Medicare and Medicaid are the primary sources of health insurance for many Americans, and some people qualify for assistance from both programs. Enrollment in the unique plan has been slow and the outreach effort is ongoing.
Only about 3 in 10 people were eligible to enroll in dual-eligible special needs plans in 2021, according to KFF Health News. Experts said this option is designed for people who need additional support because of a disability, certain health conditions, or age.
Dr. Gina Williams, UnitedHealthcare's associate medical director, said the plan attempts a dynamic approach to serving eligible populations.
“Everything from health care to behavioral health needs to managing day-to-day needs,” Williams outlined. “This is like a more comprehensive package for people who need a little more support.”
Everyday needs include food perks and bathroom safety equipment. The National Council on Aging said D-SNP aims to provide more efficient care coordination because there is assistance in arranging services. Wisconsin's enrollment is similar to the nation at 28%.
Kristin Huberty, chief benefits specialist and northern regional attorney for the Wisconsin Department of Aging Resources, said the difficult part of the plan is navigating provider network limitations. He cautioned that rural residents may have to travel further to see a doctor covered by the plan and should do careful research before signing up.
“First and foremost, check your provider's network limits,” Huberty advised. “Find out what’s available in your area.”
Meanwhile, Williams noted that efforts to encourage more eligible people to register are consistent with increased awareness of preventive care in a post-pandemic world.
“We're getting to the point where everyone's not just thinking about acute illness, but also about holistic care,” Williams said. “What impact has the pandemic had on you from a psychological perspective? Do you need more support? Do you also need benefits adjustments?”
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A recent report examined how some rural hospitals in Tennessee have managed to stay afloat despite financial difficulties.
The report includes interviews with staff from five regional hospitals with bed sizes ranging from 25 to 125.
Judy Roitman, executive director of the Tennessee Healthcare Campaign, said some hospitals are drowning in uncompensated care. She explained that as part of her research, she interviewed her CEO of a rural Kentucky hospital who expressed the importance of Medicaid expansion.
“Kentucky has expanded its Medicaid program, but Tennessee hasn't,” Roitman said. “The key to our stability, he said, is the money coming in to actually treat these patients. And Tennessee's hospital CEOs and others are worried that federal funds will come in. I said it would make a huge difference.”
Roitman added that the federal government is offering Tennessee a 9-1 match. If Tennessee expands Medicaid, at least 330,000 of her people will have access to insurance.
Roitman noted that the report suggests further steps hospitals could take, such as considering how to reimburse for services provided. He noted that private insurance plans tend to offer the highest reimbursement rates, and said more funding is needed to support TennCare because it doesn't cover enough costs.
“Everything at TennCare is managed by a managed care organization,” Roitman explained. “They're negotiating with each hospital on how they're going to be reimbursed, and the big hospitals have some leverage to demand better payments, but the smaller hospitals just aren't getting paid. .”
Roitman added in the report that strong community involvement and effective hospital leadership are key factors in staff retention. According to the report, sound management and retaining a dedicated workforce have a significant impact on a hospital's viability.
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In Mississippi and across the country, funding for community health centers is increasing thanks to bipartisan spending packages passed by Congress.
Community health centers in Mississippi serve patients regardless of insurance status or ability to pay. More than 20 locations across the state provide care to more than 380,000 people.
Joe Dunn, senior vice president for public policy and advocacy at the National Association of Community Health Centers, said about 1 in 11 Americans receive care at these types of clinics.
“Community health centers are the nation's largest primary care network, providing care to 31 million Americans,” Dunn noted. “This network is critical because it provides an array of much-needed services, including primary care, behavioral health, and dentistry.”
Dunn emphasized that more can be done. Research shows that more than 100 million Americans need better access to primary care. Mississippi's community health centers also support more than 4,000 jobs and approximately $678 million in economic activity in the communities where they are located.
Dunn said increased funding from Congress will allow clinics to provide more comprehensive care and reach more underserved patients, especially in rural areas, and ultimately help the state's He pointed out that this would save money.
“By encouraging people to receive primary care, we can further reduce downstream costs,” Dunn emphasized. “Hospitalizations and complications from chronic conditions are decreasing based on preventive screening and early care.”
The Congressional Budget Office reports that increased funding for community health centers through the end of this year will reduce federal spending on public health insurance programs by more than $700 million.
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Duchess Kate's recent medical checkup shines a spotlight on the importance of Hoosiers under the age of 50 getting tested for certain cancers. The news comes at a time when cancer rates among young people are on the rise.
Mary Robertson, director of cancer prevention at Indiana University's Melvin Bren Simon Comprehensive Cancer Center in Indianapolis, said family history has a huge impact on cancer risk and that transparency within families is important. He emphasized the importance of certain discussions.
“For those who are currently uninsured, we have certain programs in place, especially in the state of Indiana, that cover breast and cervical cancer screenings for free,” she explained. “The main recommendation is to talk to your doctor and get a referral for these tests.”
Robertson added that routine screening with individualized recommendations is recommended for those with individual risk factors, such as colorectal screening from age 45 and cervical cancer screening from age 21 for women. Ta. Duchess Kate's diagnosis at the age of 42 highlights the importance of wider awareness and access to life-saving interventions.
Robertson said the HPV vaccine can prevent multiple cancers without the need for booster shots.
“We have a cancer prevention vaccine, the HPV: human papillomavirus vaccine. It's available for ages 9 to 45. It protects you from six different types of cancer. I'm going to take every opportunity to prevent cancer. We want to prevent it, and this is it.’ It’s very accessible,” she explained.
Cancer can be an uncomfortable topic for young people to talk about, but it is important to detect and stop the disease as early as possible to give them the best chance of survival.
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