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mhpa2014 best practice and service awards
Best Practices Honorable Mentions
Congratulations to all!
"Multifaceted Interventions Improve Medication Adherence in Patients with Chronic Conditions" by AmeriHealth Caritas Family of Companies
"Healthier YOU! Baby Partners Program" by Health Partners Plans
"Care Coordination — It Takes a Team" by Meridian Health Plan
"Case Management Stabilization" by WellPoint, Government Business Division
Best Practices Awards
Technology Award: "Moms2B Program: Improving Birth Outcomes through Use of Cell Phones, Texting and Intensive Case Management" by Keystone First
Children's Health Award: "Start Smart for Baby Texting Program" by Centene® Corporation
Cultural Competency Award: "Spread the Word, Not the Disease — Improving Chlamydia Screening in Women" by Midwest Health Plan
Outreach Award: "Farm-to-Fork Program, a Partnership between UHC and Alcorn State University Extension Program" by UnitedHealthcare Community Plan of Mississippi
Innovation Award: "Oral Health Initiative" by Health Partners Plans
Making a Difference Award: "Cigna-HealthSpring Behavioral Health Intensive Outpatient Program" by Cigna-HealthSpring®
Isadore King Spirit of Service Award — PwC
Joy Wheeler Leadership Award — Frank J. Siano
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Gilead's latest hepatitis C drug breaks US sales records; MHPA comments
Financial Times (Subscription required)
A hepatitis C treatment is set to break sales records for a drug launch despite a price tag of more than $1,000 a pill that is putting pressure on the US healthcare system. Harvoni, made by Gilead Sciences, has cure rates of between 94 to 99 percent. It is the successor to Gilead's Sovaldi, which has accrued more than $7 billion in U.S. sales since it became available in the final quarter of 2013. Jeff Myers, president of MHPA, said his members were already dealing with a "tsunami of cost" from Sovaldi that would only get worse with Harvoni.
Obama getting mixed news on Medicaid expansions
President Barack Obama is getting some good news and some not-so-good news as his administration tries to persuade Republican governors to sign off on Medicaid expansions. For example, in Utah, Gov. Gary Herbert says he has a deal on a Medicaid compromise. Meanwhile, reports indicate that Indiana Gov. Mike Pence — a potential Republican presidential candidate — may nix a Medicaid deal.
Medicaid expansion finds red-state allies
The Atlanta Journal-Constitution
A growing number of states that strongly opposed Obamacare are rethinking their positions on Medicaid expansion as they watch billions in new federal dollars rain down on neighboring states.
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Current North Carolina Medicaid reform debate has familiar look
North Carolina Health News
As North Carolina lawmakers meet during the legislative interim this fall, one of the biggest topics under discussion is how Medicaid will look into the future. And as those talks take place, the debate looks very familiar. At a recent subcommittee meeting, representatives from stakeholder organizations gave testimony similar to that given last winter to the Medicaid Reform Advisory Group.
Illinois aims to improve Medicaid patients' coordination of care
Illinois is shifting at least 50 percent of Medicaid's 3 million people into care coordination programs by Jan. 1, 2015. The state started enrolling most of these people in July, though some Medicaid patients were moved to these programs as early as 2011.
Reno finds Medicaid expansion tough hand to play
Kaiser Health News
Delays are a result of the surge in newly insured patients seeking care as Nevada became one of 26 states to expand Medicaid under the Affordable Care Act in 2014. The Reno area has seen its Medicaid enrollment nearly double this year — one of the biggest jumps of any metro area nationwide.
Amerigroup Louisiana recommended for contract award to provide Medicaid managed care through the Bayou Health Program
Business Wire via Pharmacy Choice
Amerigroup Louisiana, a wholly owned subsidiary of WellPoint, Inc., has announced it has been recommended by the Louisiana Department of Health and Hospitals to receive a contract award to continue providing Medicaid managed care services through the Bayou Health Program. The contract is contingent upon successful contract negotiations with DHH and approval by the Division of Administration and the Centers for Medicare and Medicaid Services Regional Office.
Accreditation Association for Ambulatory Health Care approved to accredit Qualified Health Plans
Accreditation Association for Ambulatory Health Care
The Accreditation Association for Ambulatory Health Care has been approved to accredit Qualified Health Plans by the Secretary of the Department of Health and Human Services. Under the Affordable Care Act, an insurer must be designated as a QHP to be included in a state or federal exchange, and accreditation is a requirement of this designation.
One of the most powerful ways to demonstrate that a health plan is meeting industry standards — AAAHC QHP accreditation includes on-site peer review by highly experienced surveyors who are healthcare professionals who come from the primary care and health plan environment. Personal peer reviewers understand the challenges a health plan and its providers face and offer a deep working knowledge of the environment as well as a consultative approach.
AAAHC has been accrediting health plans since 1983 and has been recognized by CMS for Medicare Advantage plans since 2007. AAAHC offers accreditation to HMOs, prepaid health clinics, physician sponsored networks, behavioral health plans, dental health plans and PPOs/POS. For questions or to apply for AAAHC accreditation, visit the AAAHC website, or call 847-853-6060.
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IIR's FDA/CMS Summit for Payers featuring MHPA's Jeff Myers | Dec. 11-12, Washington, D.C.
Institute for International Research USA
Hear from the FDA and CMS under one roof, along with C-level executives from top health plans, at the FDA/CMS Summit for Payers. The entire healthcare continuum is coming together to understand how to better interact with the government to remain compliant, adaptive, and successful as our landscape evolves to become more patient-centric. Collaborate with the most influential people in health care, including speakers MHPA's president and CEO Jeff Myers and Janet Woodcock, M.D., director of the Center for Drug Evaluation and Research, FDA. Click here for more information.
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