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Michigan delays implementing healthcare program
The Associated Press via The Times Herald
Michigan is delaying the implementation of its health care coordination program for people eligible for both Medicare and Medicaid. The Michigan Department of Community Health said the start date for MI Health Link will move from Jan. 1, 2015, to March 1, 2015, to make sure it's prepared to deliver services. Enrollment will start in February, and the program will operate through December 2018 instead of December 2017.
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Managed Medicaid braces for influx of ex-inmates
Managed Care magazine
Most people don't lose sleep worrying about healthcare services provided to inmates in jails or prisons, but maybe they should. Lack of proper coverage is a major cause of recidivism, experts say, but this year, the Affordable Care Act allows inmates to sign up for Medicaid. This comes with challenges, and health insurance plans involved in managed Medicaid gird themselves to handle an influx of beneficiaries who have historically had little or nothing to do with the health system.
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Providers, advocates seek tougher rules on network adequacy
Modern Healthcare
Many healthcare stakeholders want more muscle from state insurance commissioners' efforts to help states police how health plans assemble and manage their provider networks. The National Association of Insurance Commissioners is circulating a draft model state law addressing increasingly fractious practices. Providers and consumer advocates have generally applauded the effort but plan to press for the document to propose more stringent standards regarding provider directories, out-of-network billing and what constitutes an adequate provider network.
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TennCare director tries to thread needle on Medicaid expansion
The Tennessean
TennCare Director Darin Gordon gave medical students insight this week on a difficult task — finding a way for Tennessee to benefit from federal tax dollars already being collected from state residents. He talked about trying to come up with a "Tennessee Plan" that will satisfy the federal government for Medicaid expansion and simultaneously get past state legislators who don't want anything to do with Obamacare.
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Virginia Democrat's Senate exit undid governor's secret plan for
Medicaid expansion

