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Senior Correspondent Phil Galewitz discusses what 2013 will hold for healthcare
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Reporters from Kaiser Health News preview some of the big issues coming this year: KHN Senior Correspondent Phil Galewitz says he'll be watching state decisions on expanding Medicaid, establishing exchanges and reaching out to the public on the law. More



Eyeing debt ceiling, Corker, Alexander offer entitlement-reform plan
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Two centrist Republican senators have introduced a plan to reduce the growth of entitlement spending by nearly $1 trillion in exchange for an equal increase to the federal debt ceiling. U.S. Sens. Bob Corker and Lamar Alexander, both of Tennessee, called on Congress to focus on entitlement reform after it addresses the impending expiration of the Bush-era tax rates. They identified the expiration of the federal debt ceiling as an opportunity to address the costly growth of Medicare, Medicaid and Social Security. More

Bigger fights loom after 'fiscal cliff' deal
Reuters    Share    Share on FacebookTwitterShare on LinkedinE-mail article
President Barack Obama and congressional Republicans face even bigger budget battles in the next two months after a hard-fought "fiscal cliff" deal narrowly averted devastating tax increases and spending cuts. The agreement by the Republican-led House of Representatives, which was signed by Obama, was a victory for the president, who had won re-election in November on a promise to address budget woes, partly by raising taxes on the wealthiest Americans. More

Obamacare: 5 states to watch
POLITICO    Share    Share on FacebookTwitterShare on LinkedinE-mail article
States entered 2012 not knowing whether President Barack Obama's healthcare law would survive. They enter 2013 facing the reality of impending deadlines and tough choices that can't be put off much longer. Even states that have turned down the chance to build their own exchanges — about 30 in all — have about six weeks to decide whether they want to partner with the feds on key functions. Although states don't face a deadline to say whether they'll expand their Medicaid programs under the Affordable Care Act, the clock is definitely ticking. More

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Florida facing huge Medicaid, 'Obamacare' decisions in 2013
The News Service of Florida via Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Dealing with issues that affect the healthcare of millions of poor and uninsured residents, Florida leaders in 2013 could move forward with a long-awaited overhaul of the Medicaid system and likely will decide how to carry out the federal Affordable Care Act. Both issues are highly complex and politically controversial. More

Illinois senator: Stroke changed perspective on Medicaid
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
U.S. Sen. Mark Kirk, R-Ill., said his debilitating stroke has sparked a new interest in the experience of people on Medicaid. In a recent interview, Kirk said that most Illinois residents insured through the low-income health program would be eligible for just 11 rehabilitation sessions following a stroke. "Had I been limited to that I would have had no chance to recover like I did. So unlike before suffering the stroke, I'm much more focused on Medicaid and what my fellow citizens face," Kirk told the Chicago Sun-Times. More

Medicaid waiver presents structuring challenges in Texas
The Texas Tribune    Share    Share on FacebookTwitterShare on LinkedinE-mail article
By year's end, healthcare providers across Texas will have submitted proposals to state leaders to transform the way they care for the poor and uninsured. They have been spurred by a Medicaid waiver Texas officials sought and received in 2011 from the federal government, one that ties financing to cooperation, cost efficiency and better patient outcomes. "We're at a real turning point, some would call it a crisis, on how much money we're spending on healthcare," said state Rep. Lois Kolkhorst, R-Brenham, the chairwoman of the House Public Health Committee. "It is incumbent upon us that the system actually transforms and doesn't become bigger and bulkier and more expensive." More



California sued over Medi-Cal patients' switch to managed care
Los Angeles Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Legal aid organizations have filed a lawsuit against the California Department of Health Care Services, alleging that the state violated patients' rights by forcing them into managed care. The suit is on behalf of five Medi-Cal recipients, all of whom have complex medical problems. Lawyers said the patients lost access to their doctors when they were automatically defaulted into managed care. More

