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CMS official: Draft of Massachusetts' duals-demo beneficiary enrollment notice 'failed miserably'    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Field tests of letters to beneficiaries explaining Massachusetts' demonstration to coordinate care for residents eligible for both Medicare and Medicaid proved unsuccessful, according to a CMS official, as beneficiaries remained confused about the program. Beneficiary advocates are glad CMS is testing the notices, but the early results disconcert them because they want the "passive enrollment" process that states are using to give duals a real choice, and they say the notices should help beneficiaries understand that choice, not confuse them or promote the demonstration. More

Upcoming Washington state duals demo offers insight on managed FFS model    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Washington state likely will be the first state to sign a memorandum of understanding with CMS on a duals demonstration that uses the managed fee-for-service model, a CMS official said, and a Washington state official outlined its plans for that demo at a recent conference in Baltimore sponsored by the National Association for State Health Policy. Stakeholders interested in the managed fee-for-service model closely are watching the Washington MOU to get an idea of what CMS expects from that approach, and the CMS official said one of the standout aspects of the state's proposal is its tool for predicting which residents are at high risk of developing costly conditions so the state can intervene early. More

MHPA's 2012 Annual Meeting only 1 week away; RSVP for free 'Diabetes Disparities' workshop
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. 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. You must RSVP to attend this complimentary workshop. See the agenda here. More

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Free webinar: 'Exchange Health Plan Management Functions: URAC Accreditation & Quality Measures for Health Insurance Exchanges' | 3 p.m. EDT | Oct. 23
URAC    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In this complimentary webinar, URAC will present an overview of its accreditation process and quality measures as they relate to qualified health plans that participate on Health Insurance Exchanges, including how URAC information may be utilized by state insurance regulators and state exchanges. For more information and to register, click here.

Video: Weighing The Impact Of Health Issues On Campaign 2012
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Kaiser Health News has convened two discussions to review the politics and policy of healthcare as the 2012 election for president nears. Included in the video are KHN's Mary Agnes Carey and Karen Tumulty of The Washington Post, who discuss President Barack Obama's and Republican presidential nominee Mitt Romney's plans with former Democratic Sen. Tom Daschle and conservative healthcare analyst Avik Roy. More

NAHQ issues 'Call to Action' for enhancing healthcare quality, patient safety
PR Newswire via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
To enhance overall quality of care, strengthen patient safety protection and minimize costly medical errors, healthcare provider organizations should expect all clinical staff to be accountable for achieving meaningful quality improvements and reporting potential safety risks. This allows healthcare professionals to feel empowered and protected when reporting concerns about potential risks and adverse events, according to the National Association of Healthcare Quality, in its "Call to Action: Safeguarding the Integrity of Healthcare Quality and Safety Systems." More

Health shift will affect 860,000 in California
The Associated Press via The Reporter    Share    Share on FacebookTwitterShare on LinkedinE-mail article
California's top healthcare official told lawmakers that she is confident the state can eliminate a health insurance program serving more than 860,000 children from low-income families without disrupting the quality of their care. Lawmakers held a hearing in the state Senate wanting to know if the administration is prepared to make the transition without disrupting children's medical care. California is eliminating its Healthy Families program and moving those children into the state's Medicaid program in an effort to save a projected $73 million a year. More

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Bill aims to block HMO cuts in New Jersey Medicaid reimbursements
NJ Spotlight    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A state Senate committee has moved to set up roadblocks in the face of reimbursement cuts planned by HMOs that oversee New Jersey's Medicaid program. Often-emotional testimony by healthcare providers and workers helped convince the Senate Health, Human Services and Senior Citizens Committee that cuts by Horizon NJ Health and the other HMOs would hit services for the frail elderly, children with disabilities and other vulnerable populations. More

Mississippi says no thanks to Medicaid expansion dollars
The Associated Press via The Picayune Item    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Mississippi has long been one of the sickest and poorest states in America, with some of the highest rates of obesity, diabetes and heart disease, and more than 1 in 7 residents without insurance. And so you might think Mississippi would jump at the prospect of billions of federal dollars to expand Medicaid. You'd be wrong. Leaders of the deeply conservative state say that even if Mississippi receives boatloads of cash under President Barack Obama's healthcare law, it can't afford the corresponding share of state money it will have to put up to add hundreds of thousands of people to the government health insurance program for the poor. More

Partnerships to help control Illinois Medicaid costs
The Associated Press via NECN    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A for-profit nursing home company owned by a politically connected Chicago businessman is a partner in a project Illinois Gov. Pat Quinn announced that aims to control health spending for high-cost Medicaid recipients. The selection of MADO Management raised questions from one advocate for nursing home residents, who pointed to some MADO facilities' below-average staffing levels and violations found by regulators during inspections. But a state official said it's important for a nursing home operator to be involved as the state moves more mentally ill residents into group homes and independent living apartments, and MADO, owned by businessman Peter O'Brien, is the only one that applied. More

