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MHPA welcomes Jeff Myers as new president and CEO
MHPA
On Nov. 4, Jeff Myers took the reins of MHPA as its president and CEO. Jeff, a government affairs veteran, comes to MHPA from the American Health Care Association, where he was senior vice president of policy and government relations. Jeff takes over for Joe Moser, who was recently appointed Medicaid director for the state of Indiana.
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PwC analysis finds major growth potential for Medicaid managed care
Inside Health Policy
Of the 23 million Medicaid beneficiaries who are not in private managed care plans, three-quarters live in states with some sort of private managed Medicaid, according to Ari Gottlieb, director of payer strategy at PricewaterhouseCoopers, and states are aggressively moving toward relying more on private managed care plans. The Medicaid health insurance market is localized so it is ripe for consolidation, Gottlieb says.
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Study finding MA plans with dual eligibles get fewer stars may bolster lobby to change rating system
Inside Health Policy
Medicare Advantage plans with higher numbers of dually eligible beneficiaries have lower star ratings than plans with low numbers, even after risk adjustment, finds a study by a provider of data-driven healthcare solutions, and the results may bolster plans' lobby to change the Star Ratings system for duals care.
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West Virginia senator again pushes drug rebates as savings to offset SGR
Inside Health Policy
West Virginia Sen. Jay Rockefeller has resumed his press to extend Medicaid drug rebates to those dually eligible for Medicare and Medicaid, touting his Medicare Drug Savings Act as a potential way to pay for a new bicameral legislative proposal to replace the troubled Medicare Sustainable Growth Rate physician payment formula.
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'NAMD ACA Implementation Snapshot — Open Enrollment, Week 4'
National Association of Medicaid Directors
This NAMD snapshot provides a summary of the state experience during the fourth week of the open enrollment period. This report discusses the progress of state implementation activities as a qualitative summary.
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In 1st month, the vast majority of Obamacare signups are in Medicaid
The Washington Post
The first month of the new health law's rollout reveals an unexpected pattern in several states — a crush of people applying for an expansion of Medicaid and a trickle of signups for private insurance. This early imbalance — in some places, 9 out of 10 enrollees are in Medicaid — has taken some experts by surprise. The Affordable Care Act, which expanded Medicaid to cover millions of the poorest Americans who couldn't otherwise afford coverage, envisions a more even split with an expanded, robust private market.
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Why state exchange sites worked while the federal site faltered
The Seattle Times and Kaiser Health News
When President Barack Obama addressed massive problems with the federal health-insurance exchange website, he couldn't cite any actual enrollments in health plans offered through the site. At the same time, several states running their own exchanges have exceeded federal-enrollment targets, including California, Connecticut, Kentucky, New York, Rhode Island and Washington.
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Poll: Healthcare.gov troubles don't change public's view of health law
Kaiser Health News
The public has a dim view of how the government has rolled out the healthcare law so far, but those stumbles have not changed people's overall opinions of the law itself, a new poll finds. The Kaiser Family Foundation poll found that 48 percent of people think the federal government has done a poor job of implementing the law, and another 32 percent give the government an "only fair" review.
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147,000 children across Pennsylvania found to lack health insurance
Pittsburgh Post-Gazette
More than 147,000 children in Pennsylvania lack health insurance, according to a recent study, despite the commonwealth's goal of ensuring coverage for all kids. Between private insurance, Medicaid for kids from low-income families and the Children's Health Insurance Program — which covers children whose families make too much to qualify for Medicaid but can't afford private insurance — children in the commonwealth ought to be universally covered.
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Anticipated changes in reimbursements for US outpatient emergency department encounters after health reform
Annals of Emergency Medicine
A secondary analysis of data (2005 to 2010) was conducted from the Medical Expenditure Panel Survey. Comparisons were made between two groups to reflect likely movements in insurance status after the Patient Protection and Affordable Care Act implementation — the uninsured who will be Medicaid eligible afterward versus Medicaid insured and the uninsured who will be Medicaid ineligible afterward versus the privately insured.

