This week, we revisited 2015 legislation introduced by Georgia Congressman Tom Price, who was announced this week as President-elect Donald Trump’s nominee for Secretary of the U.S. Department of Health & Human Services (HHS). Representative Price’s 2015 bill, H.R. 2300, known as the “Empowering Patients First Act,” included a full repeal of the Affordable Care Act (ACA) as well as all health care provisions in the related Health Care and Education Reconciliation Act passed in 2010. A version of the Empowering Patients First Act has been introduced in Congress every year since 2009. Below, we review Representative Price’s proposed replacement plans around insurance coverage, and provide brief summaries of some of the other provisions in the legislation.
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This week, we revisited a 2011 report from the Republican Governors Public Policy Committee Health Care Task Force. The report, titled “A New Medicaid: A Flexible, Innovative and Accountable Future,” was prepared with input from governors, secretaries of health and human services, Medicaid directors, and other senior policy staff in the 31 states (including two territories) with Republican governors at the time. Across these 31 states, 20 of the governors in office at the time of the report are still in office. Only three of the 31 states (Louisiana, Pennsylvania, and Virginia) now have Democratic governors in office, although Alaska’s new governor is an Independent who expanded Medicaid this year. The report provides more than 30 recommended solutions across seven broad principles that would “increase Medicaid’s efficiency and effectiveness as a part of the overall health care delivery system regardless of whether or not [the Affordable Care Act (ACA)] is repealed.”
This week, we reviewed recent Medicaid enrollment trends in capitated, risk-based managed care in 24 states. Many state Medicaid agencies elect to post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. Nearly all 24 states have released monthly Medicaid managed care enrollment data through the third quarter (Q3) of 2016. This report reflects the most recent data posted.
Medicaid enrollment and spending growth slowed considerably in fiscal 2016 following strong gains in 2015 driven by expansion under the Affordable Care Act, according to the 16th annual Medicaid budget survey from The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU). Still, states continue to push hard to further reform the Medicaid program, initiating a wide array of efforts to coordinate care, expand access, revamp payments, improve quality, and control costs. During this webinar, executives from Health Management Associates, which works with KCMU and the National Association of Medicaid Directors each year to conduct the survey, will outline key findings from the recently-released budget survey and discuss what it all means for the future of Medicaid.
- Assess the latest trends in long-term services and supports programs, including the continued push by states to implement Managed LTSS initiatives.
- Find out how Medicaid programs are working to better understand social determinants of health and coordinate with organizations involved in housing supports, foster care, correctional health, and other programs for vulnerable populations.
- Get details about state-based Medicaid delivery system and payment reform efforts, including developments in patient-centered medical homes, accountable care, and Delivery System Reform Incentive Payment (DSRIP) programs.
- Learn why Medicaid spending and enrollment growth will continue to slow in 2017, and identify the key drivers of Medicaid spending growth.
- Assess the financing of Medicaid in 2017 and beyond, when the federal matching rate for expansion enrollees begins to decline.
Who Should Attend
Medicaid directors and staff; regulators and healthcare policy analysts; executives of Medicaid managed care plans; and executives of hospitals, health systems, health centers, and long term services and other providers serving Medicaid and other vulnerable populations.
Health plans serving the market for Managed Long-Term Services and Supports (MLTSS) have a unique opportunity to strengthen their relationships with existing and new community-based organizational partners to fill important gaps in care for elderly and disabled members. During this webinar, HMA Principal Karen Brodsky will discuss how managed care organizations can assess their MLTSS-specific partnerships to better serve members and foster a comprehensive approach to meeting the long-term needs of some of the most vulnerable and high-cost members.
- Identify and address gaps in care by building a broad array of relationships and partnerships with community-based organizations.
- Maximize outreach efforts to ensure MLTSS members take advantage of available community-based services and options.
- Train employees across your health plan – including administrative and clinical staff – to recognize opportunities where members can benefit from community-based organizations.
- Develop an infrastructure to maintain a current roster of community-based organizations and the availability of various services to MLTSS members.
Who Should Attend
Executives of Medicaid managed care plans and organizations involved in Long-Term Services and Supports (LTSS); clinical and administrative leadership of community-based organizations, health systems, behavioral health providers, FQHCs, and other provider organizations serving LTSS programs; state and local Medicaid officials.
This week, we reviewed the request for proposals (RFP) issued by the Arizona Health Care Cost Containment System (AHCCCS) on November 1, 2016, to reprocure Medicaid managed care contracts for the Arizona Long Term Care System (ALTCS) program. ALTCS is one of the oldest Medicaid managed long term services and supports (MLTSS) programs in the country, providing integrated acute care, LTSS, and behavioral health services to individuals who are elderly, individuals with physical disabilities, and individuals with intellectual or developmental disabilities (I/DD). However, this RFP only covers the roughly 26,500 individuals who are elderly or individuals with a physical disability (E/PD); this RFP does not include individuals with I/DD, who are covered through a state-run model.