Accountable care explained: An experiment in state health policy
Stateline via Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Affordable Care Act and state fiscal pressures have spawned an array of new Medicaid cost containment and quality improvement schemes. Among the most ambitious is a healthcare delivery system whose components are called accountable care organizations. The phrase "accountable care organization" was coined in 2006 at Dartmouth University Medical School and then adopted by an advisory board to Medicare, the federal health plan for seniors. More

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HMS Holdings Corp. names Cora Tellez to board of directors
Business Wire via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
HMS Holdings Corp. announced that Cora Tellez joined the company's board of directors Oct. 15. Tellez is founder, president and chief executive officer of Sterling HSA, an independent health savings accounts administrator, and Sterling Self Insurance Administration, which provides cost-containment solutions for self-insured employers. More

Philips Respironics Improves Health Care Delivery and Quality of Life for Sleep and Respiratory Patients
PR Newswire via DeviceSpace    Share    Share on FacebookTwitterShare on LinkedinE-mail article
At Medtrade 2012, Philips Respironics, a unit of Royal Philips Electronics, showcased advancements that allow patients to sleep and breathe easier, demonstrating its commitment to improving the quality of life of those who suffer from chronic sleep and respiratory conditions. Medtrade, taking place this week at the Georgia World Congress Center, is the nation's largest conference and exposition focused exclusively on the home medical equipment industry. More

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

Watch now: Complexities of alternative payment methods, expert video from Truven Health
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the fourth video of this series, Bob Kelley, senior vice president of Truven Health, discusses the complexities of alternative payment methods. Watch it here. Coming up next week: How health plans can help providers and facilitate care coordination. More

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New call for submissions: Diabetes Care Best Practices Compendium
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid Health Plans of America is calling for case studies from our member organizations that will help to highlight real-world examples of best practices related diabetes prevention and treatment. We invite member and partner organizations to submit information to be included in the MHPA Diabetes Care Best Practices Compendium, to be published in January 2013. More

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.

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Bloomberg BNA webinar: 'Medicaid Managed Care: Industry Trends and the Inclusion and Exclusion of Benefits and Services' by MHPA
CEO Thomas Johnson | 1-2:30 p.m. EST Nov. 8

Bloomberg BNA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Because of budget constraints and a movement toward emphasizing better care coordination, states are increasingly interested in beginning new Medicaid managed care programs and/or expanding programs already in place. This program will address current and projected Medicaid managed care trends, provide an understanding of carve-outs, with a special focus on pharmacy benefits, discuss trends related to pharmacy carve-outs and provide insight as to what can be expected regarding Medicaid managed care benefits and services in the future. Attendees who currently work with Medicaid health plans or expect to in the future will benefit from learning industry insights into Medicaid managed care growth and expansion, treatment of various benefits and services in state contracts and industry expectations for carve-ins and carve-outs moving forward. To receive a 20 percent discount off registration and receive CLE credit for attending, choose the "Live Webinar" option and use promo code LGAUEBR2. More

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

Free webinar: 'Medication Adherence & Identifying Nonadherent Patients' by Merck | 1 p.m. EST Nov. 27
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Merck cordially invites you to a medical education program for healthcare professionals only. Merck is sponsoring this program, and the speaker is presenting on behalf of Merck. The program is a non-CME event. The information presented in this program will be consistent with FDA guidelines. The format is an interactive live webcast titled A Profile of the Concept of Medication Adherence and Strategies to Identify Nonadherent Patients Learning Objectives:
  • Define medication nonadherence and understand its prevalence among patients with chronic disease
  • Recognize the drivers of nonadherence and understand the importance of appropriate communication
  • Use the 10 Tenets model of medication adherence and the Adherence Estimator screening tool
Click here for more information or register here for the live webcast.

Health Insurance Exchanges Summit; MHPA's Thomas Johnson guest speaker | Nov. 29-30 | Las Vegas
Healthcare Education Associates    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Join Healthcare Education Associates Nov. 29-30 at the Tropicana Las Vegas Hotel for the Health Insurance Exchanges Summit. This health insurance exchanges conference will deliver real, actionable takeaways for effective exchange implementation. MHPA members are eligible for a 15 percent registration discount. Mention Priority Code HMP122 during registration to enjoy this offer. More

Slides available for Medagate webinar: 'Member Engagement: Communications & Wellness Programs'
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
See last week's presentation from Fred Haumesser from ReadyWireless and Donny Tye from Medagate about communication and wellness strategies that take advantage of Lifeline Medicaid programs to engage members. More

Insights webinar: 'Reduce Outsourcing Risk' | 11 a.m. EST Dec. 20
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Details here.

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