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Institute for Medicaid Innovation
The Institute for Medicaid Innovation (IMI), the nonprofit Medicaid research group, shed light on the economic and social conditions affecting health outcomes in underserved populations with a new report, "Innovation and Opportunities to Address Social Determinants of Health in Medicaid Managed Care."
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Forbes
Health plans that contract with state Medicaid programs are moving to address social determinants of health by paying for affordable housing, food vouchers to purchase fresh vegetables and education screenings at the doctor's office.
But challenges remain from inadequate funding to the lack of data sharing between medical care providers, insurers and community organizations, a new report from the nonprofit The Institute for Medicaid Innovation shows.
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The Hill
Per-person spending on insulin doubled in a recent five-year period, according to a report released Tuesday.
Individuals with type 1 diabetes spent an average of $5,705 on insulin in 2016, compared with $2,864 in 2012, according to a study from the Health Care Cost Institute.
The dollar amount represents the combined amount paid by a patient and their insurer, and doesn't include discounts given later.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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The Hill
Sen. Chuck Grassley (R-Iowa) is giving Republicans an early test on their commitment to lowering drug prices.
Legislation sponsored by the Senate Finance Committee chairman and Democratic Sen. Amy Klobuchar (Minnesota) would allow people to buy prescription drugs from approved pharmacies in Canada.
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ZeOmega
Watch how Kern Health Systems, a large Medicaid organization in California, uses Jiva—the industry’s leading PHM platform—to achieve seamless integration and single sign-on while also streamlining workflows, lowering costs, and improving overall health outcomes for its members.
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Modern Healthcare
As the federal government allows more states to implement controversial work requirements for Medicaid beneficiaries, managed care organizations are feeling the pressure to help their members find jobs or community service gigs. There's a lot at stake for health plans: The more members they lose because of work and reporting requirements, the bigger the squeeze on their profit margins.
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Washington Examiner
Democratic Gov. Janet Mills is rejecting an arrangement her Republican predecessor set up with the Trump administration in Maine that would have required certain people on Medicaid to work as a condition of staying enrolled in the program. Instead, she directed the state's health agency Tuesday to make vocational and work training programs available as an option for Mainers. To be on the Medicaid program, people in the state must make less than roughly $17,000 a year, regardless of whether they are working, are disabled, or what their savings are.
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The Indianapolis Star
If the experience of Arkansas is any guide, Indiana's plan to require people on Medicaid to work could wind up creating more problems than it solves, a new study from the Center on Budget and Policy Priorities suggests.
The study released earlier this month found that since Arkansas in June became the first state in the nation to implement work requirements, nearly 17,000 people, or about 20 percent of those potentially affected, lost health coverage.
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In a recent analysis of 10,573 members receiving advanced pain care procedures, 61% received opioids and 36.7% were assessed as high or severe risk. The monthly spend for these members? 17 times the average cost.
Interested in improving pain care and reducing costs across your network? Let’s connect.
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The Hill
The Trump administration has approved Arizona's request to impose work requirements on Medicaid beneficiaries.
Arizona is the eighth state to receive permission to impose work requirements on Medicaid beneficiaries, but will be the first to allow an exemption for members of federally recognized tribes.
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A commercial Medicaid plan in Nevada leveraged MCG solutions in its community health program and reduced ER visits by 20% and hospital readmissions by 30%. Click here to learn more about how MCG can support improved member outcomes and cost control.
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The Associated Press via ABC News
Arizona has become the only state in the country where members of federally recognized tribes are exempt from work or volunteer requirements for Medicaid benefits, while 120,000 state residents risk losing health coverage if they don't comply.
The announcement came Friday from the Centers for Medicare and Medicaid Services, which said it believes the exemption is consistent with the tribes' status as political entities. Early last year, the agency wrote to tribes saying exempting all Native Americans from work requirements could violate equal protection laws.
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Kern Health Systems (Kern) is overcoming numerous care management challenges using Jiva, the industry’s leading PHM platform. Learn how the powerful end-to-end platform is helping Kern consolidate data, streamline workflow, manage compliance, create holistic assessments, improve overall health outcomes, and plan for future expansion into new lines of business.
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Georgia Health News
It looks as though Gov. Brian Kemp will indeed pursue a Medicaid "waiver" proposal to expand health coverage in Georgia.
Kemp, in his State of the State speech Thursday — three days after he was sworn in as Georgia's new chief executive — said he will seek "to expand access [to care] without expanding a broken system."
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