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MHPA
Thanks to all our attendees and sponsors for attending. We hope you found it to be an informative three days. Presentations will be available on MHPA's website and the mobile app soon.
See you Sept. 21-23, 2016, for mhpa2016!
Forbes
The expansion of Medicaid benefits for poor Americans under the Affordable Care Act and the general move away from fee-for-service medicine helped boost enrollment in private health plans by 7.8 million beneficiaries in the last year, according to a new report.
"Even if no other state expands Medicaid [under the ACA], managed care is going to increase its market share because states are moving away from fee-for-service medicine," said Jeff Myers, chief executive of MHPA. The report was released last week at MHPA's annual conference.
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STAT
Private Medicaid plans are seizing on the political rancor over prescription drug prices to lobby for an overhaul of how the government insurance program pays for medicine. MHPA is working on a set of proposals to present to lawmakers and hopes to release them publicly by mid-2016, the group's president and CEO, Jeff Myers, told STAT at MHPA's annual conference.
Medicaid is "now run by very sophisticated insurers who are taking financial risk," Myers said. "It would be better if the market allowed pharmaceutical companies to take the same kind of risk."
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The Hill
The nation's largest benefit managers have cut ties with at least eight pharmacies amid growing scrutiny of the drugmaking industry, according to Reuters. Express Scripts and CVS Health, the two largest benefits managers in the U.S., have each terminated contracts with multiple pharmacies that they say work too closely with drug companies. At least a half-dozen partnerships have been severed in the last week, prompting multiple lawsuits by the pharmacies.
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Marketplace
Medicaid health insurers are meeting in Washington this week, and one issue at the top of the industry's agenda is taking a look at social factors that many Medicaid directors believe drive up E.R. and hospitalization rates for a small number of patients. There's a growing sense among states, which employ the insurers, that providing better care to some 5 percent of patients overall — a group that accounts for half of medical spending — is essential to lowering program costs long-term.
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Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
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RxAnte
Use of prescription opioids has grown rapidly in recent years. These powerful medications bring enormous value to many patients, but they also pose significant safety and cost concerns. The cost of opioid abuse in the United States was recently estimated to be $70 billion annually and led to nearly 100,000 avoidable ER visits each year. Most policy and clinical approaches to this problem focus on identifying individuals who divert abuse or otherwise misuse opioids — referring them to programs aimed at treating addiction or reducing fraud, waste and abuse. Relatively few programs aim to prevent potentially unsafe opioid use from developing in the first place.
Join, Michael Ross, M.D., chief medical officer, and Amie Joyce, MPH, vice president of account management of RxAnte, LLC. This webinar will describe a novel program that enables healthcare payers and providers to prevent potentially unsafe opioid use.
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MHPA
MHPA and its sister organization, the Institute for Medicaid Innovation, awarded select member companies for innovative best practices that have improved the health of Medicaid enrollees.
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Fox News
Over half of all illegal immigrants in California earn incomes so low that they would be eligible for the state Medicaid system Medi-Cal, a new study has found, just as California is about to extend the health insurance to children in the country illegally. The non-partisan Public Policy Institute of California concluded that, should the deep blue state choose to go further and expand the program to include all illegal immigrants, 51 percent of them would have incomes low enough to be eligible for the program.
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Los Angeles Times
When Hilda Sims earned her release from prison last year after serving 22 years for murder, she got something that could dramatically reduce the odds that she'd ever have to return — health insurance. For years, many who left California lockups on parole or probation would do so without easy access to medical care. For someone like Sims, who survived breast cancer behind bars, that meant health problems might go untreated or result in big medical bills just as they were struggling to return to society.
Studies have shown that lacking access to healthcare can make former inmates return to crime, eventually falling back into the prison system, says Elizabeth Siggins and her colleagues at the nonprofit advocacy group Californians for Safety and Justice.
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With an emphasis on innovative initiatives and data-driven solutions, DentaQuest is partnering with health plans to fundamentally change the way oral health is delivered in America. Integrating preventive oral health programs not only offers members a wider portfolio of choice - it is also a proven driver of cost control.
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Montgomery Advertiser
Before December of last year, Alabama Gov. Robert Bentley closed, locked and barred the door to Medicaid expansion. Since then, he's undone the deadbolts and turned the knob, without pulling it back. Bentley on Thursday appeared to signal a desire to crack the door, saying at a conference his office was "looking" at expansion. Friday, his office said nothing had changed. Jennifer Ardis, a spokeswoman for Bentley, said the governor remained focused on implementing regional care organizations (RCOs), aimed at changing Medicaid delivery from a fee-based model to one that rewards outcomes.
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The Hill
President Barack Obama's nominee to lead the Food and Drug Administration (FDA) on Tuesday defended himself against a chorus of Democratic criticism over his ties to the pharmaceutical industry. Dr. Robert Califf, a cardiologist who has worked closely with drugs companies on product studies, stressed that with a critical eye he has conducted his work with a particular focus on public safety.
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MHPA
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View other past webinars here.
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