Over one-third of states appear to have more stringent medical privacy laws than HIPAA (federal), which could hinder primary care and mental health providers' efforts to share information and integrate care.
The Official Disability Guidelines (ODG) Medical Treatment Guidelines is a utilization review guideline used in the field of workers' compensation. This report evaluates the ODG's technical quality and clinical acceptability.
This report estimates the potential impacts of a California Workers' Compensation formulary in terms of changes in prescription drug use and spending and discusses the potential broader impacts of these changes on the California economy.
Despite their differences, the Affordable Care Act and the current proposals to replace it take a similar approach to providing health insurance. What might some alternatives look like? And how could they provide coverage to more Americans?
Workers' compensation fraud costs insurers and businesses billions of dollars each year nationwide. This report focuses on the intentional manipulation of rules and procedures by providers of health care services and supplies.
The American Health Care Act would guarantee that individuals with pre-existing conditions could enroll in insurance even if they had a coverage lapse. But there is no guarantee that this coverage would be affordable, and coverage of some essential health benefits could be excluded.
The American Health Care Act passed by the U.S. House of Representatives to repeal and replace the Affordable Care Act allows states to waive benefits that the ACA deemed “essential.” Dropping maternity care coverage, for example, would reduce premiums by 5 percent but increase out-of-pocket spending for new mothers.
The American Health Care Act would have reduced insurance enrollment by an estimated 14.2 million people in 2020 and by 19.7 million people by 2026. The uninsured would have been older, sicker, and poorer than those currently uninsured. Also, the AHCA would have increased the deficit by $38 billion in 2020 while reducing it by $5 billion in 2026.
Medicaid enrollees are less likely than those with private insurance to see a dermatologist or receive care for a skin condition, suggesting that efforts need to be made to increase access to skin specialists.
The Medicare Access and Chip Reauthorization Act (MACRA) will decrease Medicare spending on physician services by an estimated -$35 to -$106 billion and change spending on hospital services by +$32 to -$250 billion between 2015 and 2030.