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New Keeping You Healthy video for National Breast Cancer Awareness Month: 'Gift for Life' mammography outreach program
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Keystone Mercy Health Plan's "Gift for Life," an aggressive mammography outreach and event scheduling program, provides mammography screenings for their members in their own neighborhoods. Through partnerships with mobile mammography vans and local providers, Keystone Mercy arranged accessible locations throughout their five-county service area to engage members who have not had screenings in the past two years. Learn more about this best practice, which was nominated for both the Center for Best Practices 2012 Outreach award and Innovation award, from Veronica Medina, director of the Rapid Response and Outreach Program for Keystone Mercy Health Plan. More



MHPA's Joe Moser speaks at PhRMA State Government Affairs Meeting
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid Health Plans of America Director of Government Affairs Joe Moser spoke today at the Pharmaceutical Research and Manufacturers of America State Government Affairs Leadership Meeting in Reston, Va. Moser participated in an expert panel with Donna Boswell and Melissa Bianchi of Hogan Lovells and John Fielding and Scott Sinder of Steptoe & Johnson LLP. Moser gave a broad overview of the Medicaid managed care industry and how it helps provide quality care for their enrollees while reducing costs via care coordination. More

Medicaid's high marks on preventive care contrary to its stingy image
American Medical Association    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A new study indicates that most state Medicaid programs are doing an above-average job of covering needed preventive services for beneficiaries. States generally aren't required to cover preventive services for Medicaid adults at the same levels as they do for children. But in surveying 48 states, the Kaiser Commission on Medicaid and the Uninsured found that most state Medicaid programs covered the bulk of 42 recommended services for nonelderly adults through fee for service, particularly for cancer and sexually transmitted infection screenings as well as pregnancy care. More

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CMS eyes initial voluntary enrollment in Ohio duals demo after OKing policy in Massachusetts
InsideHealthPolicy.com    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Ohio is talking to CMS about leaving enrollment in the duals demonstration voluntary for the first three to six months, a private insurance official following the process tells Inside Health Policy, which would be the same approach taken by Massachusetts, the only state so far to sign a duals demo memorandum of understanding with CMS. There likely will be a one-year transition for those in the Ohio demo, during which the dual eligibles will be allowed to continue seeing their current providers. More

Blue Cross Complete of Michigan is tops in state for service
PR Newswire via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
More than 23,000 people in Livingston, Washtenaw and Wayne counties in Michigan can feel even more secure in their healthcare plan knowing that Blue Cross Complete of Michigan, Blue Cross Blue Shield of Michigan's Medicaid HMO, has been ranked the No. 1-rated Medicaid plan in the state by the National Council on Quality Assurance. It also was ranked the No. 4 Medicaid plan in the nation out of 115 Medicaid plans. NCQA is a private, nonprofit organization dedicated to improving healthcare quality. More



WellCare, Humana, Coventry win Medicaid business in Kentucky
Dow Jones Newswires via NASDAQ    Share    Share on FacebookTwitterShare on LinkedinE-mail article
WellCare Health Plans Inc., Humana Inc., Coventry Health Care Inc. and a local not-for-profit plan have all won business to cover a total of 175,000 Medicaid recipients in Kentucky beginning next year. For WellCare and Coventry, Aetna Inc. plans to buy the latter company in a $5.7 billion deal announced in August. The move represents expansion in a state that has presented significant high-cost challenges this year. Humana, working through an alliance with the nonprofit CareSource, is launching a new Medicaid business in its home state. More

Study: Arizona death rates shrank when Medicaid coverage grew
Cronkite News via White Mountain Independent    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Arizona's 2001 expansion of Medicaid coverage resulted in lower death rates in the state, according to a study of several states that links increased coverage to fewer deaths and overall better health. The study, recently published in the New England Journal of Medicine, looked at three states that expanded their Medicaid programs in 2001 and 2002 to cover childless adults. By looking at states with that "major Medicaid expansion," the study hoped to predict what the future of Medicaid expansion might hold under the Affordable Care Act. More

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Free webinar tomorrow by Medagate: 'Member Engagement: Communications & Wellness Programs' | 3 p.m. EDT Oct. 10
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Approximately 25 percent of Medicaid members represent 70 to 80 percent of Medicaid spending. Unfortunately, many Medicaid members are transient by nature, which can make communicating and maintaining wellness programs a challenge. Join Fred Haumesser from ReadyWireless and Donny Tye from Medagate to learn about communication and wellness strategies that take advantage of Lifeline Medicaid programs to engage members. More

Florida's Medicaid program in limbo
The Associated Press via The Sacramento Bee    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Millions of uninsured Florida families and healthcare providers are in a purgatory of sorts. Gov. Rick Scott and the Republican-led Legislature want to privatize the state's Medicaid program, but need the Obama administration's permission. The Obama administration wants to make more low-income Floridians eligible for Medicaid, but needs Scott and the Legislature to agree. More



Medicaid: Doctors cautious about Arkansas payment plan
MedPage Today    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Doctors in Arkansas who treat Medicaid patients are trying their best to put on a happy face about a program designed to reward quality and move away from a traditional fee-for-service payment model. The cost-sharing program, which recently began and involves Medicaid and some of the state's largest private insurers, will determine if a provider reaches quality and cost targets based on historical models. More

