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Utah GOP leaders reach a deal on Medicaid expansion
The Salt Lake Tribune
Republican leaders have agreed to a broad, conceptual framework for expanding Medicaid to insure tens of thousands of low-income Utahns with a plan that would call on medical providers to pay for the new health coverage.

The so-called "Gang of Six" — Gov. Gary Herbert, Lt. Gov. Spencer Cox, Senate President Wayne Niederhauser, House Speaker Greg Hughes, House Majority Leader Jim Dunnigan and Sen. Brian Shiozawa &mdsh; huddled this week constructing the skeleton of a new Medicaid plan to replace the governor's Healthy Utah and the House's Utah Cares proposals.
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July 22 Webinar Wednesday: 'AACE/ACE Consensus Conference on Blood Glucose Monitoring Outcomes'
Roche Diabetes Care
Please join George Grunberger, M.D., F.A.C.P., F.A.C.E., president of American Association of Clinical Endocrinologists and chairman of the Grunberger Diabetes Institute, for a presentation of the process and outcome from the AACE/ACE Consensus Conference on Blood Glucose Monitoring and the implication to patient care. In addition, they will discuss newly released data concerning patients’ disruption and the unintended consequences of patient behavior changes, hospitalizations, costs and mortality. This will be informative as policy discussions occur to achieve quality outcomes and to reduce costs.
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Legislative committee won't take up Medicaid expansion Wednesday
Alaska Public Media
The Alaska Legislature's committee with gatekeeping authority over expediting the governor's Medicaid plans meets Wednesday, but does not intend to take up the welfare program’s expansion. That's according to the office of Rep. Mike Hawker, who chairs the Legislative Budget and Audit Committee.
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Families on Medicaid make more incorrect assumptions about antibiotics
Reuters
Parents of children insured by Medicaid, the U.S. health program for the poor, are more likely to incorrectly assume antibiotics can treat colds and flu and seek these drugs when kids don't actually need them, a study suggests.
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Medicaid enrollment surges, stirs worry about state budgets
The Associated Press
More than a dozen states that opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond projections, raising concerns that the added costs will strain their budgets when federal aid is scaled back starting in two years.
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Projected, actual enrollment for Medicaid expansion states
The Associated Press via ABC News
The included table contains projected and actual enrollment figures for the newly eligible Medicaid population in the 30 states and the District of Columbia that have opted to expand the program under the federal Affordable Care Act. Where available, it also provides the estimated and revised cost of paying for the program during the 2017 fiscal year, when states will begin paying a share of the Medicaid expansion. The state share will rise to 10 percent in the 2020 fiscal year.
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Florida says privatizing Medicaid cut costs, but insurers say they're underpaid by state
Miami Herald
In less than a year, Florida's switch to privately managed healthcare for more than 3 million poor, disabled and elderly residents has achieved one of its primary goals — cutting costs for Medicaid, the public health insurance program for low-income people that accounted for roughly one-fifth or about $9.5 billion of state spending last year.
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Healthcare advocates push North Carolina governor to expand Medicaid
The Associate Press via Fayetteville Observer
In demonstrations across North Carolina, healthcare advocates are continuing to call on Gov. Pat McCrory to release his plan to expand the state's Medicaid roles under the Affordable Care Act. About 30 protesters in front of the old Capitol building Thursday focused on expanding Medicaid to parents working low-income jobs. Other demonstrations pushing to expand healthcare coverage are taking place Thursday in Asheville, Charlotte, Fayetteville, Greensboro and Greenville.
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DC Medicaid recipients may have right to more due process
Reuters
Medicaid recipients in Washington, D.C., may be entitled to an explanation and written notice of their right to request a hearing whenever their claim for prescription-drug coverage is denied, the D.C. Circuit Court of Appeals ruled on Friday.
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Federally qualified health center use among dual eligibles: Rates of hospitalizations and emergency department visits
Health Affairs
People who are eligible for both Medicare and Medicaid, known as "dual eligibles," disproportionately are members of racial or ethnic minority groups. They face barriers accessing primary care, which in turn increase the risk of potentially preventable hospitalizations and emergency department visits for ambulatory care–sensitive conditions.

Federally qualified health centers provide services known to address barriers to primary care. 2008–10 Medicare data for elderly and nonelderly disabled dual eligibles residing in primary care service areas with nearby federally qualified health centers was analyzed.

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The Oregon Health Insurance Experiment
Health Affairs
One of the principal strategies contained in the Affordable Care Act to achieve near-universal health insurance coverage is expansion of eligibility for the Medicaid program. There has been much debate about whether expansion of the Medicaid program should be used to extend health care benefits to the low-income uninsured. This brief summarizes findings of the Oregon Health Insurance Experiment, a randomized controlled study made possible by a unique lottery process used in 2008 to expand Medicaid coverage in the state.
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July 29 Webinar Wednesday: 'Transforming Medicaid
Member Communications'

HealthCrowd
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.
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mhpa2015 registration 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.

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MHPA 2015-2016 Best Practices Compendium call for submissions
MHPA
We are pleased to announce that we are now accepting submissions from member plans that highlight best practices for Medicaid and CHIP beneficiaries. The Center for Best Practices Advisory Committee will review submissions for potential inclusion in the 2015-2016 MHPA Best Practices Compendium that will be published in November 2015. Additionally, the selected best practices will be honored during the MHPA annual conference luncheon.
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Job opportunity: Vice president of marketing and sales | Chalfont, PA
Project Transition
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.

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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.

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Job opportunity: RN, manager, Clinical Health Services,
pre-authorization | Detroit

Aetna
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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