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Home   About   Policy & Advocacy   Education & Resources   Events   Contact Us May. 17, 2012


Medicare, Medicaid overhaul deal unlikely, lawmakers say
Modern Healthcare (subscription required)    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Congress is unlikely to reach a "grand bargain" to overhaul Medicare and Medicaid during the post-election lame duck session, according to two congressional budget leaders. More

HHS won't pursue active purchaser Federal Exchange initially, pleasing insurers (subscription required)    Share    Share on FacebookTwitterShare on LinkedinE-mail article
HHS' decision to allow any health plans meeting certification requirements to be deemed qualified health plans in the federally-run exchange disappointed a consumer advocate who had wanted the department to choose an active purchasing exchange, but the decision pleased the insurance industry which has long argued that a "clearinghouse" approach is a better model. More

Successfully Reducing Emergency Room Usage | Insights Webinar on Monday, May 21
The AmeriHealth Mercy Family of Companies    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Health plans nationwide are searching for ways to address the growing increase in emergency room utilization. For the reduced member price of $69 ($79 for non-members), join VP of Corporate Medical Management for The AmeriHealth Mercy Family of Companies Karen Michael and Tina Morton, senior director of quality management at both Keystone Mercy Health Plan and AmeriHealth Mercy Health Plan, as they describe how the AmeriHealth Mercy Family of Companies succeeded in reducing ER usage. Over the past three years, the program has demonstrated an ongoing decrease in the number of members using the emergency room as a primary care facility. Why pay a high-priced consultant to help maximize your plan's efficiency when experts with a proven track record can show you how at a fraction of the cost? Learn more and register. More

Driving engagement, reducing healthcare costs

Healthx is the leading developer of portals and applications for the healthcare market. Over 130 payers and 39,000 groups, representing over 12 million individual lives, use our technology solutions. From our member and provider portals to our
mobile applications, we help payers increase constituent engagement while reducing costs. Visit

UPMC for You Proposal awarded funding from Robert Wood Johnson Foundation
PRNewswire via The Sacramento Bee    Share    Share on FacebookTwitterShare on LinkedinE-mail article
UPMC for You, a nonprofit Medicaid managed care organization of the UPMC Insurance Services Division, was awarded a grant from the Robert Wood Johnson Foundation to develop a new pathway for Medicaid payment reform designed to improve the coordination and quality of care for children with complex medical conditions while also reducing the cost of care. More

Insurers face $1 trillion revenue at stake in health law according to Bloomberg Government study
Bloomberg    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Health insurers will gain $1 trillion in new revenue over the next eight years under the 2010 health care law, assuming it's upheld by the Supreme Court, according to a Bloomberg Government study. More

Health care reform: GOP preps plan for ruling on law
Politico    Share    Share on FacebookTwitterShare on LinkedinE-mail article
House Republican leaders are quietly hatching a plan of attack as they await a historic Supreme Court ruling on President Barack Obama's health care law. If the law is upheld, Republicans will take to the floor to tear out its most controversial pieces, such as the individual mandate and requirements that employers provide insurance or face fines. More

LIBERTY Dental Plan

A national leader in providing dental benefits for Medicaid, CHIP and Medicare programs;

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Kind: ACA's imprint on health care system huge regardless of SCOTUS, election    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Affordable Care Act has already made a huge impact on the health care system and will continue to do so regardless of the Supreme Court ruling or other potential threats, Ways and Means Democrat Ron Kind tells Inside Health Policy in an interview. There is a tremendous amount of momentum resulting from the reform law that will continue to move forward, he says, specifically pointing to policies such as value-based purchasing, medical homes, accountable care organizations and clinical comparative effectiveness research. More

Health care debate will continue beyond upcoming Supreme Court ruling
NNPA via The Seattle Medium    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Even if the Affordable Care Act survives U.S. Supreme Court scrutiny, a favorable ruling this summer will not serve as a cure-all for insuring African Americans, according to health professionals and a report in the current issue of Health Affairs. More

Asthma cases continue to rise in US affecting millions
HealthDay News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Asthma continues to take its toll on Americans, with almost 19 million adults suffering from the disorder in 2010, according to a report released by the U.S. Centers for Disease Control and Prevention. More

Maine budget cuts target Medicaid
Foster's Daily Democrat    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Tricia Clark will keep her fingers crossed when the Legislature reconvenes and takes up a budget plan that calls for sharp cuts in Medicaid and health care spending. Clark, 19, stands to lose out when the Legislature votes on a plan to slash spending on Medicaid and a slew of other programs ranging from mental health assistance and school grants to dental care, drug abuse treatment and prescription drugs. More

