsupervisory employees

Real average hourly earnings for production and nonsupervisory employees fell 0.3 percent from January
2012 to February 2012, seasonally adjusted. A 0.2 percent increase in the average hourly earnings was
more than offset by a 0.5 percent increase in the Consumer Price Index for Urban Wage Earners and
Clerical Workers (CPI-W).

Real average weekly earnings was unchanged over the month due to a 0.3 percent increase in the average
workweek and the decrease in real average hourly earnings. Since reaching a peak in October 2010, real
average weekly earnings for production and nonsupervisory employees has fallen 1.7 percent.

Real average hourly earnings fell 1.5 percent, seasonally adjusted, from February 2011 to February 2012.
The decrease in real average hourly earnings combined with a 0.6 percent increase in average weekly
hours resulted in a 0.9 percent decrease in real average weekly earnings during this period.

We’re feeling better, but not so much. No wonder. And no, this does not mean that we should abandon governmental policies to stimulate the economy.

And at the same time, here’s the inflation release:

Consumer Price Index – February 2012

The Consumer Price Index for All Urban Consumers (CPI-U) increased 0.4 percent in February on a seasonally adjusted basis, the U.S. Bureau of Labor Statistics reported today. Over the last 12 months, the all items index increased 2.9 percent before seasonal adjustment.

The gasoline index rose sharply in February, accounting for over 80 percent of the change in the all items index. The gasoline increase led to a 3.2 percent rise in the energy index despite a decline in the index for natural gas. The food index was unchanged in February, with the food at home index unchanged for the second month in a row as major grocery store food indexes were mixed.

The index for all items less food and energy rose 0.1 percent in February after increasing 0.2 percent in January. Indexes for shelter, new vehicles, medical care, and household furnishings and operations all advanced, while indexes for apparel, recreation, used cars and trucks, and tobacco all declined.

The all items index has risen 2.9 percent over the last 12 months, the same figure as last month. The index for all items less food and energy was up 2.2 percent, a slight decline from last month’s 2.3 percent figure, while the 12-month change in the food index fell to 3.9 percent in February, its lowest level since last June. In contrast, the 12-month change in the energy index was 7.0 percent in February compared to 6.1 percent in January.

And no, we’re not going to see gasoline prices at $2.50 per gallon regardless of who is President.

Tagged as: Earnings, Economics, Inflation

{ Comments on this entry are closed }

Bits & Pieces

by John W Rodat on March 16, 2012

Today’s Grab Bag

More “Winner Take All” Economics

Sports star economics comes to the law profession. Dewey & LeBoeuf, the result of a 2007 merger of Dewey Ballantine and LeBoeuf, Lamb, Greene & MacRae. Star economics was the subject of Robert Frank’s 1995 book, the Winner Take All Society. Frank’s argument was that partly because of the technology and partly because of the structure of modern markets, income and wealth were increasingly concentrated. We argued here that the concentration of economic wealth is a self-reinforcing system. The rich get richer. They use their increased resources to get richer still, leaving everyone else further and further behind.

And speaking of income inequality, from the Center for Budget and Policy Priorities (CBPP) here’s A Guide to Statistics on Historical Trends in Income Inequality.

The broad facts of income inequality over the past six decades are easily summarized:

  • The years from the end of World War II into the 1970s were ones of substantial economic growth and broadly shared prosperity.
  • Incomes grew rapidly and at roughly the same rate up and down the income ladder, roughly doubling in inflation-adjusted terms between the late 1940s and early 1970s.
  • The income gap between those high up the income ladder and those on the middle and lower rungs — while substantial — did not change much during this period.
  • Beginning in the 1970s, economic growth slowed and the income gap widened.
    • Income growth for households in the middle and lower parts of the distribution slowed sharply, while incomes at the top continued to grow strongly.
  • The concentration of income at the very top of the distribution rose to levels last seen more than 80 years ago (during the “Roaring Twenties”).
  • Wealth (the value of a household’s property and financial assets net of the value of its debts) is much more highly concentrated than income, although the wealth data do not show a dramatic increase in concentration at the very top the way the income data do.

    • Data from a variety of sources contribute to this broad picture of strong growth and shared prosperity for the immediate postwar generation, followed by slower growth and growing inequality since the 1970s. Within these broad trends, however, different data tell slightly different parts of the story, and no single source of data is better for all purposes than the others.

    This guide consists of four sections. The first describes the commonly used sources and statistics on income and discusses their relative strengths and limitations in understanding trends in income and inequality. The second provides an overview of the trends revealed in those key data sources. The third and fourth sections supply additional information on wealth, which complements the income data as a measure of how the most well-off Americans are doing; and poverty, which measures how the least well-off Americans are doing.

