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Private Medicaid Plans Receive Billions In Tax Dollars, With Little Oversight
GeorgiA Public Broadcasting News ^ | 10-18-18 | Kaiser Health News

Posted on 10/18/2018 2:23:15 PM PDT by spintreebob

The current political debate over Medicaid has centered on the idea of putting patients to work so they can earn their government benefits. Yet some experts say the country would be better served by asking this question instead: Are insurance companies — which receive hundreds of billions in public money — earning their Medicaid checks?

More than two-thirds of Medicaid recipients are enrolled in such programs, a type of public-private arrangement that has grown rapidly since 2014, boosted by the influx of new beneficiaries under the Affordable Care Act.

States have eagerly tapped into the services of insurers as one way to cope with the expansion of Medicaid under the ACA, which has added 12 million people to the rolls. This fall, voters in three more states may pass ballot measures backing expansion. Outsourcing this public program to insurers has become the preferred method for running Medicaid in 38 states.

Yet the evidence is thin that these contractors improve patient care or save government money. When auditors, lawmakers and regulators bother to look, many conclude that Medicaid insurers fail to account for the dollars spent, deliver necessary care or provide access to a sufficient number of doctors. Oversight is sorely lacking and lawmakers in a number of states have raised alarms even as they continue to shell out money.

(Excerpt) Read more at ...

TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: healthcare; medicaid; socialism; work
When LBJ started Medicaid (and Medicare) it was mostly Socialism known as FFS-Fee For Service. Both Democrats and Republicans in both state and Federal offices, both partisans and bureaucrats, all agreed that FFS was not working.

So over the years Medicare Advantage and Medicaid Managed Care have shiften the money from socialism to Corporatism. The ACA is a massive welfare program for the Corporatist parasites.

Interesting how Kaiser Health News and Public Broadcasting cherry pick parts of the truth and end up giving a very distorted picture. You can count on these stories being slanted to shift from Corporatism back to Socialism ... all the while ignoring the difference between welfare to big Corporatists and true Capitalism.

1 posted on 10/18/2018 2:23:15 PM PDT by spintreebob
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To: spintreebob

Since the topic is also about Medicare, I’d like to take the opportunity to warn about all these “Medicare Advantage Plans”; to anyone considering doing this—don’t with a capital “D”. It all sounds so great and fantastic, and it’s fantastically a fraud. You pay your premium, then get next to nothing in coverage for all that’s promised. Don’t get had. Love you my FReeper friends.
(It’s okay, I didn’t fall for it because my parents warned me about it a long time ago).

2 posted on 10/18/2018 3:09:24 PM PDT by Patriot777 ("When you see these things begin to happen, look up, for your redemption draweth nigh.")
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To: Patriot777
You pay your premium, then get next to nothing in coverage..

I have a Medicare Advantage Plan and just had surgery on my hand. The total bill - $25,000. My fee - $50. I have no complaints.

3 posted on 10/18/2018 3:31:14 PM PDT by rexthecat
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To: spintreebob

Excellent points. When you have a third party paying the brunt of the bill patient care becomes an after thought.

4 posted on 10/18/2018 3:37:53 PM PDT by lastchance (Credo.)
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To: spintreebob
Having spent over 10 years working in & with Medicaid managed care (MCO), the oversight of the plans are only as good as the state's accountability offices.

Some states have NO IDEA what they are doing and are dictatorial giving instruction to the MCO’s like “You can't deny claims of providers who aren't even enrolled in the medicate system and their NPI’ designated taxonomies (specialty codes) don't match what they are billing for. (EG a psychiatrist billing for a surgery) So that state understandably is fraught with fraudulent billing.

Some states have built in incentives and penalties and have good accountability built into their systems. Including access to care requirements and measures on how many under their care get standard medical screenings & pediatric check ups.

The MCO’s aren't perfect but I believe they are MUCH MUCH better than the fraud saturated straight fee for service Medicaid programs. But they only spend the money to monitor what the states require them to.

5 posted on 10/18/2018 4:03:13 PM PDT by call meVeronica
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To: rexthecat

Then I stand corrected, and my sincere apologies.

6 posted on 10/19/2018 9:47:41 AM PDT by Patriot777 ("When you see these things begin to happen, look up, for your redemption draweth nigh.")
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