Kansas to weigh benefits, costs of expanding Medicaid
The Wichita Eagle    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Like many states, Kansas is assessing the benefits and costs of expanding Medicaid — an option it has under the Affordable Care Act. Healthcare leaders say they are pleased Gov. Sam Brownback's administration is studying the issues, rather than opting out early as some Republican governors have done. "It's really good news that the governor hasn't just automatically said no, that he is willing to look at the economic impact for the state of Kansas," said David Sanford, CEO of GraceMed Clinic, a health ministry of the United Methodist Church. More

Illinois vendor begins checks of Medicaid eligibility
The Associated Press via The State Journal-Register    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Illinois officials have announced the launch of an effort to make sure only people who are eligible receive Medicaid. Medicaid is a state and federal program that helps pay for healthcare for the poor and disabled. The goal of the new project is to verify annually the income levels and residency of the state's 2.7 million Medicaid clients. More

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Oklahoma lawmaker to lead new oversight health panel
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
U.S. Rep. James Lankford, R-Okla., will lead a new subpanel on healthcare, entitlements and energy policy in the 113th Congress, leaders announced. The House Oversight appointment comes as leaders reduce the committee's seven subpanels to five. Healthcare previously was lumped in with the District of Columbia, the Census and the National Archives. More

Awaiting approval for state health insurance exchanges
American Public Media    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The fiscal cliff wasn't the only important deadline in Washington on New Year's Day. It was the day the Secretary of Health and Human Services told states whether their plans for health insurance exchanges pass muster. These are the new insurance marketplaces provided for under Obamacare. Twenty-four states and the District of Columbia have applied to set up exchanges. Consumers in the rest of the states can use a single, federally-maintained exchange to help find coverage when the insurance mandate goes into effect in 2014. More

Report: ED use drops when medical practices extend office hours
American Medical Association    Share    Share on FacebookTwitterShare on LinkedinE-mail article
When primary care physicians keep their doors open after usual business hours, patients are able to contact those doctors for care and advice instead of going to an emergency department, a new report concludes. In surveying more than 9,500 people with steady sources of care, the Center for Studying Health System Change focused its results on 1,470 individuals who had tried to contact their primary care practices after normal business hours in the past year. The study, published online in Health Affairs, found that nearly 21 percent had difficulties reaching their physicians after hours. More



Link between healthcare spending, quality unclear
Reuters    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Whether states, hospitals and smaller practices that spend more money on healthcare provide better treatment is still an open question, according to a new review of past studies. "This is really one of the central issues we're grappling with today in healthcare," said Peter Hussey from the RAND Corporation in Arlington, Va. The topic is especially pressing because although the United States spends more of its budget on health care than any other wealthy nation — and is spending more each year — the World Health Organization ranks its health system 37th. More


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Keeping You Healthy video: CentAccount by Centene
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The CentAccount program promotes personal healthcare responsibility in Centene's membership by offering financial incentives. A consumer-driven incentive program designed to strengthen the relationships between Centene health plan members and their medical home, it increases the utilization of preventive services, reduces reliance on the ER, and increases continuity of care, resulting in better health outcomes for members. Rewarding members for targeted healthy behaviors increases the likelihood that such behaviors will be continued through positive reinforcement. Centene Senior VP Aparna Aburri discusses this innovative program with the MHPA Center for Best Practices. More

Free webinar by LexisNexis 'Why Identity Management Matters to Medicaid' | 1 p.m. EST Jan. 9
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The challenges of identity risk management can be boiled down to these two words: "Who's there?" At its core, this is the essence of security. Government efforts are driving much of the focus on identity management — a primary concern for the healthcare industry. Medical identity theft or improper access to sensitive records, as well as liability issues, are of paramount concern. Patients want to know what steps are being taken to ensure their privacy. As a Medicaid plan, you should not just be addressing the "what" of identity management — the technical side — but also the question of "who?" How do you know people are who they claim to be and what risks do they pose for the environments and systems they are attempting to enter? Clint Fuhrman, director of Government Health Care Programs for LexisNexis Risk Solutions, addresses these issues in a FREE 60-minute webinar. More



