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Medicaid reform could cut deep at rural North Carolina hospitals; defense from MHPA's Jeff Myers
The Associated Press via WNCN-TV
Although they disagree on just how to reform North Carolina's Medicaid program, lawmakers know they want to upend the way the state pays for and administers the health insurance program for low-income residents, including the elderly, disabled and children. They talk of contracting with private companies to manage the unpredictable and ever-rising costs of Medicaid.
mhpa2014 news: 1 month to go to snag early-bird rate
MHPA
You have only one month to take advantage of mhpa2014's discounted early-bird rate. But why wait until Sept. 8? Sign up now to secure your spot at the premier event for the Medicaid managed care industry. For annual conference details, please click here.
Study: States embracing Obamacare see biggest drops in uninsured
The Wall Street Journal
Some states that expanded Medicaid under the Affordable Care Act and set up all or part of their own insurance exchanges have seen a marked drop in the number of uninsured adults. The uninsured rates in states that opted to expand Medicaid and set up their own exchanges declined more in the first half of 2014 than in the states that didn't take that approach, according to a study released by Gallup. The survey was based on a random sample of adults through June 30.
Obamacare creates 'upheaval' at free clinics
Kaiser Health News via USA Today
Pam Milliken was among the 70 percent of patients at West Virginia's Wheeling Health Right Center who enrolled in Medicaid after the state expanded the program under the Affordable Care Act. Worried that patients like Milliken would leave their care and struggle to find doctors accepting new Medicaid patients, the clinic took a rather radical step: It became a Medicaid provider and started billing the state-federal health insurance program for the poor.
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University of Minnesota panel predicts all states will eventually join
Medicaid expansion
MinnPost
Many conservatives and Republicans would like to repeal Obamacare. But until they do that, it's fairly amazing that 24 states — including two of the four most populous, Texas and Florida — have decided to reject the part of the law that would expand Medicaid so that it provided benefits for Americans with incomes up to 138 percent of the poverty level.
Feds return Indiana Medicaid waiver request
The Associated Press via The Indianapolis Star
A federal agency has asked the Pence administration to resubmit its proposal for an alternative Medicaid expansion because Indiana's initial application didn't include input from a band of Potawatomi Indians. Gov. Mike Pence has made expanding Medicaid using a version of the state-run Healthy Indiana Plan, dubbed "Healthy Indiana Plan 2.0," one of his top priorities. He touted the proposal in a private meeting with congressional Republicans and recently spent a day in Washington, D.C. privately negotiating with Health and Human Services Secretary Sylvia Burwell.
How Arkansas explains the politics of Obamacare
Vox
Arkansas was a pioneer in crafting an "alternative" Medicaid expansion. Last September, the Obama administration signed off on their unprecedented proposal to move hundreds of thousands of newly eligible people into the state's health insurance exchange, using Medicaid dollars to pay private premiums. As the state's "private option" enters its second year, Arkansas is exploring possible changes to the program — ones that Republican-run states have already won approval for, and which could push the limits of how flexible the federal government will be with a program that covers some of the country's most vulnerable patients.
Medicaid expansion creates explosion in demand for mental health care
Health News Colorado
Mental health centers in Colorado are seeing a surge in new clients seeking services under the state’s expansion of Medicaid. And while center officials say they expected an increase, the number of new calls surprised them, so they have ramped up efforts and instituted new programs to meet the demand.
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States want more time on ACA funds
Politico
States running their own Obamacare exchanges were supposed to wean themselves off federal funding by the end of this year, but some of them want that Obama administration spigot open a bit longer. The states aren't asking for the feds to dole out more money on top of the $4.6 billion already dedicated to exchange planning and construction. But they do want to be able to spend their federal exchange grants into 2015 as they grapple with core components of the insurance portals that are balky, unfinished or in disrepair.
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GOP governors push reforms mirroring state Medicaid directors' ideas
Inside Health Policy
Republican governors sent Senate leaders Medicaid proposals that track closely with ideas state Medicaid directors are urging CMS to embrace — streamline and move away from waiver requirements, treat states as full partners in the rulemaking process and make pricing transparent.
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MHPA commends North Carolina Senate on Medicaid reform plan
PRNewswire via InsuranceNewsNet.com
MHPA, the leading advocacy organization representing Medicaid managed care organizations, congratulates North Carolina's Senate for approving on second reading a real Medicaid reform plan that will deliver coordinated, high-quality care to the needy in The Tar Heel State while providing much needed budget predictability for state taxpayers.
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Did you miss our Aug. 6 Webinar Wednesday? Not to worry
MHPA
If you couldn't attend the MHPA/LexisNexis webinar "Where am I? Finding and Impacting Members to Improve Quality Ratings, Reduce Administrative Costs, and Transform Processes," download the presentation PDF here.
Upcoming Webinar Wednesdays
MHPA
Here are some upcoming Webinar Wednesday events to mark on your calendars:
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Aetna job opportunities
Aetna
The following are job opportunities from Aetna. Visit here, and enter Req # for full description and details.
MD/Psychiatrist; Newark, Delaware; Req# 19223BR
This successful candidate will become the Delaware Physicians Care (DPCI) Medical Director for Behavioral Health and will serve as our expert physician resource in the areas of utilization management, quality management, case management and overall medical management. This critical role sits at the intersection of behavioral and physical health services in helping DPCI to develop holistic programs to improve the quality and outcomes of our constituent members.
MD/Physical Health; Newark, Delaware Req# 19166BR
The position entails duties and responsibilities of Medical Director for Delaware Physicians Care (DPCI). The successful candidate will serve as a critical contributor to the DPCI medical management team in the role of clinical expert to the various functional areas including utilization management, case management and quality management. A key component of this position is to use the clinical credentials, experience and judgment in rendering benefit determinations based on medical necessity.
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