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The Hill
Hillary Clinton is under mounting pressure from supporters of Sen. Bernie Sanders to back California's ballot measure aimed at reducing steep drug prices ahead of the state's primary on Tuesday. The first-in-the-nation ballot measure would allow California's health agencies to negotiate directly with drug companies to lower drug costs. Sanders and his supporters are now pressing Clinton to put teeth behind her oft-repeated campaign promise to crack down on price-gouging by "big pharma."
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Kaiser Health News
Dr. James Gill walked through the morgue in Farmington, Connecticut, recently, past the dock where the bodies come in, past the tissue donations area, and stopped outside the autopsy room. Gill is the chief medical examiner for the state of Connecticut, and of the nine bodies in his custody that day, four were the remains of the people who likely died from an accidental drug overdose. A fifth was a probable suicide involving drugs. It was a sad, but typical day, he explained, with a practical consequence for the state’s morgue: Gill is running out of room to store bodies.
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The Hill
Lawmakers are considering adding a mental health reform bill to the work of a conference committee focused on opioid legislation, according to congressional aides. The idea is to add a mental health bill from Sens. Bill Cassidy (R-Louisiana) and Chris Murphy (D-Connecticut) to the product coming out of the conference committee that is reconciling the differences between House and Senate bills on the opioid crisis.
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3M
Special needs populations require special care. This calls for services that address mental health and substance abuse issues, certain comorbidities, economic disadvantages, housing instability, minorities, frail elderly, and chronically sick children. These members may also face unique challenges accessing care, such as lack of transportation.
The problem for health plans? These services generally cost more, especially if care is not managed appropriately. When reimbursement is tied to clinical outcomes, it’s particularly important for providers to have access to these services so they can be successful under value-based payment. Join us for this webinar on Wednesday, June 8, and learn how to:
- Stratify your population to see which subgroups and individuals have the greatest health risk.
- Pinpoint issues related to cost, quality and access.
- Manage care for super-utilizers by prioritizing those who persistently need extra care and predicting who may become high-need in the future.
- Allocate resources to serving special needs populations within an existing value-based care program
- Establish and reward providers who deliver preventive care and reduce avoidable high-cost utilization.
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TMG Health has the experience and expertise you need to administer your Medicaid plan efficiently and effectively. Our technology-enabled solutions can help you attain the highest achievable performance while OPTIMIZING COSTS and ENSURING COMPLIANCE. Contact us to learn how outsourcing with TMG Health can improve your plan performance.
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North Carolina Health News
Surrounded by lawmakers, doctors in white coats and emergency medical technicians in their dress uniforms, Gov. Pat McCrory signed off on a document ——an application to federal regulators requesting an overhaul of North Carolina's Medicaid program. The proposal would change the way the state pays for the care of low-income children and many of their parents, of people with disabilities and of low-income seniors who are beneficiaries of the program, 1.9 million people in all.
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North Carolina Health News
As Gov. Pat McCrory introduced North Carolina's Medicaid reform plan Wednesday, he praised this year's "$300 million surplus in the Medicaid budget made possible by Republican-led reforms that have gotten the chronically troubled program back on track." When the budget numbers came in this spring, they showed the program was at least $313 million below it’s target budget. And Republican leaders in the legislature have crowed over that number, most of which was returned to the state's general fund this year.
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Alaska Dispatch News
Lawyers hired by Alaska lawmakers to sue Gov. Bill Walker over Medicaid expansion said in a court filing last week that the Alaska House can properly take over the appeal of a case originally brought by the Alaska Legislative Council even though no legislative body has voted to approve the move. But one of the Senate leaders, John Coghill, who supported the original lawsuit, said Wednesday that he didn't think the House could insert itself into the already-existing contracts between the two hired law firms and the 14-member Alaska Legislative Council, a committee of House and Senate lawmakers that meets year-round and that voted to sue Walker.
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Casper Star-Tribune
A majority of Wyoming residents support using money from the federal government to expand Medicaid over tapping the rainy day fund, cutting government or raising taxes. While 41 percent of Wyoming residents supported the budget the legislature adopted in March, support for the bill would have increased to 52 percent had lawmakers had accepted $268 million in federal money to expand Medicaid, a new survey showed.
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AJMC
State Medicaid programs are under increasing pressure to contain pharmaceutical spending. Many states have attempted to limit spending through greater Medicaid managed care penetration, which rose nationally from 54.5 percent in 1999 to 74.9 percent in 2011. It is not clear how this expansion has affected beneficiaries with serious mental illness (SMI) — a vulnerable population that often has their drug spending "carved out" from their managed care benefit. Researcers sought to assess the association between managed care penetration and pharmaceutical spending on drugs for SMIs in these states.
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PLOS
Financial relationships between organizations that produce clinical practice guidelines and biomedical companies are vulnerable to conflicts of interest. Researchers sought to determine whether organizations that produce clinical practice guidelines have financial relationships with biomedical companies and whether there are associations between organizations' conflict of interest policies and recommendations and disclosures provided in guidelines.
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MHPA
Visit the new event website for details about MHPA's annual conference in September.
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Inside Health Policy (Subscription required)
MHPA's Jeff Myers comments on the Advancing Care for Exceptional (ACE) Kids Act of 2015
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