Illinois: Outraged seniors dump 'survival kits' at Quinn's door
The Register-Mail    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A dozen seniors dumped "senior survival kits" in front of Illinois Gov. Pat Quinns office during a news conference at the State Capitol to show their outrage at proposed cuts to Medicaid and other social services that provide health care to seniors and people with disabilities. More

North Carolina: Senate passes Medicaid fix
WRAL-TV    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The state Senate voted 47-0 to fill a $205 shortfall in North Carolina's Medicaid health insurance program for the poor and disabled. Under a measure that will now go to the House, the Department of Health and Human Services will be able to move money from other sources, including money set aside for building repairs and funds left unspent from across state government at the end of the year. More

Improving Lives. Reducing Costs.
Health Integrated, the leading innovation partner for health plans, provides evidence- based solutions to achieve health management goals for clinical outcomes, quality measures and cost containment.

Our expertise with vulnerable populations and 360-degree view of the impact of bio-psycho-social risk factors on health makes us the perfect partner for Medicaid and Medicare plans.

Washington state awarded $128 million grant to implement new health insurance exchange    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Washington Gov. Chris Gregoire announced that the state will receive a $128 million federal Level II Exchange Establishment Grant to develop and implement the state's health benefit exchange, which will help residents find, compare, and enroll in health care coverage in 2014. Washington is only the second state in the nation to qualify for the Level II Exchange grant. More

Kentucky to have health exchange if Supreme Court approves Obamacare    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Kentucky will set up a health benefit exchange if the Supreme Court approves the health care law. The idea of the exchange is to allow individuals and small businesses to compare coverage, provider networks and costs and purchase affordable Kentucky health insurance online. More

Researchers say: Insurance exchanges could mean savings for some
Modern Healthcare (subscription required)    Share    Share on FacebookTwitterShare on LinkedinE-mail article
People who purchase health insurance policies on the individual market may save an average of $280 annually under the health care overhaul's coming insurance exchanges, according to projections by a federal researcher.  More

GHG Forum 2012: Access the Agenda Now

Gorman Health Group is the leading solutions provider in Government programs. Join us June 12 & 13 in Washington, D.C. for a conference event designed for teams from cross-functional operational areas. Register your team now. MORE.

MHPA's New Keeping You Healthy video: Network Improvement Team by MDwise
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Quality in health care is of paramount importance for Medicaid health plans. Learn how MHPA member plan MDwise improved their quality outcomes as Dr. Caroline Carney-Doebbeling, CMO at MDwise, and Laura Trainor, manager of this initiative, discuss their program. Watch the YouTube video here.

Are you maximizing your capitation revenue? How do you know? — Wednesday June 6, 2012 at 1:30 pm ET, A free webinar by DataWing Software
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Have you ever paid claims for ineligible members? Reconciling your capitation payments can help.

During this hour presentation, DataWing Software will cover:
• Where does the data come from and why there are discrepancies
• How do I know that our MCO has an issue
• Ideas from other MCO's on how they address the challenge
• Technology solution to solve this challenge

Register for this free webinar

Partnership for reducing readmissions and length of stay — Thursday June 14 at 1:00 pm ET, A free webinar by VITAS Innovative Hospice Care
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Hospital Readmission Reduction Program is intended to reduce hospital readmissions by aligning them with payment incentives. Hospice and palliative care programs can help providers reduce hospital readmissions by providing comprehensive care to patients. They improve discharge planning and increase coordination of care while being cost effective. This results in improved quality patient care and increased patient/family satisfaction.

Register for this free webinar

2nd Annual Leadership Summit on Medicaid | July 24-25, Arlington, Va.
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With the Supreme Court Ruling to determine the future of Medicaid Expansion in June, the 2nd Annual Leadership Summit on Medicaid will be the first national platform for all stakeholders to come together to discuss the implications and next steps. Hear Thomas Johnson, president and CEO of MHPA, participate on a keynote panel with other industry leaders to address the Supreme Court Ruling on Medicaid expansion and health reform. MHPA members, receive a $200 discount when you register online or at 800.767.9499 with promo code MHPA200. More

Banner advertising available with MHPA NewsBriefs
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Now you can ensure that your message gets out to the Medicaid managed care industry. For rate information, contact James Debois for opportunities 469.420.2618 or email at

MHPA on Twitter, Facebook and LinkedIn
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Follow us on Twitter, and Facebook and LinkedIn to get industry-related news and the latest MHPA announcements.
More connections mean higher capitation rates.
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