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Politico
Scott Walker, Marco Rubio and others are competing for the best plan to replace Obamacare, a unified theme among Republican presidential contenders. But there is growing evidence that even GOP voters are more concerned about curbing drug prices than dislodging the president's signature health program.
In April, the nonpartisan Kaiser Family Foundation was surprised by a poll showing more Republicans view drug prices as the No. 1 healthcare priority than repealing Obamacare. So the foundation looked further, asking Americans what steps they would back to reduce drug costs.
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The Financial Times
You create a drug that cures a hitherto difficult and expensive-to-treat killer disease. How much should you charge for your invention? Do you price it at a level linked in some way to the cost of development and manufacture? Or should you mark it up for the "value" you believe you are offering the patient — even if that far exceeds what the market may be able to bear?
The drugs industry has little difficulty answering this question. Increasingly it opts aggressively for the value-based approach. Sovaldi's price has of course thrilled Wall Street, and Gilead is now valued at $170 billion — more than Merck, the world's fifth-largest pharmaceutical company by sales. Jeff Myers, president and CEO of MHPA, compares Gilead's conduct unfavorably with those of past drug inventors.
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WRAL-TV
Negotiators for the House and the Senate say a deal on Medicaid is within reach now that House Republicans have tentatively agreed to adopt a "hybrid" insurance model similar to one the Senate put forward earlier this month. "I think we're close to getting something done," said Sen. Louis Pate, one of the lead negotiators for the Senate.
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The Hill
Alaska's legislature is suing the governor over his decision to expand Medicaid under Obamacare. The move marks an escalation of the fight over expansion of Medicaid, the government health insurance program for the poor. Alaska is the 30th and latest state to expand the program.
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Pittsburgh Post-Gazette
Low-income families who might have waited months for medical assistance last winter are enrolling within weeks under Pennsylvania's Medicaid expansion, sailing through simplified applications that help them see doctors faster. Still, critics remain cautious whether the expanded program could overburden the state budget.
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The New York Times
Arkansas Gov. Asa Hutchinson on Wednesday told an advisory group weighing the future of the state's alternative Medicaid expansion that he favored keeping it — but only if the federal government allowed changes that seemed intended to appeal to conservative legislators who continue to oppose the program.
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Arkansas Business
Arkansas will resume its push to terminate coverage for thousands of Medicaid beneficiaries who haven't verified their income, Gov. Asa Hutchinson said Tuesday, despite complaints that many being kicked off the program still qualify. Hutchinson said the Department of Human Services has eliminated a backlog of responses from Medicaid recipients trying to prove they still qualify for coverage. The Republican governor had ordered a two-week pause in the terminations so DHS officials could process thousands of responses they had received.
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The Arizona Republic
Arizona Gov. Doug Ducey's plan to tighten eligibility requirements for some enrolled in Arizona's Medicaid program drew questions and concerns at a public meeting Tuesday. Critics said it would harm access to care for low-income residents with no evidence that it would save taxpayers money.
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California Healthline
CMS officials last week approved California's Drug Medi-Cal waiver, opening the door for the state to dramatically change the way mental health services are delivered in Medi-Cal. "The goal of the waiver is to support an integrated safety-net delivery system by better coordinating substance use disorder, physical and mental health services," officials from the Department of Health Care Services said in a written statement.
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Kaiser Health News
The number of uninsured California adults under the age of 65 dropped by more than 15 percent between 2013 and 2014 because of the Affordable Care Act, including California's Medi-Cal expansion, according to data released Tuesday. "We're seeing the biggest drop in the uninsured population in a generation," said David Dexter, communications coordinator for the California Pan-Ethnic Health Network, an advocacy group.
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The Salt Lake Tribune
When Heather Hirsche of Lindon, Utah, sent her daughter to Lake Powell with friends last month, she worried about her safety and the possible price of an accident. One injury away from financial devastation, Hirsche and her daughter fall into the "doughnut hole" — the nickname for the health coverage gap that leaves thousands of low-income Utahns uninsured.
Utah Democrats told Hirsche's story and others' at a news conference Tuesday in an effort to prod Gov. Gary Herbert and Republicans in the Legislature to reach a resolution before the next legislative session starts in January 2016 — and to do it out in the open, rather than behind closed doors.
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Deseret News
Democratic leaders expressed frustration that lawmakers are being called into a special session Wednesday to deal with relocating Utah's state prison but not what they called a life-and-death issue: Medicaid expansion. "It says that economic development is taking priority over the lives of our citizens of Utah. And that shouldn't be the case," Utah Democratic Party Chairman Peter Corroon said.
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Managed Medicaid regulatory changes carry significant information technology implications. What will you need to comply? Where will you find it? Download today to learn more!
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Montgomery Advertiser
Dr. Don Williamson was direct when asked how to improve Alabama's health. But Williamson, a 20-year veteran of Alabama state government leaving in November to head the Alabama Hospital Association, pointed out after a meeting of the Alabama Health Improvement Task Force Wednesday afternoon that the state's health care politics aren't simple.
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PsychiatryOnline
This study examined how state decisions not to expand Medicaid have affected behavioral health services utilization in health centers. Because health center revenues are adversely affected, the ability to provide on-site nonrequired services, such as specialty mental health and substance abuse treatment services, is compromised.
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MHPA
The agenda for mhpa2015 — "Medicaid Turns 50: Its ongoing evolution via managed care and best practices" — is now online. View all of the sessions we have in store for you as well as get info on registration, lodging, and sponsorships here.
For a taste of the conference, please watch this moving video of last year's event.
For more information, please contact Sarah Swango (sswango@mhpa.org/202-857-5772).
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MHPA
Time is running out to submit member plan programs 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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MHPA
Download the presentation (PDF)
For additional information, contact Lizzy Feliciano at leonides.feliciano@lexisnexis.com, or visit www.lexisnexis.com.
For copies of other past webinars, visit here.
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Express-Scripts
Health plans are increasingly challenged with managing the costs associated with specialty medications while providing the specialized care these patients require to ensure medication adherence. Whether it's expensive hemophilia products or new oncology drugs in the pipeline, it is critical for plans to be able to provide the right patients access to the right medication at the best possible price with the highest level of care. Plans also need to take into consideration the new PCSK9 inhibitors — specialty drugs now being used in more common conditions like high cholesterol — where the total annual cost burden of therapy for U.S. payers and patients is on a path to become the most costly therapy class this country has ever seen.
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Optum
Over the past decade, health plans have developed programs to meet the needs of expectant mothers in the Medicaid population, but still struggle to overcome psychosocial barriers to engagement. How can plans overcome these challenges? Join OB/GYN Dr. Kevin Stephens, senior national medical director for Optum, who will discuss how plans can engage Medicaid mothers with OB homecare services that supply caring nurses who meet members where they are in their communities.
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MHPA
Market Access World and Evidence Congress held an interview with keynote speaker MHPA CEO Jeff Myers, the keynote speaker of Market Access World USA 2015, which is scheduled for Sept. 30 and Oct. 1 in Philadelphia. Listen to Myers discuss the future of patient access, current challenges the sector is facing and why he will be attending this year's congress.
Join the congress to examine:
- Innovative pricing strategies for high-value drugs
- How to overcome barriers to patient access
- How to adapt to the changing models of the payers globally
- How you can meet payers' expectations
- Securing reimbursement for personalized medicines
Book now using code BR01.
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