Noteworthy News

Archive for Medicaid

 

Study Looks at Medicaid and Managed Care

A new Commonwealth Fund study examines how managed care plans have tackled serving new members in Affordable Care Act-authorized Medicaid expansion states. According to the report, these managed care organizations have …focused on identifying and helping high-risk populations and addressing the social determinants of health. MCOs are testing value-based payment strategies that link payment with performance and are increasingly focused on engaging patients in their care. Leaders report common challenges: setting appropriate payment rates; managing members whose needs differ from traditional Medicaid beneficiaries; ensuring access to specialty care; and effectively implementing payment reform and practice transformation. Learn more about how [&hellip

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. last week to discuss a number of Medicaid and CHIP meetings.  The following is MACPAC’s summary of this meeting. MACPAC’S March 2018 meeting began with a review of two draft chapters with recommendations that will be included in MACPAC’s June 2018 report, the first to improve operation of the Medicaid drug rebate program and the second to improve the clarity of substance use disorder (SUD) confidentiality regulations. At the opening session the Commission reviewed a draft chapter on Medicaid drug policy and later voted to approve [&hellip

States Adopt New Tools to Control Rising Medicaid Drug Costs

Faced with continued increases in the cost of prescription drugs in their Medicaid programs, states are pursuing new approaches in attempts to control those rising costs. In the past states have employed approaches such as beneficiary prescription limits, negotiating supplemental rebates from manufacturers, requiring prior authorization, implementing state maximum allowable cost programs, and operating preferred drug lists. Recently, however, states are turning to a number of new mechanisms to limit the growth of Medicaid prescription drug costs, including: introducing spending growth caps for Medicaid prescription drug costs, with unplanned increases in spending triggering a closer look at overall drug spending [&hellip

Medicaid Changes: More Than Just Work Requirements Coming?

While the green light for state applications to impose work requirements on their Medicaid recipients is receiving all of the attention, the Trump administration has issued guidance that appears to pave the way for other major changes in the Medicaid program as well. Specifically, the Centers for Medicare & Medicaid Services has issued guidance that will enable states to pursue section 1115 waivers to test different ways of serving Medicaid patients that are otherwise not permitted under federal Medicaid law, including: establishing time limits on how many months or years individuals may be enrolled in Medicaid; locking out for a [&hellip

A New Wave of Medicaid Expansion?

Spurred by the Trump administration’s invitation to states to apply for approval to make work requirements a part of their Medicaid program, a number of states that spurned the opportunity created for expansion under the Affordable Care Act may consider pursuing Medicaid expansion in the near future. Currently, some elected officials in Idaho, Kansas, North Carolina, Utah, Virginia, and Wyoming appear to be considering what they once considered unthinkable:  making more of their residents eligible for Medicaid. For the most part, expansion talk is coming from moderate Republican legislators who believe a work requirement may help soften the staunch opposition [&hellip

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