Lightnews — Scholar-powered news

Adrianna McIntyre @adrianna.bsky.social · 15d

A new paper led by Harvard Health Policy PhD student Ye Shen finds that, in the current policy environment, more than six in ten kids will have been enrolled in Medicaid for some period of time by their 18th birthday; the program is absolutley critical for children.

jamanetwork.com/journals/jam...

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Adam Raymakers @araymakers.bsky.social · 16d

Excited to share new research led by Jessica Harvey exploring the budget impact of gene therapies for sickle cell disease, with a focus on Medicaid programs.

Co-As: @ankurfactorial.bsky.social, @leah-rand.bsky.social, @akesselheim.bsky.social, & George Goshua.

🔗: link.springer.com/article/10.1...

Modeling the Budgetary Impacts of Sickle Cell Disease Gene Therapies on State Medicaid Programs - Journal of General Internal Medicine

Journal of General Internal Medicine -

link.springer.com

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Michael L. Barnett @mlbarnett.bsky.social · Sep 8

Overall, we estimate that longer hospital stays for Medicare Advantage patients are contributing to close to 2 million extra hospital bed days occupied by people who don't need to be there any more annually. This is a huge waste and bad for patient care.

Why is this happening?

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Louise Norris @louisenorris.bsky.social · Jul 30

Next year, Marketplace enrollees are going to have a pay a larger percentage of their income in premiums (assuming Congress doesn't extend the current subsidy enhancements).

Here's my overview of how it all works, including examples: www.healthinsurance.org/faqs/is-the-...

Does the IRS change how much I'll have to pay for my health insurance each year?

Unless Congress extends the subsidy enhancements, the percentage of income that you have to pay for self-purchased (individual/family) health coverage is going to increase significantly in 2026. This ...

www.healthinsurance.org

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John Graves @johngraves.bsky.social · Jul 29

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John Graves @johngraves.bsky.social · Jul 29

alas it will have to live as “personal correspondence” for now …

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John Graves @johngraves.bsky.social · Jul 29

When TN had it's "mini unwinding" back in 2016 (due to difficulties implementing the MAGI conversion, resulting in delays implementing eligibility system) the demographic group that saw the most rapid disenrollments were those 19-21.

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John Graves @johngraves.bsky.social · Jul 29

in a way--the enhanced premiums were scheduled to expire and the OBBB codified a decision not to extend them past 2025

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John Graves @johngraves.bsky.social · Jul 29

Until this year, consumers were largely shielded from rising premiums in exchange plans because enhanced premium tax credits capped premiums at no more than ~9% income for everyone.

But not next year: premium tax credits will be lower & consumers will additionally shoulder the premium increases.

George Pearkes @peark.es · Jul 29

Cost trends in general for patients on ACA exchange and Medicaid plans. Basically the premiums they set aren't high enough to cover the actual health care utilization of those to groups. Policy changes in Medicaid payouts are also playing a role.

Cas Piancey @cascoinfoundation.org · Jul 29

Any idea why payouts are suddenly skyrocketing?

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John Graves @johngraves.bsky.social · Jul 29

www.maths.dur.ac.uk/users/jochen...

www.maths.dur.ac.uk

John Graves @johngraves.bsky.social · Jul 29

Reminds me of the classic Basu's Elephant paper I learned from Alan Zaslavsky in his survey design course.

We're doing a similar exercise you recommend for a new insurance simulation model: MLE w/ (unweighted) survey data, with later weighted aggregation & MCMC calibration for population ests

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George Pearkes @peark.es · Jul 29

Cost trends in general for patients on ACA exchange and Medicaid plans. Basically the premiums they set aren't high enough to cover the actual health care utilization of those to groups. Policy changes in Medicaid payouts are also playing a role.

Cas Piancey @cascoinfoundation.org · Jul 29

Any idea why payouts are suddenly skyrocketing?

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JAMA @jama.com · Dec 13

Viewpoint from John Graves and Gabrielle Lyons discusses enrollment in Medicare Advantage vs traditional Medicare among older adults and common reasons for plan disenrollment.

https://ja.ma/3VCyjA9

PDF preview image of "Incentivizing Network Adequacy in Medicare Advantage"

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John Graves @johngraves.bsky.social · Jul 23

New teaching hook for covering "job lock" in health economics courses just dropped.

