• 06.20.18

    Sharing Behavioral Health Information Amid the Opioid Crisis

    As the old model of patient care silos—where behavioral health providers treat patients separately from the rest of the healthcare system—breaks down, participants from across healthcare are attempting to access patient-specific behavioral health data to create integrated care models. ...

  • 06.20.18

    Using Skilled Nursing Facility Placement to Generate PAC Savings

    The aging population is putting intense financial and operational pressure on the healthcare system, especially for post-acute care (PAC). As health systems and providers get more involved in value-based payment (VBP) models in which they are responsible for the PAC costs of their patients, they ...

  • 06.19.18

    Medicaid Managed Care Rate Setting and Payment Innovation Study

    As of February 2018, Maryland’s Medicaid managed care program, HealthChoice, provides coverage to approximately 1.2 million people. Accessing coverage for a wide range of Medicaid services through the managed care delivery system of the HealthChoice program is mandatory for approximately 85 ...

  • 06.14.18

    NYC PHIP Small Practice Project, Final Report

    Primary care practices in New York face pressure from payers and regulators to transition to a medical home model and to participate in value-based payment (VBP) contracts. The changes require increased operating costs in a way that is particularly onerous for small primary care practices, which ...

  • 06.01.18

    Medicaid Work Requirements: Policy and Practical Considerations

    In January 2018, the Centers for Medicare & Medicaid Services (CMS) issued guidance setting forth the standards it will apply in granting state waivers conditioning Medicaid eligibility on compliance with work and community engagement requirements. Thereafter, it approved section 1115 waivers ...

  • 05.16.18

    Medicaid Buy-in: State Options, Design Considerations and 1332 Implications

    During the open enrollment period for the 2018 plan year, approximately 11.8 million people enrolled in marketplace coverage and 74 million people enrolled in Medicaid, bringing the United States’ uninsured rate to 12.2 million. States continue to identify and pursue strategies to further ...

  • 04.05.18

    Modernizing Medi-Cal Rate-Setting to Improve Health and Manage Costs

    A new report prepared for the California Health Care Foundation reviews California’s Medicaid rate-setting process and offers recommendations for adjustments to that process to encourage health plan investments in health-related benefits and services that improve care and lower costs.

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    03.26.18

    Children’s Health Insurance Program Extended Through Fiscal Year 2027

    The Children’s Health Insurance Program (CHIP) covers nearly 9 million children and is a key contributor to record-low levels of children being uninsured. However, Congress only provided funding for CHIP through FY 2017, which ended Sept. 30. After a series of short-term patches that left ...

  • 03.19.18

    Medicaid: Linchpin in State Strategies to Address Opioid Epidemic

    The nation’s opioid epidemic claimed more than 42,000 lives in 2016, and more than 2 million people in the United States have an opioid use disorder (OUD). Yet only 1 in 5 people suffering from an OUD receive treatment. The federal government has responded to the crisis by declaring a public ...

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    03.19.18

    State Reinsurance Programs: 1332 Waiver Considerations for States

    The Affordable Care Act was designed in part to help bring stability to the individual health insurance market. But faced with a fluid federal regulatory environment, many states continue to encounter challenges, including large premium increases and declining insurer participation. One solution ...

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