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Healthcare's dirty little secret: No one may be coordinating care
Kaiser Health News
Coordinated care is touted as the key to better and more cost-effective care. It is being encouraged with financial rewards and penalties under the 2010 federal healthcare overhaul, as well as by private insurers. But experts say the communication failures that landed Betsy Gabay in a rehab center — rather than in surgery — remain disturbingly common.
Healthcare experts propose $1 trillion in savings
A bevy of healthcare experts released recommendations for cost-conscious reforms to Medicare, Medicaid and private insurance they said could save $1 trillion over two decades. In a Brookings Institution study, the experts urge Washington, D.C., to embrace small, consensus-driven policy moves to lower healthcare costs rather than wait for a major deficit-reduction deal.
Pearson: 'The outlook for Medicaid expansion looks bleak'
The Washington Post
Twenty states and the District of Columbia have agreed to expand their Medicaid programs to cover everyone under 133 percent of the federal poverty line. That leaves 30 states that haven't, although Avalere Health categorizes four states as leaning in that direction — Tennessee, Kentucky, Florida and New York. "As state legislative sessions are wrapping up, the outlook for Medicaid expansion looks bleak," Avalere's Caroline Pearson tweeted.
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Next big challenge for health law: Carrying it out
The New York Times
A political organization aligned with House Republicans sent an email to reporters attacking President Barack Obama's healthcare law. "Young adults on parents' plan pay more," said the organization, the YG Network, citing a new employee benefits study. The email's subject line read: "So Much for Popularity."
KanCare savings shift proposed; Kansas governor proposes transferring
funds to Medicaid waiting lists
Topeka Capital-Journal via Pharmacy Choice
Kansas Gov. Sam Brownback's office released changes to his proposed budget, with KanCare savings allowing the governor to push for about $37 million to pay down Medicaid waiting lists. Brownback lauded the "KanCare dividend" on April 19, saying his plan to shift Medicaid to a managed care model this year had already saved the state about $67 million.
Colorado Medicaid expansion moves forward with 1 Republican vote
Kaiser Health News
The only real surprise about Colorado's bill to expand Medicaid, now that it's been approved by both legislative chambers, is that it won a vote from a Republican legislator. Sen. Larry Crowder from the San Luis Valley said he couldn't vote against the bill when hospitals in his district are strained to the breaking point caring for the uninsured. Colorado hospitals strongly support the expansion, saying it will replace many of their unpaid bills with new Medicaid payments.
It's official: Florida House turns down money
Health News Florida
By a 71-45 vote, the Florida House of Representatives passed its own health plan, which relies on state money and bypasses more than $50 billion in federal funds. The vote, as expected, fell almost entirely along party lines.
Feds say no to funding a leaner Arizona Medicaid
The Arizona Republic
Federal health officials dealt a blow to opponents of Medicaid expansion, saying they're unlikely to fund a slimmed-down version of the state's indigent healthcare program as the political battle over the issue intensified.
Medicaid problems hinge of Texas doctor, nurse pay
The first question many doctors ask when new patients call for appointments is how they intend to pay. If the answer is Medicaid, the doctor can expect to lose money.
HMS is the nation's leader in coordination of benefits and program integrity services for healthcare payers. Our clients include health and human services programs in more than 40 states; commercial programs, including group health plans, employers, and 150 Medicaid managed care plans; the Centers for Medicare and Medicaid Services; and Veterans Administration facilities. MORE
Texas Medicaid debate pits rival visions of health care law
The Dallas Morning News (subscription only)
A battle at the Capitol over whether Texas should expand Medicaid is coming down to two competing philosophies.
One, the likely winner, is pushed by Brenham, Texas, Republican Rep. Lois Kolkhorst, chairwoman of the House Public Health Committee. The other view is represented by Houston Democratic Rep. Garnet Coleman.
Governor's health proposal advances in Iowa House
A House committee pushed through Iowa's Gov. Terry Branstad's Healthy Iowa plan even as some members of the majority Republican Party expressed misgivings about the plan.
Rep. Dave Heaton was one of 14 House Republicans who voted unanimously to move the bill out of committee so it could be taken up on the floor. Democrats cast 11 unanimous dissenting votes.
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Managing Medi-Cal with enrollment up, spending down
A report from the National Center for Policy Analysis shows California at or near the extremes in two Medicaid categories. California has the second-highest percentage of Medicaid beneficiaries compared with the state's population, and the state's average Medicaid spending per enrollee is the lowest among the states.
Nebraska lawmakers take note of Arkansas Medicaid plan
Omaha World Herald
Could the "private option" that brought together Republicans and Democrats in Arkansas offer an alternative to expanding Medicaid in Nebraska? Some Nebraska lawmakers say the idea is worth checking out.
Navigant job opportunities in DC, Chicago areas
Navigant is a specialized, global expert services firm dedicated to assisting clients in creating and protecting value in the face of critical business risks and opportunities. Navigant's Healthcare Practice strives to be the premier independent management consulting practice assisting senior level healthcare executives deal with their core business challenges.
Aetna job opportunity: Director of medical management for
Delaware Physicians Care
Aetna is looking for a new director of medical management for Delaware Physicians Care. The position oversees the implementation and on-going execution of the strategic and operational business plan for the business segment's clinical operations, inbound/outbound call queue, implementation and/or plan sponsor operations. The position also coordinates business segment policies and procedures in support of financial, operational and service requirements.
Recent webinar presentations from Deloitte, Reckitt Benckiser, ProgenyHealth available free on MHPA's website
View PDFs or listen to audio for "Blurring Boundaries: Considering the Role of Medicaid-oriented Health Plans in 2014 and Beyond", by Deloitte Consulting, "Opioid Dependence — A Chronic Relapsing Brain Disease" by Reckitt Benckiser, "NICU Costs, Trends, and Effective Management Solutions" by ProgenyHealth and more.
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2012-2013 Best Practices Compendium on sale now
MHPA's 2012-2013 Best Practices Compendium is the sixth edition of our annual publication that contains Medicaid health plans' best practices, as well as helpful resource information. Get yours today ($25 for members, $30 for non-members). To order, call 202-857-5720, or email us.
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