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AIS Health's Health Plan Weekly
A national collaborative of 17 major health systems recently unveiled a two-year initiative that it anticipates will transform the Medicaid program by leveraging shared digital solutions and innovative care models to improve care for complex, costly, vulnerable populations. The broadly defined approach somewhat baffles a Medicaid health plan association, which says the health systems' initiative seems to be taking a page from managed care's playbook — basically, focusing on what plans already do.
"Andy Slavitt is incredibly smart. He's visionary, the kind of leader CMS needed to move forward ... and we're all for Medicaid transformation. That's what plans do," said Jeff Myers, president and CEO of Medicaid Health Plans of America.
"But to do Medicaid transformation is more than cool ideas. It's actually implementing things on the ground," Myers told AIS Health. "I'm not sure what 'secret sauce' they have that isn't being explored already."
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Henry J. Kaiser Family Foundation
Arkansas is the first state to implement a Section 1115 waiver that conditions Medicaid eligibility on meeting monthly work and reporting requirements. The Centers for Medicare and Medicaid Services (CMS) approved Arkansas' waiver amendment on March 5, and the new requirements took effect for the initial group of beneficiaries on June 1. As of Sept. 9, the state reported that more than 4,300 enrollees have lost Medicaid coverage as a result of the new work and reporting requirements, and another 5,000 were at risk of losing coverage with another month of non-compliance.
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The Associated Press
When she was struggling financially this past year, Laura Peniche traveled all over Denver to get free food from churches to feed her three young children. She was too scared to apply for government food assistance.
When she was offered a chance a few weeks ago to get a reduced-rent apartment through a city program, she turned it down. Instead, she stretches her budget to pay several hundred dollars a month more to rent somewhere else. It was all because of rumors she heard that immigrants seeking green cards would be rejected if they had ever used government aid programs.
Now the Trump administration has proposed a rule change that would codify some of those rumors, and immigrants and their advocates are scrambling to figure out what it means if it takes effect. They worry that the measure is a back-door attempt to restrict immigration by low-income people and that it could make immigrants fearful of using social services that they or their families need.
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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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The New Yorker
Patty Castleberry, an unemployed white woman in her early 50s, lives in Cuthbert, a small town in southwestern Georgia. Last June, she suffered a ruptured aneurysm that required multiple surgeries. "One day, I went to bed and woke up at Emory," she recalled, referring to the hospital in Atlanta. She didn't have insurance at the time. She has since secured Medicaid, but it didn't kick in immediately, and she has hospital bills exceeding $300,000.
“I was like, 'What’s gonna happen to me?' If I get home and I can't go see a neurologist because I don't have money, I would just have to die." Her voice cracked. "People say, 'No, we wouldn't let that happen.' But if I can't afford to go to the neurologist or get an MRI ..." She trailed off. "I wish there was a healthcare system where I could afford it."
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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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Deseret News
In early 2012, Kat Martinez's infant son had a bad case of a respiratory illness called RSV. Martinez and her family had no health insurance, so she put off a visit to the doctor in the hopes of remedying her son's illness at home, but the infant's condition worsened. Martinez shared her story Monday with Utah healthcare advocates, making her case for passing Proposition 3's Medicaid expansion plan next month in order to make roughly 150,000 more Utahns eligible for the federal health insurance program.
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Idaho State Journal
The first TV campaign commercial is out in the initiative campaign to expand Medicaid in Idaho, and it focuses on returning federal tax dollars to Idaho rather than letting them go to other states — a claim the measure's opponents immediately decried as false.
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Becker's Hospital Review
A Montana initiative to increase the tobacco tax to fund Medicaid expansion is garnering some big spending, the Independent Record reports. One of the spenders is Altria Client Services, which represents tobacco company Philip Morris. Altria has spent more than $12 million on the campaign against the measure, making this initiative the most expensive Montana ballot initiative in state history, according to the report. The $12 million is also 3.5 times what the initiative's largest supporter, the Montana Hospital Association, has spent on the effort.
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Boston Globe
Modifying the federal Supplemental Nutrition Assistance Program to encourage better food choices could improve recipients’ health and cut billions of dollars in healthcare costs, according to researchers at Tufts and Harvard. The antihunger effort, once commonly known as the food stamp program, provides $70 billion each year for low-wage working families, low-income seniors and disabled people to buy food, Tufts said in a statement.
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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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MHPA
Journalist Dan Gorenstein will moderate the MHPA18 conference session "The Evolution of Medicaid Business: The Role and Impact of Capital" on Monday, Oct. 22. Dan served as the senior reporter for National Public Radio's Marketplace and continues to cover the business of health care. He has reported on the price of prescription drugs, Medicaid reform, health care consumerism and end-of-life care. His stories have appeared in The New York Times, The Washington Post and Kaiser Health News. His session will include Melanie Bella (former CMS, current MACPAC commissioner and executive at CityBlock Health) and Sandbox Industries. For more information on this and other sessions, visit here.
MHPA via YouTube
Watch this short recap of MHPA17 to get a feel of the excitement, energy, and content of MHPA's annual conference.
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