Monthly Archives: October 2018

 

States using managed care for home- and community-based services report better delivery, better outcomes

States using managed care for home- and community-based services report better delivery, better outcomes “managing a limited number of MCOs, who in turn have contracts with HCBS providers, allows for better oversight and outcomes, and has led to service delivery improvements, compared to paying providers on a fee-for-service basis” https://www.gao.gov/assets/700/694174.pdf (page 17 of GAO report)
Posted in News

SC to get a second ACA marketplace option as Centene announces Charleston county plans for 2019

SC to get a second ACA marketplace option as Centene announces Charleston county plans for 2019 “A Columbia-based insurer will offer health plans on the state’s Obamacare open marketplace, giving some South Carolina buyers a choice for the first time since 2016.  Absolute Total Care isn’t planning to compete statewide with the much larger provider, BlueCross […]

Medicaid could save almost $5B annually through electronic claims management

State Medicaid programs are significantly lagging with the adoption of fully electronic claim submissions, claim reimbursements, prior authorizations, and other claims management processes, according to a new Council for Affordable Quality Healthcare, Inc. (CAQH) report. CAQH’s Committee on Operating Rules for Information Exchange (CORE) found that state agencies and health plans covering just 44 percent of […]
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Despite a judge’s disapproval, Trump administration is doubling down on Medicaid restrictions

In the real world, it has become clear that placing restrictions such as work and reporting requirements on Medicaid is disastrous. They’re legally dubious, for one thing — as a federal judge stated in late June when he tossed out work requirements imposed in Kentucky. More important, they lead to needy beneficiaries being thrown off the program […]
Posted in Uncategorized