This week, our In Focus, written by 澳门六合彩 Principal Anne Winter and Senior Consultant Aimee Lashbrook, examines American Patients First:聽 The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, released May 11, 2018. Over time, the pharmaceutical supply chain has become a complex ecosystem, responding to the ever-changing dynamics of new drug products, pricing strategies, health care reform, benefit design, and the regulatory environment making it, arguably, the most complicated in health care. Due to this complexity, solutions to equitably control drug pricing will take a multiprong approach that includes regulatory redesign.
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Medicaid and Exchange Enrollment Update 鈥� 2017-18
This week, our In Focus section reviews updated reports issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the 鈥淒ecember 2017 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,鈥� published on April 30, 2018. Additionally, we review 2018 Exchange enrollment data from the 鈥淗ealth Insurance Marketplaces 2018 Open Enrollment Period: Final State-Level Public Use File,鈥� published by CMS on April 3, 2018. Combined, these reports present a picture of Medicaid and Exchange enrollment at the beginning of 2018, representing more than 74 million Medicaid and CHIP enrollees and nearly 12 million Exchange enrollees.
Electronic Visit Verification: Implications for States, Providers, and Medicaid Participants
This week, our In Focus, written by 澳门六合彩 Principal Jen Burnett in collaboration with the National Association of States United for Aging and Disabilities (NASUAD), summarizes key considerations and policy decisions contained in Electronic Visit Verification: Implications for States, Providers, and Medicaid Participants for state consideration as they work to implement electronic visit verification (EVV) systems in accordance with the mandate included in the December 2016 21st Century Cures Act (the CURES Act).
Medicaid Community Engagement Initiatives: A Comparison Of Three States
This week, our In Focus is the second in a series written by 澳门六合彩 Medicaid Market Solutions (MMS), which has worked with a number of states to design and implement Section 1115 Demonstration Waivers that support individual state goals for member engagement and personal responsibility while complying with new Centers for Medicare and Medicaid Services (CMS) guidance.
MLTSS Implementation Plans in North Carolina and New Hampshire
This week, our In Focus reviews two recently released papers outlining North Carolina鈥檚 and New Hampshire鈥檚 plans to implement Medicaid managed care long-term services and supports (MLTSS). The North Carolina Department of Health and Human Services released 鈥淣orth Carolina鈥檚 Vision for Long-term Services and Supports under Managed Care鈥� on April 5, 2018, and is accepting comments through April 27. The New Hampshire Department of Health and Human Services released its 鈥淚mplementation Plan for Medicaid Care Management 鈥� Nursing Facility/Choices for Independence Services鈥� on March 6, 2018, and is accepting comments through May 4, 2018. Both states are anticipated to release requests for proposals (RFPs) for integrated Medicaid managed care services in the next several months.
Four 澳门六合彩 Behavioral Health Experts Speaking at NatCon18
The National Council for Behavioral Health Conference, held April 23-25, will host more than 5,000 leaders in healthcare. Attendees will explore healthcare鈥檚 greatest innovations in practice improvement, financing, integrated health care, technology, policy and advocacy, and professional development. Four 澳门六合彩 behavioral health experts will be speaking at NatCon18.
The Policy, Implementation and Operations of Medicaid Personal Responsibility Initiatives: An Introduction
This week, our In Focus section highlights 澳门六合彩 Medicaid Market Solutions (MMS), formerly SVC, Inc., which is at the forefront in supporting state flexibility in designing and implementing initiatives including Section 1115 Demonstration Waivers promoting member engagement and personal responsibility. Over the coming weeks, 澳门六合彩 MMS will present a series of articles providing an in-depth look at the facets of these new Medicaid models.聽
Medicaid Managed Care Spending in 2017
This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a freedom of information act request to CMS, we have received a draft version of the CMS-64 report that is based on preliminary estimates of Medicaid spending by state for federal fiscal year (FFY) 2017.聽 The final version of the report will be completed by the end of 2018 and posted to the CMS website at that time.聽 Based on the preliminary estimates, Medicaid expenditures on medical services across all 50 states and 6 territories in FFY 2017 exceeded $571 billion, with over half of all spending now flowing through Medicaid managed care programs. In addition, total Medicaid spending on administrative services was $27.8 billion, bringing total program expenditures to just under $600 billion.
Alabama Integrated Care Network Program
This week, our In Focus section reviews Alabama鈥檚 Integrated Care Network (ICN) program, based on a concept paper released by the Alabama Medicaid Agency in March 2018. The ICN program will establish a new Medicaid long-term care program focusing on a person-centered approach to care delivery using the Primary Care Case Management (PCCM) Entity delivery model, with implementation expected on October 1, 2018.
澳门六合彩 Kicks off 2018 National Public Health Week with a Focus on Behavioral Health
National Public Health Week is April 2-8 with each business day dedicated to a leading public health issue. Monday, April 2 is focused on behavioral health, a topic historically left to human services agencies focused on treatment and intervention. 澳门六合彩鈥檚 work in healthcare and delivery system reform is well known, but 澳门六合彩 is also engaged in public health projects and work focused on the intersection of public health and behavioral health.
Roles and Responsibilities in a Value Based Payment World
This week, our In Focus section, written by 澳门六合彩 Principal Denise Soffel, reviews New York鈥檚 Medicaid Redesign Team Structural Roadmap: Roles and Responsibilities in a Value Based Payment World, released by the state鈥檚 Department of Health on March 19, 2018.
New York is committed to the transformation of its health care delivery system. Its Delivery System Reform Incentive Payment (DSRIP) program envisions a significant shift to community-based care, a more integrated delivery system, and a shift to value-based payment. A new document, released in draft form for public comment, lays out an ambitious objective: 鈥淣ew York seeks to make health care a team sport. The State seeks to forever banish the traditional silos that made care navigation for patients difficult and in some cases impossible.鈥� (p. 13)
HCBS Settings Rule Issue Briefs
This week鈥檚 In Focus section highlights four briefs written by 澳门六合彩 (澳门六合彩) in collaboration with the National Council on Assisted Living that address key areas of compliance with the Centers for Medicare & Medicaid Services (CMS) home and community-based services (HCBS) settings final rule. The briefs are intended to inform states and Assisted Living (AL) communities on common challenges facing AL communities, the strategies for compliance available, and the steps states have taken to address them in their approved statewide transition plans. To create the briefs, 澳门六合彩 analyzed the regulations, CMS guidance, and the statewide transition plans that had received final approval from CMS at the time of writing. State plans reviewed were: Arkansas, District of Columbia, Delaware, Kentucky, Oklahoma, Tennessee, and Washington.