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Forbes
UnitedHealth has invested $350 million since 2011 in affordable housing in 14 states. And the nation's second-largest health insurer, Anthem has committed more than $380 million to affordable housing over the last decade. And other insurers, such as Humana, are investing and partnering in certain communities as part of a "Bold Goal Initiative" that targets a variety of social determinants.
State Medicaid programs, working with health insurers, are also opening up to covering more nontraditional services and the health plan lobby is pushing state legislatures and governors to spend more money on social determinants of health. "All of our members are starting to look at this," said Jeff Myers, president of Medicaid Health Plans of America, which represents most major health insurers including Centene, Unitedhealthcare and Wellcare Health Plans. "Obviously, states cannot afford to pay for everything, but until you meet those basic needs, it's almost impossible to address their healthcare. It's hard to get a diabetic to focus on eating well if they don't know where they are going to live."
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WFAE-FM
North Carolina is looking for insurance companies as it privatizes its Medicaid system. The program that covers 2.2 million poor and disabled North Carolinians is undergoing a massive overhaul, but patients won't see any changes until next year.
According to Medicaid Health Plans of America, an association of health plans, 41 states already use some form of this managed care system for parts of their Medicaid programs.
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The New York Times
Trump administration officials, whose push to impose work requirements on Medicaid beneficiaries was dealt a blow by a federal judge in June, say they have found a way around the ruling and will continue to allow states to put the restrictions in place.
The judge, James E. Boasberg of the Federal District Court in Washington, stopped a Kentucky plan to introduce the work requirements after finding that the secretary of health and human services had failed to consider the state’s estimate that the new rules would cause 95,000 low-income people to lose Medicaid coverage. Limiting access to medical assistance does not promote the objectives of the Medicaid program, he said.
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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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Kaiser Health News
Three months after President Donald Trump announced his blueprint to bring down drug prices, administration officials have begun putting some teeth behind the rhetoric. Many details have yet to be announced. But experts who pay close attention to federal drug policy and Medicare rules say the administration is preparing to incrementally roll out a multipronged plan that tasks the Centers for Medicare & Medicaid Services (CMS) and the Food and Drug Administration with promoting competition, attacking the complicated drug rebate system and introducing tactics to lower what the government pays for drugs.
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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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STAT
Top federal health officials are heralding new guidance they say will keep drug makers from taking advantage of a loophole in the Medicaid program's complex payment structure for certain medicines. The new policy, first laid out in a February law, will help states and the federal government save money when drug makers increase the price of their drugs faster than inflation. The Department of Health and Human Services detailed the complicated algebra related to the change in new letters to states and drug companies.
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The Hill
An advocacy group pushing for lower drug prices is launching a $500,000 campaign against Rep. Anna Eshoo (D-California) for her "cozy ties to the drug industry." Patients for Affordable Drugs Action announced Friday it would send mailers to voters in Eshoo's district as she seeks her 14th term in Congress.
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Columbia University via ScienceDaily
The percentage of low-income Americans with substance use disorders who were uninsured declined more sharply in states that chose to expand Medicaid under the Affordable Care Act versus states that did not, according to a new study. The percentage of low-income residents with substance use disorders without coverage decreased from 34 percent in 2013 to 20 percent in 2015 within states that had implemented Medicaid expansion — or expansion states — compared to 45 percent to 39 percent in non-expansion states.
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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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The Oklahoman
The Oklahoma Health Care Authority will hold several public meetings hoping to hear from people who might be affected by a proposed change in Medicaid work requirements. While the requirements are only expected to affect a few thousand people who meet certain criteria, the Oklahoma Health Care Authority will hear from people across the state. The agency hopes to get comments from those who would be affected by the change in SoonerCare, as well as potential community partners and other entities that would interact with recipients.
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You know you need to be prepared to respond quickly to CMS audit requests – including A&G history, activity, and status. Find out how effective, automated A&G management can protect revenue, improve network quality, ensure regulatory compliance, and lower the cost of disenrollment.
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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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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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