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Modern Healthcare
The shift toward value-based payment in healthcare that countless advocates say will cut costs and improve the quality of care isn't without its downsides. This week's earnings show the evolution is weighing on some providers' bottom lines. And according to providers, another potential side effect of shorter lengths of stay could be higher readmission rates. Medicaid managed-care advocates disagreed on that point.
Alex Shekhdar, vice president of federal and state policy with Medicaid Health Plans of America, the trade association representing the managed Medicaid industry, said managed-care providers receive a capitated payment for a patient's total cost of care, so they're "fully at risk" for the readmission costs. "We're not incentivized to do something harmful for the patient," he said. Elizabeth Lagone at CipherHealth, a technology company that helps managed-care providers with patient care management supported this, saying that shorter lengths of stay shouldn't result in higher readmission rates because patients will be better engaged with their healthcare providers.
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The Washington Post
"Medicare for all" is the hottest position on the left these days, but there's a quieter push afoot to create a public option using Medicaid. Chanting "Medicaid for more" may not sound as bold for progressives seeking to prove their bona fides before the midterm elections. Yet all the most-hyped 2020 Democratic presidential candidates are on board with the idea, including the Medicare expansion's biggest champion, Sen. Bernie Sanders (I-Vermont).
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Health News Florida
A federal court decision to block a change to Kentucky's Medicaid program could affect a similar request from Florida. Both states asked to eliminate retroactive eligibility, which allows recipients to get coverage up to three months after they see a provider. Florida officials requested a waiver from the federal government to change the eligibility requirement in March and are awaiting a decision from the Centers for Medicare and Medicaid.
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Project Transition
Learn how one provider is challenging the status-quo in behavioral healthcare and advocating for society’s most vulnerable members to discover their life worth living by providing a recovery experience like no other. Individuals with serious mental illness (including dual diagnosis) are empowered and able to realize a life in the community, on terms they define with the right treatment and services. In Philadelphia, PA and Nashville, TN, a unique extended behavioral support program has been proven to reduce cost and increase positive outcomes, by combining apartment-style community living with intensive, daily, evidence-based programming. This setting helps minimize stigma and create normalized social expectations and consequences.
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Jackson Sun
The failure of the State of Tennessee to expand Medicaid is the reason hospitals in rural communities are closing across the state, according to Craig Fitzhugh, a candidate for the Democratic nomination for governor. His last campaign stop before Thursday's primary was outside McKenzie Regional Hospital Wednesday.
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Veyo is a full-service transportation brokerage designed specifically for healthcare. By integrating consumer technology with rideshare fleets, we have decreased costs and increased efficiencies. Operating in eight states with over 6 million completed trips and a 97.1% on-time rate, we're changing NEMT - one trip at a time. Learn More
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Healthcare Dive
Despite payer and provider efforts to reduce opioid prescribing, a new report from researchers at the Mayo Clinic published in the BMJ found that prescription rates remained level for commercially insured patients between 2007 and 2016. Researchers found that over the course of one year, 14 percent of commercially insured patients, 26 percent of Medicare Advantage (MA) senior patients, and 52 percent of disabled MA patients received an opioid prescription.
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The Hill
The number of Americans who say that drug abuse has caused problems in their families has climbed to 30 percent, according to a Gallup survey released Thursday. That's significantly higher than the last time such a survey was conducted by Gallup in 2005, when 22 percent of respondents cited drug abuse as a cause of trouble in their families.
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Health Affairs
The nation's opioid crisis is well documented, but the effect on pregnant women and infants has been overlooked. Opioid use disorder in pregnancy has increased along with an increase in neonatal opioid withdrawal, or neonatal abstinence syndrome (NAS). Medicaid covers roughly half of all births, and more than 80 percent of NAS births, so the motivation of those working with the program to help and find solutions is high. This post on the effect of the opioid crisis on pregnant women and babies in Medicaid covers barriers in care delivery, policy obstacles and recommendations to improve outcomes.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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MHPA
Did you know? MHPA's Annual Conference is CME accredited! Register here for the chance to earn up to 10 CME credits.
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Leading Medicaid plans are constantly evolving their care management programs and IT solutions. Download this white paper to understand the 4 ways that your program should expand beyond traditional care management with stronger data integration, insights, and flexibility.
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Financial Times
The American healthcare landscape is brimming with uncertainty. Pressures and priorities vary among stakeholders but whether it's pharma, payer, PBM, provider or patient, everyone is looking for value. The FT Pharma Pricing and Value Summit will discuss the future of pharmaceutical pricing and market access in an evolving healthcare environment. MHPA President and CEO Jeff Myers will give his insights at the Pricing pressures and healthcare reform panel on issues such as what could fuel pricing pressures on pharma, healthcare reform and the market access landscape, and overcoming political barriers in healthcare.
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