Editor’s note: Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs into the nation’s largest health insurer. Medicaid’s 50th birthday is a fitting time to...more
10/27/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Eligibility ,
Enrollment ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance ,
Healthcare ,
Healthcare Costs ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Tax Credits ,
Value-Based Purchasing ,
Waivers
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...more
9/30/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Enrollment ,
Health Insurance ,
Information Technology ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Waivers
Overview -
On August 18, 2015, Arizona released the Modernizing Arizona Medicaid proposal for a new 1115 waiver to implement coverage and delivery system reforms in its Medicaid program, the Arizona Health Care Cost...more
9/21/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Cost-Sharing ,
Health Savings Accounts ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
New Legislation ,
Premiums ,
State Medicaid Programs ,
Waivers
Examining Fee Splitting Statutes in the Context of Value-Based Healthcare -
Editor’s note: One of the goals of the Affordable Care Act (ACA) is to align incentives among provider communities and their patients and...more
6/23/2015
/ Affordable Care Act ,
Cardinal Health ,
Federal Trade Commission (FTC) ,
Fee-Splitting ,
Hospital Mergers ,
Hospitals ,
Licensing Boards ,
Medicare Shared Savings Program ,
Mergers ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
Radiopharmaceuticals ,
SCOTUS ,
Value-Based Fees
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,...more
Building a Culture of Health: The Value Proposition of Retail Clinics -
Editor’s Note: Since first emerging on the healthcare landscape more than 15 years ago, retail clinics have seen significant growth. There are now...more
On April 29, 2015, Montana Governor Steve Bullock signed Senate Bill 405, referred to as the Montana Health and Economic Livelihood Partnership Act (HELP Act), which expands Medicaid to cover an estimated 70,000 new adults....more
This brief examines the budget implications of expanding MaineCare (Maine’s Medicaid program) and finds that the state savings coupled with the new revenues are sufficient to offset state costs attributable to expansion in...more
Arkansas broke new ground with its Marketplace Premium Assistance Medicaid expansion (widely referred to as the “Private Option”) last year, spurring additional states to consider the model. Under Marketplace Premium...more
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. health care system in the throes...more
Abstract -
States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by...more
In a report prepared for the State Health Reform Assistance Network, Manatt highlights key ways in which eight states—Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington and West Virginia—were able to...more
The Affordable Care Act provides states with a powerful incentive to expand Medicaid to adults with incomes up to 133% of the Federal Poverty Level, paying for 100% of Medicaid coverage through 2016, and eventually phasing to...more
Supporting Informed Decision Making in the Health Insurance Marketplace: A Progress Report -
Editor’s note: As Affordable Care Act (ACA) implementation moves forward and the marketplace continues to evolve, there is a...more
Editor’s Note: On Wednesday, March 4, the Supreme Court heard oral arguments in King v. Burwell, a case that will determine whether the Affordable Care Act (ACA) permits individuals who buy individual health insurance...more
Managed care is the dominant delivery model in state Medicaid programs, and is rapidly growing with the Affordable Care Act bringing over 8 million new beneficiaries into Medicaid in 2014. Today, 39 states (including the...more
Medicaid is the single largest payer for healthcare services in every state. With nearly 10 million people enrolling in 2014 alone, total enrollment nationally tops 68 million, or one in five Americans....more
2/3/2015
On January 27, 2015, the Centers for Medicare and Medicaid Services (CMS) approved Indiana’s waiver request under Section 1115 of the Social Security Act to implement its Medicaid expansion. Referred to as the Healthy Indiana...more
In a highly anticipated speech on January 22, 2015, the newly inaugurated Governor of Arkansas, Asa Hutchinson, laid out his vision for charting the future of Medicaid in Arkansas. Governor Hutchinson outlined a plan that...more
On January 8, 2015, Tennessee released a proposal to expand its Medicaid program through an amendment to its current TennCare II waiver under Section 1115 of the Social Security Act. Tennessee’s two-year proposal, called...more
By the end of 2014, 27 states and the District of Columbia had expanded Medicaid eligibility to adults with incomes up to 133% of the Federal Poverty Level (FPL). And, governors in Indiana, Montana, Tennessee, Utah and...more
Medicaid’s role in purchasing and delivering substance abuse services is changing dramatically. Prior to the implementation of the Affordable Care Act (ACA), most state Medicaid programs did not cover childless adults and...more
Medicaid plays a central role in financing mental health and substance use disorder (SUD) services, accounting for 26 percent of all spending on behavioral health services in this country. Medicaid beneficiaries with...more
Increasingly, states are moving beyond their traditional Medicaid programs to embrace new roles as leaders of statewide payment and delivery system transformation. The search for statewide solutions is fueled by cost...more
On August 28, 2014, the Centers for Medicare and Medicaid Services (CMS) approved Pennsylvania’s application under Section 1115 of the Social Security Act to implement a Medicaid expansion effective January 1, 2015, through a...more