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On Medicaid expansion, A question of math and politics
The Pew Charitable Trusts
With its ruling in King v. Burwell, the U.S. Supreme Court likely settled the question of whether President Barack Obama’s signature Affordable Care Act will survive. Whether and when the health law will be fully implemented in all 50 states is a different question.
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Utah fails to expand Medicaid
Another state's attempt to expand Medicaid has bitten the dust.
Utah lawmakers announced that they will end their legislative session without reaching agreement on a plan to expand Medicaid under the Affordable Care Act in an alternative fashion, as several other Republican-led states have done.
A good omen for Georgia Medicaid waiver plan?
Georgia Health News
An Ohio program that gave insurance to thousands of low-income patients helped them improve on health measures and also produced unexpectedly low costs, according to a study published. Those findings may have a significant impact in Georgia. The study focused on Care Plus patients with high blood pressure or diabetes and on patients who had the same conditions but remained uninsured. Compared with the uninsured group, Care Plus patients with diabetes during 2013 improved more on quality-of-care standards such as receiving recommended eye exams.
Big tests ahead for Montana Medicaid expansion plans
Helena Independent Record
Montana’s plan to expand Medicaid to the working poor is under the public magnifying glass starting with the release of key documents needing federal approval.
The state plans to offer Medicaid to as many as 70,000 working Montanans who can't afford insurance but currently make too much to qualify for Medicaid. The proposal, known as the HELP Act, narrowly passed the Montana Legislature in April and contains a couple of curve balls that federal officials haven’t agreed to.
Feds unlikely to approve Montana Medicaid expansion plan in its entirety
Montana Public Radio
Montana’s legislature said yes to Medicaid expansion this spring, but the state’s expansion plan still needs approval by the federal government.
The state made the details of its expansion plan public, and is giving the public 60 days to comment on the plan before sending it to the White House.
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Rhode Island Medicaid group says providers should be paid for quality
The Sacramento Bee
The group formed by Gov. Gina Raimondo to transform the Medicaid system recommended paying health care providers for the quality of their services in its final report, which was recently released.
Most Medicaid payments in Rhode Island are made based on the amount of services provided. That can incentivize providers to focus on volume rather than value.
What has half a century of Medicaid meant for US?
On July 30, 1965, President Lyndon Johnson signed controversial legislation creating two ambitious national health programs. Fifty years later, Medicare and Medicaid are still controversial, but for different reasons.
Several assessments of the programs' effects over the first half century have been published this year, including "Medicaid at 50" from the Kaiser Family Foundation and "Medicare's 50th Anniversary" from the Center for Medicare Advocacy. Medicare, aimed at seniors and people with disabilities, is a federal program and involves little participation from states.
Medicaid, aimed at low-income people of all ages, is a partnership between states and the federal government, and programs vary from state to state.
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mhpa2015 registration now open!
MHPA via YouTube
Thanks to all of you who made our 2014 annual conference a smashing success. For a recap of the event, please watch this short video.
This year, we will examine Medicaid's 50-year evolution through thought-provoking sessions on the latest in managed healthcare operations, policies and populations, as well health plan best practices. Please visit our mhpa2015 home page for info on registration, lodging and sponsorships.
For more information, please contact Erin Liberatore via email or by phone at 202-857-5773.
July 15 Webinar Wednesday: 'Delivering Healthy NICU Outcomes through a Coordinated Model'
Many times, it's the most fragile members that use the most resources. ProgenyHealth addresses this by managing the care coordination delivered to infants admitted to the NICU. Join Jerry Lee, M.D., and Letitia Lieb, MHA, medical director and strategic business executive, respectively, for ProgenyHealth to discuss specialized population management in managed care that's expected to improve outcomes and save costs.
The webinar will preview some of the successes achieved through collaborative partnerships with providers, families and managed care plans. Specific findings will be discussed that address current NICU trends and variations in care.
July 29 Webinar Wednesday: 'Transforming Medicaid
Member Communications' (rescheduled from July 8)
Join Neng Bing Doh, CEO of HealthCrowd, for a presentation on how macro healthcare trends are requiring a transformation in Medicaid member communications. This webinar will cover current hot topics including how to scale text messaging programs to affect HEDIS scores, using multiple modalities "in concert" to improve member experience while optimizing outreach budget, the need to move away from transactional communications, and how to make each outreach campaign better than the last. Accompanied by case studies and even comics, this webinar will be one every health plan employee can derive value from.
Did you miss Webinar Wednesday: 'The New Frontier: Measuring Patient Engagement and Experience' by Avalere?
View and listen to the webinar recording.
For additional information, please contact Madeline Abram, visit www.avalere.com or follow Avalere on Twitter.
For copies of other past webinars, visit here.
Job opportunity: Vice president of marketing and sales | Chalfont, PA
Project Transition enables people with serious mental illness, co-occurring substance use disorder and/or a dual diagnoses of SMI and IDD live meaningful lives in the community on terms they define. This position is responsible for the planning, development, and implementation of marketing and sales strategies. View the complete job description.
To apply, please email your resume to Adorable Harper.
Job opportunity: Senior Medicaid Strategist | Raleigh-Durham, NC
North Carolina Department of Health and Human Services
The Senior Medicaid Strategist has responsibility for the execution of the day to day activities in all efforts related to implementing Medicaid Reform for DMA. This position acts a project manager by directing internal and external resources to successfully operationalize reform policy. This individual will report directly to the DHHS Deputy Secretary for DMA.
For more details and to apply: click here.
Job opportunity: RN, manager, Clinical Health Services,
pre-authorization | Detroit
Aetna seeks an experienced RN with managed care, leadership and prior authorization expertise. Reinforces clinical philosophy, programs, policies and procedures. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
Visit here and search for requisition #24937BR to learn more and apply.
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