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Critical reports mount on hepatitis C pill costs; MHPA's Myers weighs in with classic quote
The staggering costs of hepatitis C pills are the subject of two new medical journal reports pointing out that employers, insurers and the U.S. government will have difficulty paying for these pricey pills for years to come.
Jeff Myers, president and chief executive of MHPA, said, "It's a lot like buying diamonds on sale: Discounts are great, but everyone knows they're so marked up that even with the discount, you're still overpaying."
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Should states use bonds to pay for breakthrough drugs? More comments from Myers
When the maker of a breakthrough hepatitis C drug Sovaldi set the price at $1,000-a-pill but promised a cure that could lower costs in the long term, states scrambled last year to limit treatment to patients with the most severe cases, anticipating billions in near-term costs. A new report argues a good solution might be to use an approach that state governments already prefer with infrastructure and some social programs — taking out bonds.
House GOP budget and Medicaid block grants
There are plenty of ways Republicans could lose this year's massive intraparty fight over the budget. But so far there is at least one big winner — the Pentagon. The fiscal 2016 spending blueprint unveiled by the House GOP Tuesday shifts money around to give a big cash boost to the military, even as the party's fiscal hawks and defense hawks are already drawing battle lines. Republicans will need majorities in both chambers to pass a budget this year, and with just 54 Republicans in the Senate, the math is tight and the obstacles to a deal are huge.
Senate GOP budget to break with Paul Ryan's blueprints
Senate Republicans will not include detailed plans to overhaul entitlement programs when they unveil their first budget in nearly a decade this week, according to GOP sources. The decision would break from Wisconsin Rep. Paul Ryan's House budgets from recent years, which Democrats used to pound Republican candidates in the 2012 and 2014 elections.
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March 18 Webinar Wednesday: ''Continence Management for Managed Care: Cost Containment through Better Care'
Join this webinar to learn best practice strategies for managing the complex job of continence care. As a manufacturer, supplier and provider of continence products in the industry, Medline Industries has created a turn-key program for health plans that can help leverage the capabilities of manufacturer-direct unit pricing and member utilization. Participating plans in Medline's Continence Solutions program have saved as much as 25 percent on their incontinence spend while still continuing to manage to coverage guidelines.
Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
HHS: 16.4 million enrolled in coverage since ACA passed; Medicaid expansion states see fewer uninsured
Inside Health Policy (Subscription required)
A net 16.4 million uninsured Americans gained health coverage since provisions of the Affordable Care Act first took effect in 2010, according to an HHS report released Wednesday, March 16. The new figure includes 14.1 million adults who enrolled in on- and off-exchange coverage from October 2013 through March 4, and 2.3 million young adults age 19 to 25 who hopped onto their parents' insurance before the insurance exchanges opened.
Healthcare professionals skeptical of Missouri governor's Medicaid expansion proposals
St. Louis Public Radio
Hospitals are pushing for Medicaid expansion in Missouri. Physicians say it's crucial. And yet, lawmakers in favor of expansion have been unable to offer a proposal that the legislature's Republican majority will accept. In Gov. Jay Nixon’s latest pitch for Medicaid expansion, he outlined a number of caveats to appease conservatives. Nixon's proposal calls for people wanting to apply for Medicaid coverage to be working or actively looking for work to qualify for the lowest rates. Also, enrollees who call for ambulances under "non-emergent" circumstances could be penalized. Nixon also recommended offering incentives for healthy lifestyle choices, such as quitting smoking or losing weight.
KDADS secretary plans to introduce reworked Kansas Medicaid mental health drug bill
Kansas Health Institute
A Senate-rejected bill meant to allow KanCare, Kansas' privatized Medicaid program, to regulate mental health patients' access to antipsychotic medications is making a comeback. Kansas Department for Aging and Disability Services Secretary Kari Bruffett on Thursday said she hopes to introduce a revised version of the bill within the next few weeks. The intent of the new bill, she said, will be to ensure patient safety without jeopardizing ready access to mental health drugs.
New Hampshire Medicaid expansion could end in 2016
New Hampshire Union Leader
A House committee voted along party lines Sunday to allow New Hampshire's Medicaid expansion to expire on Dec. 31, 2016. a move a spokesman for Gov. Maggie Hassan called "misguided." Hassan had called for the expansion to be extended as part of her proposed fiscal year 2016-2017 budget.
