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Great Gaps Persist in State Safety Nets, Interactive Policy Tool Shows

February 27, 2015 Comments off

Great Gaps Persist in State Safety Nets, Interactive Policy Tool Shows
Source: National Center for Children in Poverty

Today, the National Center for Children in Poverty (NCCP) launches an updated and enhanced edition of its 50-State Policy Tracker, a unique online tool for comparing safety net policies that are critical to the economic security of working families. The tool reveals striking variation among states, showing that state of residence has a major impact on whether low-income working parents succeed in making ends meet.

The Policy Tracker makes it easy for policymakers, journalists, social researchers, and advocates to quickly and accurately compare state policies and programs vital to the well-being of low-income families. It includes key state data for 10 important social programs:

  • Child care subsidies
  • Child and Dependent Care Tax Credit
  • Earned Income Tax Credit
  • Family and medical leave
  • Income tax policy
  • Medicaid/Children’s Health Insurance Program
  • Minimum wage
  • Supplemental Nutrition Assistance Program
  • Temporary Assistance for Needy Families
  • Unemployment insurance

Savings Expected from Slowdown in Medicare Spending

February 24, 2015 Comments off

Savings Expected from Slowdown in Medicare Spending
Source: AARP Public Policy Institute

Medicare growth rates have remained low since 2009, indicating that mid-term and long-range Medicare spending will be dramatically lower than expected just 5 years ago.

Experts believe that the slowdown in Medicare spending is due to a combination of factors, including health care reforms brought about by the Affordable Care Act, slower growth in new technologies, and the recession.

CBO — The Long-Term Costs of Major Health Care Programs: Fiscal Implications and Projection Methods (presentation)

February 18, 2015 Comments off

The Long-Term Costs of Major Health Care Programs: Fiscal Implications and Projection Methods
Source: Congressional Budget Office

Presentation by CBO’s Deputy Assistant Director for Health, Jessica Banthin, Ph.D., to the Joint Network on the Fiscal Sustainability of Health Systems, Organisation for Economic Co-operation and Development in Paris, France.

New From the GAO

February 10, 2015 Comments off

New GAO Reports
Source: Government Accountability Office

1. Prenatal Drug Use and Newborn Health: Federal Efforts Need Better Planning and Coordination. GAO-15-203, February 10.
http://www.gao.gov/products/GAO-15-203
Highlights – http://www.gao.gov/assets/670/668386.pdf

2. Medicaid: Additional Federal Action Needed to Further Improve Third-Party Liability Efforts. GAO-15-208, January 28.
http://www.gao.gov/products/GAO-15-208
Highlights – http://www.gao.gov/assets/670/668135.pdf

3. Critical Technologies: Agency Initiatives Address Some Weaknesses, but Additional Interagency Collaboration Is Needed. GAO-15-288, February 10.
http://www.gao.gov/products/GAO-15-288
Highlights – http://www.gao.gov/assets/670/668383.pdf

CBO — Medicare’s Payment to Physicians: the Budgetary Effects of Alternative Policies Relative to CBO’s January 2015 Baseline

February 5, 2015 Comments off

Medicare’s Payment to Physicians: the Budgetary Effects of Alternative Policies Relative to CBO’s January 2015 Baseline
Source: Congressional Budget Office

The table, Medicare’s Payment to Physicians: the Budgetary Effects of Alternative Policies, includes estimates for several replacement and short-term alternatives to the current rules for setting Medicare’s payment rates for physicians’ services. The starting date for all of these alternative policies would be April 1, 2015.

The table includes an updated estimate for H.R. 4015 and S. 2000, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, which are identical bills introduced on February 6, 2014. This updates the CBO cost estimate of that legislation for the April 2014 baseline—which incorporates H.R. 4302, the Protecting Access to Medicare Act of 2014 (Public Law 113-93), enacted on April 1, 2014—and the final physician fee schedule rule.

HHS OIG — Federal Marketplace: Inadequacies in Contract Planning and Procurement

January 21, 2015 Comments off

Federal Marketplace: Inadequacies in Contract Planning and Procurement
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
The Federal Marketplace at HealthCare.gov was designed to enable millions of Americans to select health insurance in a “one-stop shop” environment. A project of this magnitude and complexity required the development, integration, and operation of multiple information technology (IT) systems and Government databases. CMS acquisition planning and procurement activities were among the first steps critical to ensuring the success of this project. CMS awarded 60 contracts across 33 companies to perform this work. The troubled launch of the Federal Marketplace at HealthCare.gov in October 2013 raised a number of concerns, including questions about the adequacy of CMS’s planning and procurement efforts for this key project under the Affordable Care Act.

HOW WE DID THIS STUDY
We conducted a detailed review of documentation provided by CMS for the 60 Federal Marketplace contracts, selected 6 key contracts for indepth review, and interviewed Department of Health and Human Services (HHS) and CMS officials involved with contracting for the Federal Marketplace. We also reviewed procurement regulations, manuals, guides, and procedures provided by both HHS and CMS for acquisition planning, contractor selection, and contracting oversight processes.

WHAT WE FOUND
When awarding the Federal Marketplace contracts, CMS did not always meet contracting requirements. For example, CMS did not develop an overarching acquisition strategy for the Federal Marketplace or perform all required oversight activities. Moreover, for a project of this size and importance, CMS missed opportunities to leverage all available acquisition planning tools and contracting approaches to identify and mitigate risks. Specifically, CMS did not exercise the option to plan for a lead systems integrator to coordinate all contractors’ efforts prior to the launch of the Federal Marketplace. The complexity of the Federal Marketplace underscored the need for CMS to select the most qualified contractors. However, CMS did not perform thorough reviews of contractor past performance when awarding two key contracts. CMS also made contracting decisions that may have limited the number of acceptable proposals for much of the key Federal Marketplace work. In addition, CMS selected contract types that placed the risk of cost increases for this work solely on the Government.

WHAT WE RECOMMEND
We recommend that (1) CMS ensure that acquisition strategies are completed as required by regulation, (2) CMS assess whether to assign a lead systems integrator for complex IT projects, (3) CMS ensure that contract actions are properly documented, (4) CMS ensure that all contracts subject to oversight review requirements undergo those reviews, (5) HHS limit or eliminate regulatory exceptions to acquisition planning requirements, and (6) HHS revise its acquisition guidance to include specific standards for conducting past performance reviews. HHS and CMS concur with all of our recommendations.

Medicare Per Capita Spending By Age And Service: New Data Highlights Oldest Beneficiaries

January 20, 2015 Comments off

Medicare Per Capita Spending By Age And Service: New Data Highlights Oldest Beneficiaries
Source: Health Affairs

Medicare per capita spending for beneficiaries with traditional Medicare over age 65 peaks among beneficiaries in their mid-90s and then declines, and it varies by type of service with advancing age. Between 2000 and 2011 the peak age for Medicare per capita spending increased from 92 to 96. In contrast, among decedents, Medicare per capita spending declines with age.

As the US population ages and more people on Medicare live into their 80s, 90s, and beyond, analysts and policy makers are examining the impact of these trends on the federal budget and the Medicare program. At the same time, geriatricians and other providers who care for older patients are paying greater attention to the question of how best to meet the needs of an aging population. By 2050 the number of people on Medicare ages 80 and older will nearly triple; the number of people in their 90s and 100s will quadruple.

To inform discussions about Medicare’s role in providing coverage for an aging population and to assess the relationship between Medicare spending and advancing age, this article presents findings from an analysis of Medicare per capita spending among beneficiaries over age 65 in traditional Medicare, by age and type of service.

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