Free webinar by Navigant Consulting: 'Medicaid Managed Care Program Management: The Next Generation' | 11a.m. EST Jan. 16
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
There has been "skepticism" about managed care in the policy process and in the public at large. Medicaid Health Plans need to help policy makers understand the value of MCOs and be able to design delivery systems where MCOs can be innovative and valued leaders in delivery and management of Medicaid services. The webinar will cover what MCOs need to do to be ready for the next generation of Medicaid managed care, emphasizing the need to use value-based purchasing to drive for improvement and achievement. Presented by Anne Jacobs, managing director, Navigant Consulting. More

Insights webinar by Baxter: 'Proper Capitation Rates for Hemophilia Patients' | 11 a.m. EST Jan. 23
Baxter    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In 2013, Medicaid managed care will be affected in a variety of ways — from the shakeout of the 2012 elections and the fiscal cliff negotiations to the continued implementation of the Affordable Care Act. This presentation will address the current status and implications of many outstanding state and federal decisions affecting Medicaid managed care, including: state Medicaid expansion, Health Insurance Exchange decisions and level of integration, and CMS regulatory guidance on Medicaid reforms. Presentations by Jim Hardy and Sarah Wiley of Deloitte Consulting LLP. More

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Free webinar by Deloitte: 'The Fiscal Cliff, ACA, and Medicaid Managed Care' | 2 p.m. EST Jan. 29
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In 2013, Medicaid managed care will be affected in a variety of ways — from the shakeout of the 2012 elections and the fiscal cliff negotiations to the continued implementation of the Affordable Care Act. This presentation will address the current status and implications of many outstanding state and federal decisions affecting Medicaid managed care, including: state Medicaid expansion, Health Insurance Exchange decisions and level of integration, and CMS regulatory guidance on Medicaid reforms. Presentations by Jim Hardy and Sarah Wiley of Deloitte Consulting LLP. More

Watch, listen to the Sept. 18 webinar, 'Importance of Coordinated Care in the Management of Members with Hemophilia,' free on MHPA's website
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The presentation on coordinating care in hemophilia and how to improve outcomes and reduce costs by Jeff Januska, PharmD, pharmacy director at CenCal Health and Dr. Steven Pipe, associate professor, Department of Pediatrics and the Department of Pathology, University of Michigan, now is available on MHPA's website.



Free webinar by AMFC: 'Optimizing Pharmaceutical Care and Measuring Outcomes in a Collaborative Drug Therapy Management Program' | 2 p.m. EST Jan. 30
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medication-related problems and medication mismanagement are massive public health problems in the U.S. Experts estimate that 1.5 million preventable adverse events occur each year that result in $177 billion in injury and death. In response to these problems, PerformRx, in collaboration with the AmeriHealth Mercy Family of Companies, successfully have developed a collaborative Drug Therapy Management program that has demonstrated significant reductions in emergency room visits and inpatient admissions, as well as significant costs savings. More

Free webinar by PwC: 'Getting to know the 30 million newly insured: New patients equals new challenges' | 2 p.m. EST Feb. 6
PwC    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the wake of the Supreme Court's ruling to uphold the Affordable Care Act, approximately 30 million uninsured Americans under age 65 stand to gain coverage under the law. States are making two crucial decisions: Whether to expand Medicaid coverage, and which type of health insurance marketplace to create — state-run, state-federal run, or federally facilitated. As decisions are made and plans put in place, one thing is certain: When the exchange population is combined with the new Medicaid beneficiaries, the result will be a distinctly different customer base for the health sector, bringing with it many new challenges and opportunities. More



MHPA CEO Thomas Johnson to speak at Strategic Solutions Network's 4th Annual 'Medicaid Innovations Forum' | Feb. 5-7 | Orlando, Fla.
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid Innovations is designed to be the meeting place for all participants in the Medicaid universe who want to participate, share and learn about innovations that promote quality improvement, cost reduction and transformation in the face of reform. Use discount code MHPA when registering to receive a $200 discount off the current rate. For complete agenda and to register, click here.

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