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    Medicaid at 50: The Program’s Evolution and Future

    Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs to the nation’s largest health insurer. The occasion of Medicaid’s 50th birthday is a fitting time to consider that evolution, not to reminisce, but to help chart the ...

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    In or Out: An Examination of Medicaid's Coverage Determination Policies

    Medicaid, the joint federal and state program that provides health insurance for low-income individuals, is rapidly becoming the largest purchaser of healthcare services in the United States. Given Medicaid's size and scope, and the central role it plays in the health insurance market, ...

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    A Look at the Private Option in Arkansas

    In September 2013, Arkansas became the first state in the nation to receive approval from the federal government for a Section 1115 demonstration waiver to require most adults who are newly eligible for coverage through the Affordable Care Act’s Medicaid expansion to enroll in Marketplace ...

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    Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Heal

    “Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace” is based on in-depth interviews with national consumer assistance experts and navigators in California, Colorado, Florida and Illinois during an open ...

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    Biosimilars Coding & Reimbursement Significance Under Medicare Part B

    On April 15, 2015, The Centers for Medicare and Medicaid Services (CMS) issued a preliminary recommendation for a Healthcare Common Procedure Coding Systems (HCPCS) code for Zarxio, the first biosimilar product ever to be approved by the Food and Drug Administration (FDA). CMS’s ...

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    The Impact of Medicaid Expansion on Uncompensated Care Costs: Early Results and Policy Implications

    Since the implementation of the Affordable Care Act (ACA), more than 10 million people in 30 states (including the District of Columbia) that expanded Medicaid have gained Medicaid or CHIP coverage, and the collective rate of uninsured individuals in expansion states has fallen from 18 percent to ...

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    Coverage Options for Massachusetts: Leveraging the Affordable Care Act

    Massachusetts led the nation in expanding healthcare coverage and reforming its payment and delivery models, with considerable success. The Affordable Care Act (ACA) provided Massachusetts with new tools and new funding, while imposing new requirements. Now, almost 10 years after the passage of ...

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    Building a Culture of Health: The Value Proposition of Retail Clinics

    Retail clinics offer convenient, low-cost basic primary care treatment, screening and diagnostic services in a variety of settings. Increasingly, these clinics are an integral part of a U.S. healthcare system in the throes of massive change as payers and providers migrate toward Triple Aim goals ...

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    Passage of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): The “Doc Fix”

    The President has signed into law bipartisan bill H.R. 2, the “Medicare Access and CHIP Reauthorization Act of 2015,” which permanently repeals the flawed Sustained Growth Rate (SGR) formula and replaces it with a stable Medicare payment system that rewards physicians for providing ...

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    Innovation Waivers: An Opportunity for States to Pursue Their Own Brand of Health Reform

    States have long been the testing ground for new models of healthcare and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by authorizing states to rethink the law’s coverage designs. Under State Innovation ...



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