The Tennis Letter @thetennisletter.bsky.social · Jul 23

Venus Williams after becoming the oldest WTA match winner since 2004:

“I had to come back for the insurance, because they informed me this year that I’m on cobra. So it’s like, I got to get my benefits on” 😭😭😭😭

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The Tennis Letter @thetennisletter.bsky.social · Jul 23

Venus Williams after becoming the oldest WTA match winner since 2004:

“I had to come back for the insurance, because they informed me this year that I’m on cobra. So it’s like, I got to get my benefits on” 😭😭😭😭

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John Graves @johngraves.bsky.social · Jul 13

Nearly everything I do today is empirics and coding. But my English degree is unquestionably the most important thing I took from (liberal arts) undergrad.

Glen O'Hara @gsoh31.bsky.social · Jul 13

Decades of mechanistic talk about university degrees as if they were bundles of 'skills' and 'prep' are about to be proved completely wrong (obviously). Want to get a real boost? Do History or English.

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Glen O'Hara @gsoh31.bsky.social · Jul 13

Decades of mechanistic talk about university degrees as if they were bundles of 'skills' and 'prep' are about to be proved completely wrong (obviously). Want to get a real boost? Do History or English.

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Zeke Emanuel, MD, PhD @zekeemanuel.bsky.social · Jul 9

Trump's bill could strip Medicaid from 12 million Americans. Repeal isn't enough. Democrats must use this opportunity to propose bold reforms that truly fix Medicaid’s core problems.

In @thebulwark.com, I share how to build a system that actually works: www.thebulwark.com/p/democrats-...

Dems Must Really Fix Medicaid, Not Just Undo Trump’s Damage to It

The party should use this as an opportunity to build toward universal coverage—working from these seven principles for reforming health care.

www.thebulwark.com

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John Graves @johngraves.bsky.social · Jul 3

my sense is a lot of the new verification requirements (e.g., address, work, etc.) are going to really limit the practical effectiveness of ex parte

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John Graves @johngraves.bsky.social · Jul 3

so that's one possible avenue ...

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John Graves @johngraves.bsky.social · Jul 3

When states couldn't implement MAGI conversions in time (and they had four years of lead-time...), CMS allowed states flexibility to extend renewal periods (you may recall, as I think I've discussed w you, TN had a lot of vendor challenges on this ...)

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John Graves @johngraves.bsky.social · Jul 3

Get ready for the Enrollment Industrial Complex to emerge

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John Graves @johngraves.bsky.social · May 15

Ugh. I'm so sorry to hear this.

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Aaron Schwartz @aschwartz.bsky.social · May 14

Eric Roberts and @joefigs.bsky.social led a groundbreaking new study on Medicaid and Medicare, out today in NEJM. I’m lucky to have been a part of it.

Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | NEJM

A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS), which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication access and affect mortality. U...

www.nejm.org

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John Mullahy @johnmullahy.bsky.social · May 12

ADVISEES: YOUR MENTORS WANT TO KNOW HOW YOU'RE DOING.

(And, yes, I know I could do better with reaching out to you, but leave that aside for the moment.)

Please don't ever think you're bothering your former mentors with requests to catch up. They are not a bother. They want to hear from you.

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John Graves @johngraves.bsky.social · Apr 24

at this point I am an uber/lyft driver with a side hustle as a university professor

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John Graves @johngraves.bsky.social · Apr 19

Amazing, Laura - congrats!!

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Ellen Meara @ermeara.bsky.social · Apr 12

The Value Zeitgeist — Considering the Slowdown in Health Care Spending Growth | New England Journal of Medicine www.nejm.org/doi/full/10.... @melindabbuntin.bsky.social , Carrie Colla, and I argue it's too soon to give up on value-based care.

The Value Zeitgeist — Considering the Slowdown in Health Care Spending Growth | NEJM

Over the past two decades, the health care spending growth rate in the United States has declined. But reducing the emphasis on value-based care could lead to a resurgence in spending growth.

www.nejm.org

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Simon F. Haeder @simonfhaeder.bsky.social · Apr 9

New article out in Health Affairs Scholar with a great group of co-authors led by Jane Zhu providing a novel view on provider networks & adequacy from the carrier perspective

Medicaid managed care organizations' experiences with network adequacy

doi.org/10.1093/hasc...
#HAScholar

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John Graves @johngraves.bsky.social · Apr 8

Indeed -- from our recent JAMA viewpoint

jamanetwork.com/journals/jam...

Reflecting these trends, high-stakes network contracting
battles have begun to spill out into media reports of major hospital
and physician groups withdrawing—or threatening to withdraw—
from popular MA networks. Without further policy changes, MA’s
redesigned networks could leave older adults facing difficult decisions over affordability and access as MA’s majority era in the Medicare program commences.

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