The Washington Post
Virginia Gov. Terry McAuliffe had run out of options to pull off his marquee campaign promise to expand Medicaid under the Affordable Care Act. Even a risky plan to circumvent the legislature had fallen apart. That's when the governor, his top priority defeated, picked up the phone and called the man he blamed for the catastrophe. "Hey, Phil? Terry McAuliffe," the governor said in a seething voice message to Phillip P. Puckett, a Southwest Virginia Democrat who had quit the state Senate days earlier, throwing control of it to the GOP. "I want you to know we just lost the vote, 20 to 19, in the Senate. Medicaid is done. I hope you sleep easy tonight, buddy."
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Prematurity Awareness Month news: MHPA releases brief on health plan roles to reduce preterm birth; ; Capitol Hill briefing on Dec. 11
MHPA
To commemorate World Prematurity Day, MHPA, the national advocacy group for Medicaid managed care organizations, released "Preterm Birth Prevention: Evidence-Based Use of Progesterone Treatment — Issue Brief and Action Steps for Medicaid Health Plans" to help health plans target the problem of preterm birth, the leading cause of infant morbidity and mortality in the U.S. MHPA will participate in a Capitol Hill briefing on Dec. 11 featuring the March of Dimes and other stakeholder groups (details to follow).
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Costly hepatitis C treatments help drive 12 percent drug spending jump
Kaiser Health News
After several years of modest increases, American spending on medications is projected to shoot up by 12 percent this year, pushing the nation's drug bill to between $375 billion and $385 billion, according to a report by the IMS Institute for Healthcare Informatics.
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Voter opposition to Obamacare led Kansas Democrats to shy away from Medicaid expansion issue
Kansas Health Institute
Post-election soul-searching by Kansas Democrats includes disagreement over whether Medicaid expansion should have been a larger part of the party's strategy. The Democrats lost all statewide races for the second straight time and lost another five House seats to drop their number in that chamber to 27. The defeats were part of a national wave of Republican election wins, but they have nonetheless led to talk within the Kansas Democratic Party about what could have been done differently.
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To attack health disparities, states take a broader view
The Pew Charitable Trusts
For years, proposals to raise the minimum wage in Minnesota bogged down over economic concerns: Would a raise impel businesses to leave the state? Would it decrease employment? Would it touch off inflation? The supporters' main argument, that raising the minimum wage would put more money into the pockets of low-wage workers and their families, fell short. This year, proponents seized on a new strategy: They convinced the legislature to ask the Minnesota Department of Health to analyze the health impact of the state's minimum wage of $6.15 an hour, which is among the lowest in the country.
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Nov. 26 Webinar Wednesday: 'Why All Medicaid Managed Care Organizations Need an ACO Strategy'
Epstein Becker Green
The growth and persistence of the state ACO movement is being fueled by CMS' State Innovation Model grants and by state implementation of Medicaid accountable care organizations (ACOs) — 17 states have already implemented some form of Medicaid accountable care. Join Clifford Barnes, partner at Epstein Becker Green, PC, and Jenny Gladieux, senior health policy analyst for Health Policy Source, Inc., as they provide the tools to develop an understanding of how Medicaid ACOs affect Medicaid managed care and provide the rationale on why Medicaid managed care needs to develop state-specific ACO strategies.
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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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MHPA's Myers to chair WHCC 4th Annual Medicaid and Medicare Reform Summit | March 2015 | Washington, DC
World Congress
MHPA President and CEO Jeff Myers will chair the WHCC 4th Annual Medicaid and Medicare Reform Summit, a meeting that convenes executives from health plans, hospital systems and policy organizations to share, learn and discuss approaches to improve the quality of government programs and achieve payment and delivery reform. For conference details, agenda and registration, please visit here.
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MHPA's Myers to speak at Sixth Annual Medicaid Innovations 2015 Forum | Feb 3-5, 2015 | Orlando
Medicaid Innovations Forum
Join MHPA President and CEO Jeff Myers at the Sixth Annual Medicaid Innovations 2015 Forum in February 2015. This meeting offers a unique combination of forward-thinking perspectives including first-hand case studies and examples of true innovation from both Medicaid managed care plans and state government agencies. The forum, which gathers hundreds of representatives from states, health plans and solution providers in one room, goes beyond policy to explore the specific strategies these organizations are leveraging to improve quality of care, reduce costs and position themselves for success in serving the rapidly expanding Medicaid population. Use Discount Code MHPA200 to receive $200 off the current rate.
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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    MHPA's best practices letter to the Hill (MHPA)
Feds OK extension of Healthy Indiana Plan (Lafayette Journal & Courier)
US court rejects Maine's effort to trim Medicaid rolls (Reuters)
Most Illinois Medicaid patients denied new hepatitis C drugs (Chicago Tribune via Kaiser Health News)
New Medicaid rule could challenge state shift away from nursing homes (The Pew Charitable Trusts)
Prospects to expand Medicaid services in North Carolina dim for 2015 (News & Observer)
Report: US states get more, spend more on Medicaid under Obamacare (Reuters)

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


Dec. 3 Webinar Wednesday: 'Navigating Managed Care in Rare Diseases'
Baxter Healthcare Corporation
Rare diseases such as hemophilia are complicated conditions that present unique challenges to the healthcare system with respect to treatment, cost and coverage of care. Consideration of factors that contribute to best practices for managing care for individuals with hemophilia are paramount. These include:
  • Care transitions that impact pediatric patients with hemophilia as they move into adulthood
  • Coordinated care strategies
  • Pharmaceutical manufacturer partnerships
Baxter Healthcare Corporation invites you to join leading managed care expert Richard Stefanacci, DO, MGH, MBA, AGSF, CMD, as he presents opportunities to improve rare disease state management through an engaging presentation and interactive question-and-answer session.

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Job opportunity: Clinical director, Homecare & Managed Care
First Quality
First Quality, a leading manufacturer of disposable home health care products, is seeking a clinical director for our Homecare & Managed Care Business. This candidate will provide leadership and have a focus on clinical education, utilization management protocols and programs and operational program development within home care and managed care markets.
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