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PBMs: Managing Medicaid pharmacy benefits could pay off
big for states and federal government

InsideHealthPolicy.com
Pharmacy benefit managers are touting their services as a way to save Medicaid money, and the Pharmaceutical Care Management Association says PBMs' ability to negotiate lower drug prices could save state and federal governments $74.4 billion over 10 years, most of which would be federal government savings.
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MHPA sends letter to CMS on PCP pay increase implementation
MHPA
MHPA sent a letter to CMS Acting Administrator Marilyn Tavenner, highlighting the importance of simplification as states and MCOs implement the Medicaid primary care physician (PCP) payment increase in managed care for 2013 and 2014.
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2 studies assert lower spending growth is due to structural health changes
Kaiser Health News
Two new studies assert that the country's unusual slowdown in health spending growth rates may be due more to structural changes in the health care system than to the lagging economy, and thus could continue even after business picks up.
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Florida rejects Medicaid expansion, leaves 1 million uninsured
The Washington Post
It seemed like a watershed moment for the Affordable Care Act when Florida Gov. Rick Scott, a staunch Obamacare opponent, embraced the Medicaid expansion in February. Scott wouldn't be the one to "deny Floridians" a part of the healthcare law, but the Florida legislature had other plans.
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Florida's Medicaid managed care plan to begin in August
News Service of Florida via Naples Daily News
Two years after getting approved by lawmakers, Florida's shift to a statewide Medicaid managed-care system will start Aug. 1 for seniors who need long-term care in the Orlando, Fla., area.
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In several states, Medicaid expansion remains in limbo as time runs short
The Washington Post
In the closing days of their legislative sessions, lawmakers in more than a dozen states are struggling with whether to expand Medicaid under the federal healthcare law, with many of them leaning against participating in a program that is key to President Barack Obama's aim of extending coverage to 30 million uninsured Americans.
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Medicaid expansion stalls in red states
Politico
Conservative state legislators have thwarted Republican governors who broke with their base in favor of Obamacare's massive expansion of Medicaid. Governors such as John Kasich in Ohio, Rick Scott in Florida and Jan Brewer in Arizona spent political capital but saw their Medicaid expansion plans stall, the latest glitch in implementing the sweeping 2010 health law.
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West Virginia governor backs Medicaid expansion for poor
Bloomberg
West Virginia Gov. Earl Ray Tomblin said for the first time that he will expand Medicaid under President Barack Obama's healthcare law. About 91,500 low-income residents will be added to Medicaid, the Democrat told reporters in Charleston, W.V.
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Medicaid expansion standoff in Arizona?
Arizona Daily Sun
Facing a recalcitrant Senate president, Arizona Gov. Jan Brewer said she is instead working with individual lawmakers — and around Andy Biggs — in her bid to expand the state's Medicaid program. Biggs has sworn he will do "everything in my power" to keep any Medicaid legislation from even getting to the floor for a vote. And his position gives him vast power to decide where to assign measures for a hearing or even whether to schedule a debate.
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Ballot is backup for Ohio Medicaid expansion plan
The Columbus Dispatch
If Republican lawmakers won't pass Medicaid expansion, it could be up to Ohio voters. "We are beginning as of today. We will start reaching out and put together a coalition," said Scott Borgemenke, a veteran Republican operative who would lead an effort to extend insurance coverage for hundreds of thousands of poor Ohioans by getting voters to approve a constitutional amendment.
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EIX to invest $25 million into Medicare and Medicaid organizations to 'jumpstart' healthcare-integrated delivery
PRWeb via Yahoo News
EIX Systems will provide free IT Systems to Medicare and Medicaid organizations in order to help them meet looming compliance deadlines and "jumpstart" interoperability and meaningful collaboration among health plans, health providers, HIEs and ACOs.
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For providers, Medicaid expansion means revenue
Human Arc
Medicaid expansion is at the forefront of healthcare reform, especially with current debates over the fate of expansion in states where governors and legislatures are at odds. For providers, the outcome of these debates is critical. In states that forgo expansion, providers will likely experience a negative impact to reimbursement and, ultimately, their balance sheets.
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TRENDING ARTICLE
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MHPA sends letter to CMS on PCP pay increase implementation
MHPA
MHPA sent a letter to CMS Acting Administrator Marilyn Tavenner, highlighting the importance of simplification as states and MCOs implement the Medicaid primary care physician (PCP) payment increase in managed care for 2013 and 2014.

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State by state: A progress report on Medicaid expansion
Stateline via Kaiser Health News
Ever since the U.S. Supreme Court ruled that expanding Medicaid to more low-income people was optional for the states, the focus has turned to what Republican governors and GOP-controlled legislatures would do.

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Healthcare's dirty little secret: No one may be coordinating care
Kaiser Health News
Coordinated care 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.

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MHPA job opportunity: Director of membership and development in
Washington, DC

MHPA
The director will assist MHPA in recruiting new members and managing membership accounts. Applicants will be accepted through May 17.
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Navigant job opportunities in DC, Chicago areas
Navigant
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.

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Aetna job opportunity: Director of medical management for
Delaware Physicians Care

Aetna
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.
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Recent webinar presentations from Deloitte, Reckitt Benckiser, ProgenyHealth available free on MHPA's website
MHPA
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
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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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Healthcare's dirty little secret: No one may be coordinating care (Kaiser Health News)
State by state: A progress report on Medicaid expansion (Stateline via Kaiser Health News)
In several states, Medicaid expansion remains in limbo as time runs short (The Washington Post)
Pearson: 'The outlook for Medicaid expansion looks bleak' (The Washington Post)
Healthcare experts propose $1 trillion in savings (The Hill)

Don't be left behind. Click here to see what else you missed.


MHPA on Twitter, LinkedIn and Facebook
MHPA
Follow us on Twitter, LinkedIn and Facebook to get industry-related news and the latest MHPA announcements.
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