    Looks like a useful resource for an issue that we will be grappling with for decades. Or at least, hopefully we’ll grapple with it.

    Job Growth Without Economic Growth?

    Ezra Klein writes in the Washington Post, Wonkbook: We’re seeing the jobs. But where’s the growth?

    Something odd is happening in the economy. Jobs are coming back, and relatively quickly. But growth is lagging. Or, at the least, we think it is. Virtually every estimate of GDP growth for the first quarter of 2012 is below two percent — that’s a third lower than it was in the fourth quarter of 2011, when payroll growth was lower — and many of those estimates are being revised downward as new data streams in.

    That’s not normal, to say the least. Typically, payrolls and the economy grow in tandem. When that doesn’t happen, it’s usually because the economy is growing and jobs are stuck. That’s the situation the term “jobless recovery,” which came into vogue after the 2001 recession, describes. But we don’t even have a term for the opposite of a jobless recovery. Job-full recovery, maybe? A Jobcovery?

    A couple of things could be going on here. One possibility is that the preliminary GDP data is wrong…

    Klein goes on to discuss other explanations and what might be done. It’s also possible that the jobs that are “coming back” are relatively low paying. That’s an ugly thought. Keep an eye on this one.

    Texas cuts off Planned Parenthood; the Federal Government cuts off Texas.

    From the Houston Chronicle, Feds will phase out funds for Women’s Health Programs:

    The federal government said Thursday it will phase out funding to Texas for a key women’s health program, calling a transition period necessary to ensure that low-income clients don’t abruptly lose access to screenings and contraceptives.

    Money for the Medicaid Women’s Health Program is drying up because the state has decided to exclude clinics affiliated with abortion providers, even if the clinics don’t provide abortions. The federal government says that’s not allowed.

    The ban notably affects Planned Parenthood.

    Gov. Rick Perry promised anew that the state will pick up the cost of the program, in which nearly 130,000 Texas women are enrolled. Where that money will come from is unclear.

    Texas was expected to get about $29.8 million from Washington this fiscal year for the program, with the state paying the remaining $3.3 million.

    Nuttiness.

    New Hampshire Gets Federal Grant to Keep People Out of Institutions

    Earlier this month, the Centers for Medicare & Medicaid Services (CMS) announced that New Hampshire will be the first State in the country to receive new Federal (Medicaid) grant dollars — $26.5 million over three years— provided by the Affordable Care Act to keep people out of institutions and living productive lives in their communities. From the CMS statement:

    The Administration strongly supports a shift from institutional care to community services and supports for those with long-term needs. While most Medicaid dollars for long-term services and supports still go to institutions, the national percentage of Medicaid spending on home and community based services has more than doubled from 20 percent in 1995 to 43 percent in 2009.

    “No one should have to live in an institution or nursing home if they can live in their homes and communities with the right mix of affordable supports,” said Cindy Mann, director of the CMS Center for Medicaid and CHIP Services. “These new grants will help States like New Hampshire give people with long-term care needs the choice about how and where to live their lives.”

    States are eligible for these grants, in the form of higher Medicaid matching payments, if they currently spend less than 50 percent of their total long-term care costs on community-based options. The enhanced Medicaid payments must be spent increasing the availability of long-term community-based services and supports. The New Hampshire Department of Health and Human Services Balancing Incentive Program, in partnership with community organizations throughout the State, plans to further develop the systems of community-based care that serve seniors and individuals with behavioral health needs, physical disabilities, and intellectual disabilities.

    The Affordable Care Act was not primarily focused on long-term care. But where it covered long-term care issues, its emphasis was on expanding long-term care coverage and further shifting the service balance away from institutional care and toward home and community based services.

    New Hampshire’s Certificate-of-Need Program Ending?

    It looks like New Hampshire is repealing its Certificate-of-Need Law.

    Tagged as: Affordable Care Act, Bits and Pieces, CBPP, Certificate-of-Need, Economics, Healthcare, Long Term Care, New Hampshire, OWS, Texas, Women's Health

    { Comments on this entry are closed }

    In My Next Life I Want to be a Cartoonist!

    by John W Rodat on March 14, 2012

    John De Rosier just said in one picture what I and many others have spent thousands of words on. Here’s betting that this picture represents a turning point.

    Go look now!!!

    Still laughing.

    Tagged as: Albany County, Cartoon, Deficit, Long Term Care, Nursing Home

    { Comments on this entry are closed }

    ← Previous Entries

    Next Entries →