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As 2012 comes to a close, MHPA would like to wish its members, partners, and other industry professionals a safe and happy holiday season. As we reflect on the past year for the industry, we would like to provide the readers of the MHPA's Industry Newsbrief a look at the most accessed articles from the year. Our regular publication will resume Jan. 3, 2013.

The Republican plan to overhaul healthcare
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From Aug. 28: The 2008 Republican party platform on Medicare and Medicaid was pretty vanilla. It called for minor tweaks to the program that just about any health wonk could get behind, things like better coordination between doctors and more vigilance against fraud. The whole section came in at about 200 words. POLITICO has obtained a draft of the 2012 proposal and, for healthcare, four years has meant a sea change. The Republican party now throws its weight behind a complete restructuring of both entitlement programs. More

Urban Institute analysis shows state-by-state impact if Medicaid expansion rejected    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From July 5: About 80 percent of the 22.3 million Americans that could be eligible for Medicaid under the health reform law's expansion could remain uninsured if all states refuse to participate, according to an analysis by the Urban Institute. The report concludes that potentially 4.6 million Americans earning between 100 and 138 percent of the federal poverty level would be eligible for subsidies under that scenario, leaving the remaining 17.8 million that earn below 100 percent of poverty at risk of being uninsured. More

The state of the Medicaid expansion in 1 map
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From July 10: Texas Gov. Rick Perry became the sixth Republican governor to opt out of the Medicaid expansion. Six governors may not seem like a lot, but consider this: A full quarter of the 15.8 million Americans expected to gain Medicaid under the Affordable Care Act live in these states. These six governors, if they follow through on their pledges, can singlehandedly shrink the Medicaid expansion by 3.89 million people. More

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CMS estimates 26 states exploring capitated payment model under new duals demo    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From Feb. 9: CMS estimates that 26 states are exploring pursuing a demonstration that would allow states to experiment with capitated payments to align financing between Medicare and Medicaid to improve care for dually eligible beneficiaries, according to recent guidance Medicare-Medicaid Coordination Office Director Melanie Bella and CMS Medicare chief Jonathan Blum sent to health plans interested in participating in that payment model. More

States trim what they can to restrain Medicaid costs
Managed Care    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From June 5: In early April, state officials in Ohio unveiled a new regional structure for Medicaid. In place of the eight zones it has now, they carved the state into three big markets: North, Central and Southeast, and West. And they tapped five plans — Aetna Better Health of Ohio, CareSource, Meridian Health Plan, Paramount Advantage, and United Healthcare Community Plan of Ohio — to operate in all three zones starting Jan. 1, 2013. More

Only 7 states, DC expand Medicaid ahead of 2014
American Medical News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From June 12: Most states have taken advantage of new health system reform law provisions to upgrade or improve care within their Medicaid programs, but only seven and the District of Columbia so far have sought an option to cover more adults before the 2014 expansion of the program, according to a recent Kaiser Commission on Medicaid and the Uninsured policy brief. More

New Medicaid report finds health reform law insurer fee costly to states
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From MHPA Feb. 1: A new report from actuarial consulting firm Milliman Inc. shows a provision of the health reform law intended to tax health insurance companies to help fund coverage expansions, will be paid entirely by state Medicaid programs for the portion assessed to Medicaid managed care organizations. More

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Key report on Medicaid calls for big change in Georgia
Georgia Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From Jan. 24: A consulting firm's long-awaited report calls for Georgia to consider adopting an enhanced managed care system for its Medicaid and PeachCare populations. The Navigant report was commissioned by the state, and it was released by state officials. Hundreds of pages in length, it analyzes Medicaid set-ups in several states and points to weaknesses in Georgia's overall health care system. More

Rep. Pingree presses HHS to block Medicaid cuts in wake of Supreme Court ruling
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From July 10: The Supreme Court's landmark healthcare decision has touched off a fiercely partisan debate not just over whether to expand Medicaid, but also whether governors can cut their programs immediately. Maine Gov. Paul LePage was the first GOP governor who announced plans to cut the existing Medicaid program in addition to opting out of its expansion in 2014. U.S. Rep. Chellie Pingree, D-Maine, urged the Obama administration Tuesday to block LePage's efforts, and healthcare advocates say the high court's decision doesn't allow immediate cuts. More