Comptroller: New York Medicaid spending to rise
The Associated Press via WKTV-TV
New York State Comptroller Thomas DiNapoli says state spending on Medicaid is projected to rise by nearly $700 million a year over the next four years. However, DiNapoli said Thursday that the state's efforts to limit Medicaid spending are showing signs of progress with annual growth at less than 2 percent. The growth rate had previously been more than 5 percent annually.
March 25 Webinar Wednesday: 'AAAHC Health Plan Accreditation with a Spotlight on Chronic Disease Management'
Learn how AAAHC Health Plan Accreditation can help health plans demonstrate their commitment to improving healthcare quality and how health plans can benefit from AAAHC's collaborative accreditation process. This webinar will be presented in partnership with the Care Copilot Institute (CCI), part of Allina Health, pursuing a mission to transform care delivery through the use of lay healthcare workers.
Reduce compliance risk by working with a partner that understands the industry’s complexities. We will work with you to improve your:
• Policies, Procedures and Standards of Conduct
• Compliance Program Oversight
• Training and Education
• Compliance Program Communication
• Monitoring, Auditing and Identification of Compliance Risks
• Compliance Investigations and Incident Management
April 1 Webinar Wednesday: 'Medication Monitoring & Pharmacogenetic Testing (PGT): Helping Clinicians to Individualize Safer Opioid Management'
Opioid side effects and the effect of poly pharmacy have been highlighted recently in the media. Clearly, there are challenges to safely treating chronic pain in the midst of the national crisis of prescription drug abuse. This case-based webinar will highlight clinical and research experiences of integrating UDT & PGT to help improve care for the treatment of chronic pain and common co-morbidities such as anxiety and depression.
Did you miss Webinar Wednesday: 'Seismic Changes in Pharmacy Creating Unprecedented Trend Increases' by Express Scripts?
To view the full 2014 Express Scripts Drug Trend Report, please visit here. For additional information please contact Krista Ward.
For copies of other past webinars, visit here.
Pay for success, social impact bonds: Request for proposals
Green & Healthy Homes Initiative
The Green & Healthy Homes Initiative released a request for proposals from asthma-related service providers to develop asthma social impact bond/pay for success projects. GHHI and its partner Calvert Foundation will provide technical assistance to five selected service providers in the catchment areas of the previously selected healthcare organizations:
An informational webinar will be held on Friday, March 20. Please review the RFP; proposals are due April 8.
- Baystate Health (Springfield, MA)
- Le Bonheur Children's Hospital (Memphis, TN)
- Monroe Plan for Medical Care (Buffalo/Rochester, NY)
- Spectrum Health (Grand Rapids, MI)
- University of Utah Health Plans (Salt Lake, UT)
MHPA's Myers to chair WHCC 4th Annual Medicaid and Medicare Reform Summit | March 2015 | Washington, DC
MHPA President and CEO Jeff Myers will chair the WHCC 4th Annual Medicaid and Medicare Reform Summit, a meeting that convenes executives from health plans, hospital systems and policy organizations to share, learn and discuss approaches to improve the quality of government programs and achieve payment and delivery reform. For conference details, agenda and registration, please visit here.
MHPA's Legislative Fly-In | May 11 | Washington, DC
Join us for MHPA's Legislative Fly-In, scheduled May 11 and 12 at the Liaison Capitol Hill Hotel, to educate lawmakers on our industry and its key issues.
Click here for reservation information.
For details, please contact Nikida Levy via email or by phone at 202-857-5720.
Medicaid Managed Care Congress: May 20-22 in Baltimore
Medicaid Managed Care Congress
At the Medicaid Managed Care Congress, government officials, health plan executives and other key players of the healthcare ecosystem come together to hear new case studies from industry peers and expert insights from state and federal regulatory bodies. This event will discuss the successes and challenges of implementation of major ACA provisions, delivery reform and payment reform and states pursuing better value. Use code XP2026MHPAB for a 15 percent discount.
Job opportunity: Clinical director, Homecare & Managed Care
First Quality, a leading manufacturer of disposable home healthcare products, is seeking a clinical director for our Homecare & Managed Care Business. This candidate will provide leadership and have a focus on clinical education, utilization management protocols and programs and operational program development within home care and managed care markets.
Job opportunity: Physician contract negotiator | Chicago
Negotiates, re-negotiates and executes physician and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals. Medicaid and Medicare contracting experience strongly preferred. Enter Requisition #22158.
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