• 03.06.20

    Evolving Physician-Practice Ownership Models

    Physician practice acquisitions and/or equity investment by nontraditional players, such as health plans, private equity investors, venture capitalists and large employers, is a growing trend. These new entrants give physicians additional options for where and how to work.

  • 03.06.20

    The Fiscal Impact of the Trump Administration’s Medicaid Block Grant Initiative

    The Trump administration recently invited states to apply for the new Healthy Adult Opportunity Medicaid demonstration initiative, which lets states opt in to a block grant funding model for a portion of their Medicaid enrollees in exchange for fewer federal rules. By capping federal funding, the ...

  • 02.20.20

    Paying for Value in Behavioral Health

    In recent years, state Medicaid programs and the U.S. healthcare system as a whole have shifted from traditional fee-for-service payment methodologies toward value-based purchasing (VBP) models. To date, most VBP efforts have focused on physical health. Given the significant share of Medicaid ...

  • 02.06.20

    Bipartisan Rx for America’s Health Care: A Practical Path to Reform

    Tom Daschle, Co-Chair, Former Senate Majority Leader, Co-Founder, BPC Andy Slavitt, Co-Chair, Senior Advisor, BPC, Former Acting Administrator, Centers for Medicare & Medicaid Services (CMS) Sheila Burke, Fellow, BPC, Strategic Advisor, Baker ...

  • 02.04.20

    CMS Guidance Authorizes Medicaid Demonstration Applications That Cap Federal Funding: Implications f

    On January 30, the Department of Health and Human Services (HHS) released long-anticipated guidance that invites states to pursue capped funding demonstrations for the Affordable Care Act Medicaid expansion population as well as optional, non-elderly, non-disabled adults. States that pursue such ...

  • 01.31.20

    Strategies to Expand Transparency, Enhance Competition and Control Costs: A Toolkit for Insurance Re

    State insurance regulators play many roles in making health insurance more available and affordable to consumers. Two that stand out are enhancing transparency and promoting competition. Every state department of insurance (DOI) has a consumer complaint hotline and provides information to help ...

  • 01.30.20

    Medicare Part D Redesign With Out-of-Pocket Caps

    During the Medicare Payment Advisory Commission’s (MedPAC’s) January 16 public session, MedPAC staff continued their drumbeat for reforming the Part D benefit following recommendations previously made in their June 2016 Report to Congress. Continuing themes include eliminating the ...

  • 12.05.19

    Implementing a Statewide Healthcare Cost Benchmark

    State interest in healthcare cost containment has grown dramatically since Massachusetts enacted the nation’s first cost benchmarking program in 2012. At that time, most states were focused on coverage expansion through the Affordable Care Act. More recently, however, coverage gains have ...

  • 11.12.19

    Using Medicaid to Advance Evidence-Based Treatment of Substance Use Disorders

    In 2019, the number of drug overdose deaths in the United States declined, suggesting that the efforts of state and local governments, providers and other stakeholders to stem the crisis of drug-related deaths are beginning to have some effect. But there is much more work to do: Over 70,000 ...

  • 11.12.19

    Expanding Payer and Provider Participation in Data Exchange

    States have struggled for decades to establish infrastructure that allows for the efficient and secure sharing of health information, despite it being associated with improved quality and reduced duplicative services and associated costs. California has made some progress, including the growth of ...

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