Assuming historical reimbursement patterns remain after Patient Protection and Affordable Care Act implementation, outpatient ED encounters could reimburse considerably more for both the previously uninsured patients who will obtain Medicaid insurance and for those who move into private insurance products through health insurance exchanges, according to Jessica E. Galarraga, M.D., MPH, and Jesse M. Pines, M.D., MBA.

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TRENDING ARTICLE
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CMS mantra: It'll work by December
Politico
November's shaping up to be a major test of Obamacare functionality. That's when new features of the health law's enrollment system — some of which have been put off repeatedly because of insufficient testing — are slated to go online. Among them: Online enrollment in the marketplace for small businesses, a Spanish-language enrollment website and the transfer of Medicaid applications from the feds to the states.

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Sebelius on healthcare law rollout: 'Hold me accountable for the debacle'
The Washington Post
The battle over the government's problem-plagued healthcare website recently escalated as Republicans attacked the Obama administration over an array of emerging issues involving the health law, including potential security vulnerabilities on the site and complaints from Americans facing cancellations of existing policies.

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Medicaid enrollment surges ahead of ACA signups
Politico
HealthCare.gov may be limping along to full viability, but Medicaid is flying off the shelves. New Medicaid enrollment is far outpacing new insurance customers under Obamacare so far, a subtle sign that the program could play a greater role in the law's coverage expansion than first anticipated.

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MHPA 2013: Your feedback is important to us
MHPA
If you went to MHPA 2013, please complete the short online attendee survey. Updated presentations are also available on the app and MHPA's website here.
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Job opportunity: Johns Hopkins HealthCare LLC COO
Johns Hopkins HealthCare LLC via FurstGroup
Johns Hopkins HealthCare LLC seeks an accomplished operational leader to join the executive management team to drive performance excellence, growth and strategy. The chief operating officer is a strategic business partner to the JHHC President, and together they will implement a plan for growth and transformation in response to healthcare reform that is in concert with that of JHM.

Qualified candidates will possess a bachelor's degree in business administration or a related field with a preference for a master's degree or MBA. We require at least 15 years of increasingly responsible senior management experience in health plan operations or a similar highly transactional environment with demonstrated skills in innovation, change management and strategic systems thinking.

Access the position profile on our Web site via the link here. For immediate consideration, please apply directly to Deanna Banks, principal at FurstGroup.

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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Medicaid enrollment surges ahead of ACA signups (Politico)
Florida adds Medicaid managed care contracts (Health News Florida)
Avalere: Duals demo delays expected as plans eye 3-way negotiations (Inside Health Policy)
Obama health official apologizes for broken HealthCare.gov (The Hill)
Plans seek mergers, Medicaid business to remain competitive (Managed Healthcare Executive)

Don't be left behind. Click here to see what else you missed.


Sign up for a free trial to Health Exchange Alert, a news service from InsideHealthPolicy.com
Inside Washington Publishers
The Affordable Care Act's mandated health exchanges are on the front burner for policymakers and should be for you, too. Stay on top of the evolution and implementation of health exchanges with Health Exchange Alert, the news service from InsideHealthPolicy.com. Act now by clicking here to activate a no-obligation, four-week free trial to gain immediate access to InsideHealthPolicy.com and Health Exchange Alert.

Your free trial will include access to the numerous articles and documents posted every business day, as well an email alert every morning highlighting the latest news. You'll also have access to our three weekly newsletters (Health Exchange Alert, Inside CMS and FDA Week), which you can download in PDF format and circulate.

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Webinar Wednesday on Nov 13: 'ACA: Outlook 2013 and Beyond' by PartnerRe
MHPA
Tasha Barbour, vice president and director of specialty medical programs for PartnerRe, outlines the implications for employers and healthcare providers of the ACA.
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Recent webinar presentations from PwC, SCA Personal Care, Lilly, First Quality, Millennium Labs and others available free on MHPA website
MHPA
View PDFs or listen to audio for the following webinars: Additional webinars can be viewed here.
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MHPA on Twitter, LinkedIn and Facebook
MHPA
Follow us on Twitter, LinkedIn and Facebook to get industry-related news and the latest MHPA announcements.
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