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'To play or not to play: Dual Eligible Integration Models, Challenges and Critical Success Factors:' A free webinar by PwC | June 12 | 3 p.m. EST
The Dual Eligible Financial Alignment Demonstration and state waivers are changing the face of the dual eligible marketplace. States are tackling dual eligibles in different ways, which means that plans cannot approach this population as "one size fits all." Health plans need to understand their market and regulatory environment and then consider if, when and how to successfully enter this market.
- Gain insights into the arrangements states are using to manage the duals population
- Understand the challenges and opportunities for health plans as the new marketplace evolves
- Understand the success factors required to prevail in the new duals marketplace
- Gain awareness of solutions being used by plans as they pursue participation in new state programs
TMG Health has the experience and proven solutions you need
for SUCCESS in the Managed Medicaid, Medicare Advantage, and Medicare Part D markets. Our purpose-built applications ensure the highest level of ACCURACY and COMPLIANCE for Enrollment, Eligibility, Reconciliation, Premium Billing, Print Fulfillment,
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Selling of Obamacare underway
The Obama administration is reaching out to Democrats and Republicans in Congress as it gears up to try to sell Obamacare to the public this summer.
Ohio Senate drops Medicaid expansion
The Ohio Senate's take on a $62 billion, two-year budget is headed for a vote, complete with $1.4 billion in tax relief for small business owners and more money for K-12 schools than either the House or Gov. John Kasich had proposed.
Wisconsin budget committee upholds governor's rejection of
Republican lawmakers in control of the state's purse strings rejected federal dollars to expand Medicaid coverage in Wisconsin. Joint Finance Committee Republicans followed through on Gov. Scott Walker's February announcement that his administration would not seek some $4.4 billion in federal money to expand BadgerCare, the state's Medicaid program.
Arizona House leader moves forward on budget, Medicaid
The Arizona Republic
Saying he was running out of time and patience in negotiations with Arizona Gov. Jan Brewer over Medicaid expansion, Arizona House Speaker Andy Tobin ended a nearly three-week standoff by putting into play the state budget and healthcare program for Arizona's poor.
Arizona governor becomes unlikely ally of Obamacare
Arizona Gov. Jan Brewer has become an unlikely warrior for Obamacare. Brewer is a conservative Republican who sued to topple the health law, refused to set up a health insurance exchange and memorably wagged her finger at President Barack Obama on a Phoenix airport tarmac. But now she's so determined to put the Obamacare Medicaid expansion in place in her state that she's vetoing any legislation that reaches her desk until the Republican legislature caves.
Mississippi governor opposes Democrats' Medicaid expansion alternative
Mississippi House Democrats recently proposed an "alternative" to Medicaid expansion that would use federal money to buy insurance for 300,000 of the state's working poor, similar to a proposal in Arkansas. But Gov. Phil Bryant and other Republicans said the Democrats' plan is just a repackaged Medicaid expansion as called for with the Affordable Care Act, which they oppose.
Learn the latest tailored ways your plan can save. Visit Booth 451
at AHIP's Institute 2013.
Drawing for a $500 gift card. Photo booth. Fun.
Doctors, hospitals, unions push to stop Medi-Cal cuts
The Sacramento Bee
Thousands of doctors, nurses, unionized health care workers and Medi-Cal patients flocked to the Capitol to protest possible cuts to the Medi-Cal program. California Gov. Jerry Brown's proposed budget calls for a 10 percent reduction in payment to Medi-Cal providers, a move that opponents say would reduce the poorest patients' access to healthcare.
Oklahoma considers Medicaid managed care options
In the wake of the denial of a Medicaid waiver by President Barack Obama's healthcare regulators, Oklahoma policymakers are considering pursuing market-oriented reforms of their Medicaid program, changes that have previously secured federal waivers for three other states from administrators in Washington.
'Reaching Low-Income and Senior Patients with Digital Media:' A free webinar by dLife and MHPA | June 19 | noon EST
Communication channels are constantly evolving, and patients are accessing health information in new and innovative ways. The best channel to reach the Medicaid population might not be the best fit for the Medicare population — or even the Medicare/Medicaid dual eligible population. This webinar, co-presented by dLife and MHPA's Liza Greenberg, will address the latest trends in reaching and engaging these populations in their own diabetes self-care.
'Strategies to Succeed Under the New Commercial Payment Rules:' A free webinar by Altegra Health | June 19 | 3 p.m. EST
The Commercial Market Reform Rules, new payment methodologies and the opening of the marketplace bring a significant shift in strategy and operations to commercial health plans. This webinar will discuss the operational challenges created by the new market enrollee profile, the implications for the new risk adjustment model and practical strategies to improve financial performance.
Deloitte job opportunities
Deloitte Consulting LLP
Health plans face a number of unique market and regulatory pressures that impact how they conduct business today and in the future. Deloitte Consulting LLP is one of the world's leading management consulting firms for executable strategy, operations, technology and human capital advisory services, and it is uniquely positioned to provide business solutions to our clients.
Deloitte's Government Programs practice is seeking candidates who have consulting, compliance and operational experience as it relates to Medicaid, Medicare Advantage, and Medicare D plans.
Navigant job opportunities in DC, Chicago areas
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.
Missed our previous issues? See which articles your colleagues read most.
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.
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 nonmembers). To order, call 202-857-5720, or email us.
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