Avicenna Medical Blog

Care Management Weekly News Update 5/31/23

Posted by DeAnn Dennis on Wed, May 31, 2023 @ 11:59 AM

Congressional Republicans and the White House reached a deal over the weekend to raise the debt ceiling that includes healthcare wins for both sides of the aisle, creating a path forward to prevent economic upheaval roughly a week before a potential federal default.

Millions of Americans in the past few years have run into this experience: filing a health care insurance claim that once might have been paid immediately but instead is just as quickly denied. A recent KFF study of ACA plans found that even when patients received care from in-network physicians—doctors and hospitals approved by these same insurers—the companies in 2021 nonetheless denied, on average, 17% of claims.

Retail clinics have seen a 200% increase in utilization over the past five years, higher than urgent care centers, primary care practices and hospital emergency rooms, a new report finds.  The extensive report, published last week by Definitive Healthcare, uses proprietary data as well as external sources and aimed to analyze the influence of retailers in healthcare and how traditional providers should respond.

Growth in median total compensation for primary care physicians doubled last year, from pay growth of 2.13% in 2021 to 4.41% in 2022. However, the growth failed to overtake inflation, which increased 7% in 2021 and 6.5% in 2022, according to a survey by the Medical Group Management Association.

The Unwinding of Medicaid Continuous Enrollment: Knowledge and Experiences of Enrollees

Continuous enrollment in Medicaid ended on March 31, 2023, and over the coming months, states will redetermine eligibility for people enrolled in Medicaid and will disenroll those who are either no longer eligible or who are unable to complete the renewal process. This brief gauges Medicaid enrollees’ knowledge of and preparedness for the Medicaid renewal process and possible disenrollment from the program.

Tags: Weekly Industry News