Navitus implements PBM program for Texas health plans
Richard J. Plezia & Associates    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Navitus Health Solutions LLC, a national, full pass-through pharmacy benefit manager, has announced the successful implementation of a PBM program for the Texas Association of Community Based Health Plans, a group of managed Medicaid and CHIP plans in Texas. More


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The Economist: Texas has only 1 rational choice about Medicaid expansion
Victoria Advocate    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The choice facing Texas (and every other state) regarding expanding Medicaid under the Affordable Care Act is a difficult one. On the one hand, state funds will be required and the budget is tight; on the other hand, federal funds will be gained and access to care for low-income residents will improve. According to an analysis by The Perryman Group, every $1 spent by the state of Texas to expand Medicaid coverage under the Affordable Care Act returns $1.29 in dynamic state government revenue during the first 10 years of the expansion. Medicaid expenditures lead to substantial economic activity, federal funds inflow, reduction in costs for uncompensated care and insurance and enhanced productivity from a healthier population. More

HealthNow New York Inc. selects Inovalon's Prospective Advantage solution
PR Newswire via Baltimore Business Journal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Inovalon Inc., a provider of data-driven healthcare solutions, has announced that HealthNow New York Inc., parent company of BlueCross BlueShield of Western New York and BlueShield of Northeastern New York, has expanded its partnership to include Inovalon's Prospective Advantage solution, in a partnership that will focus on identifying and closing gaps in assessment, documentation and quality of care More



Kaiser brief: 'Emerging Medicaid Accountable Care Organizations: The Role of Managed Care'
The Henry J. Kaiser Family Foundation    Share    Share on FacebookTwitterShare on LinkedinE-mail article
This brief examines efforts by a number of states to set up accountable care organizations within their Medicaid programs. An ACO is a provider-run organization in which participating providers collectively are responsible for the care of an enrolled population, and may share in any savings associated with improvements in the quality and efficiency of care. The structure of Medicaid ACO initiatives is influenced by individual states' experience with managed care, other existing care delivery arrangements within Medicaid, and the challenges of serving low-income and chronically ill populations. More

Countdown to MHPA's 2012 Annual Meeting; 'Diabetes Disparities' workshop for all attendees
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
If you haven't signed up yet for the MHPA 2012 Annual Meeting, "A Pivotal Time for Medicaid Health Plans," slated for Oct. 24-26, now is the time to register online from your PC or PDA with only 15 days to go. We've also added a diabetes disparities workshop Oct 24, free for all conference attendees. "Diabetes Disparities: Innovations in Identifying and Addressing Them in Medicaid Managed Care Plans" will feature Dr. Kasia Lipska from Yale University School of Medicine; Dr. Gary Puckrein of the National Minority Quality Forum; Mary Barton from NCQA; and Dr. Andrea Gelzer, CMO of The Amerihealth Mercy Family of Companies. See the agenda here. More

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Watch now: Payer/Provider Relationships, expert video from Truven Health (formerly Thomson Reuters Healthcare)
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Bob Kelley, senior vice president of Truven Health, talks about how reform is causing health plans to change their business model and discusses innovative ways that health plans can begin to share risk with providers. Payer/Provider Relationships is the third in a free video series by Truven Health. Coming up next week: Complexities of alternative payment methods.

Insights webinar: 'Prepayment Reviews & Minimizing Medicaid Exposure' | 11 a.m. EDT Oct. 15
Presidio Excess Insurance Inc.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Discuss high-dollar Medicaid claim trends from a reinsurer's prospective. REGISTER NOW.

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Insights webinar: 'The Ins and Outs of Encounter Reporting' | 11 a.m. EDT Oct. 29
Altegra Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Health plans have many compliance requirements tied to their state Medicaid contracts, not the least of which is encounter reporting. REGISTER NOW.

Free webinar by MHPA partner LexisNexis: 'Why Identity Management Matters to Medicaid' | 1 p.m. EST Nov. 8
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As a Medicaid Plan you should not just be addressing the "what" of identity management — the technical side — but, more important, the question of "who?" How do we know who the person on the other end is who they say they are and what risks they may pose for the environments and systems they are attempting to enter? More



Take action for World Diabetes Day: Attend MHPA's free webinar by Novo Nordisk on diabetes trends to 2025 and resources for policymakers, patients | noon EST Nov. 14
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In an effort to help confront the epidemic of diabetes, Novo Nordisk commissioned and funded "United States' Diabetes Crisis: Today and Future Trends," the first study to provide detailed diabetes prevalence and cost forecasts individually for all 50 states out to the year 2025. The study not only provides insight into how the growing diabetes epidemic geographically will spread in the U.S., but also highlights how this demographic shift might affect local economies. This webinar will provide an overview of the study from lead researcher Dr. Bill Rowley and will introduce the Novo Nordisk Diabetes Barometer, an interactive tool and comprehensive resource that highlights important research about the current state of diabetes in the United States. Participants also will learn how to use the interactive map portion of the website to benchmark and compare diabetes prevalence and cost forecasts to 2025 for all 50 states. More



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