Medicaid's big spenders, in 1 chart
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From Feb. 28: Aaron Carroll has put together this helpful graph to show whom, exactly, Medicaid dollars go toward covering. And as you can see above, blind, disabled and elderly beneficiaries of the program cost a lot more to cover than adults and children. More

2 campaigns differ sharply on Medicaid, seeking vast growth or vast cuts
The New York Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
From Sept. 4: The way Mitt Romney and U.S. Rep. Paul D. Ryan frame it, the debate over social programs that has become a dominant theme of the presidential race is all about the future of Medicare, the government health insurance program for retirees. But the outcome of the election will probably have a more immediate and profound effect on Medicaid, the joint state-federal program that provides health care to poor and disabled people. Few other issues present a starker difference between the Republican and Democratic tickets. President Barack Obama, through the healthcare law that was a centerpiece of his domestic agenda, seeks a vast expansion of Medicaid, which currently covers more than 60 million Americans — compared with 50 million in Medicare — and costs the states and the federal government more than $400 billion a year. More

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Free webinar by LexisNexis 'Why Identity Management Matters to Medicaid' | 1 p.m. EST Jan. 9
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The challenges of identity risk management can be boiled down to these two words: "Who's there?" At its core, this is the essence of security. Government efforts are driving much of the focus on identity management — a primary concern for the healthcare industry. Medical identity theft or improper access to sensitive records, as well as liability issues, are of paramount concern. Patients want to know what steps are being taken to ensure their privacy. As a Medicaid plan, you should not just be addressing the "what" of identity management — the technical side — but also the question of "who?" How do you know people are who they claim to be and what risks do they pose for the environments and systems they are attempting to enter? Clint Fuhrman, director of Government Health Care Programs for LexisNexis Risk Solutions, addresses these issues in a FREE 60-minute webinar. More

Watch, listen to the Sept. 18 webinar, 'Importance of Coordinated Care in the Management of Members with Hemophilia,' free on MHPA's website
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The presentation on coordinating care in hemophilia and how to improve outcomes and reduce costs by Jeff Januska, PharmD, pharmacy director at CenCal Health and Dr. Steven Pipe, associate professor, Department of Pediatrics and the Department of Pathology, University of Michigan, now is available on MHPA's website.

Free webinar: 'Optimizing Pharmaceutical Care and Measuring Outcomes in a Collaborative Drug Therapy Management Program' | 2 p.m. EST Jan. 30
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medication-related problems and medication mismanagement are massive public health problems in the U.S. Experts estimate that 1.5 million preventable adverse events occur each year that result in $177 billion in injury and death. In response to these problems, PerformRx, in collaboration with the AmeriHealth Mercy Family of Companies, successfully have developed a collaborative Drug Therapy Management program that has demonstrated significant reductions in emergency room visits and inpatient admissions, as well as significant costs savings. More

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Insights webinar: 'Proper Capitation Rates for Hemophilia Patients' | 11 a.m. EST Jan. 23
Baxter    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The webinar will cover the uniqueness of the hemophilia disease state and the difficulties to apply an appropriate capitation for this disease. Also on the agenda: considerations for managed health care plans to ensure that states understand this unique disease state and that adequate reimbursement is received for hemophilia patients to receive the needed care. For details, click here. More

Free webinar: 'Getting to know the 30 million newly insured: New patients equals new challenges' | 2 p.m. EST Feb. 6
PwC    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the wake of the Supreme Court's ruling to uphold the Affordable Care Act, approximately 30 million uninsured Americans under age 65 stand to gain coverage under the law. States are making two crucial decisions: Whether to expand Medicaid coverage, and which type of health insurance marketplace to create — state-run, state-federal run, or federally facilitated. As decisions are made and plans put in place, one thing is certain: When the exchange population is combined with the new Medicaid beneficiaries, the result will be a distinctly different customer base for the health sector, bringing with it many new challenges and opportunities. More

MHPA CEO Thomas Johnson to speak at Strategic Solutions Network's 4th Annual 'Medicaid Innovations Forum' | Feb. 5-7 | Orlando, Fla.
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid Innovations is designed to be the meeting place for all participants in the Medicaid universe who want to participate, share and learn about innovations that promote quality improvement, cost reduction and transformation in the face of reform. Use discount code MHPA when registering to receive a $200 discount off the current rate. For complete agenda and to register, click here.

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