Monthly Archives: January 2019

Tight budgets slow Medicaid plans’ pursuit of social determinants of health “challenges remain from inadequate funding to the lack of data sharing between medical care providers, insurers and community organizations” https://www.forbes.com/sites/brucejapsen/2019/01/22/tight-budgets-slow-medicaid-plans-pursuit-of-social-determinants-of-health/#30caa4666911

Managed LTSS drives whole person health strategies “The policy goals around these shifts are straightforward: The goal is to improve consumer health status and decrease costs with better care coordination of all types of Medicaid funding for consumers with multiple chronic conditions and disabilities” https://www.openminds.com/market-intelligence/executive-briefings/ltss-drives-whole-person-care-strategies/

SCDHHS extends public comment period for proposed Medicaid community engagement requirement (through Feb. 4) “SCDHHS intends to submit an application for a new section 1115 demonstration waiver to the Centers for Medicare & Medicaid Services (CMS) to promote South Carolina Healthy Connections Medicaid beneficiaries’ health and well-being through incentivizing community engagement” https://www.scdhhs.gov/public-notice/scdhhs-extends-public-comment-period-community-engagement-section-1115-demonstration

SCDHHS announces 2019 institutional provider application fee ($586) “(SCDHHS) will collect the applicable application fee of $586 before executing a provider agreement. This includes an initial enrollment, reactivation, revalidation or addition of a new practice location” https://www.scdhhs.gov/pro-alert/2019-provider-enrollment-application-fee

Hospital pricing transparency:  The administration is doing something right “(Trump’s) administration has ordered hospitals to reveal their prices. If patients and politicians pay attention, this could be a big deal” https://www.nytimes.com/2019/01/21/opinion/trump-hospital-prices.html

The buzz about Medicaid state block grants “the Administration will issue guidance to states to encourage them to apply for a waiver — likely through the 1115 waiver program — to cap federal Medicaid dollars and receive additional flexibility in how they run the program.  This is a concept that sounds very similar to a block grant, […]

CMS to Medicaid directors:  Use managed care to improve services for Duals “The guidance emphasized that states can leverage managed care, via existing dual eligible special needs plans (D-SNPs) and Programs of All-Inclusive Care for the Elderly (PACE), to integrate Medicare and Medicaid services” https://www.openminds.com/market-intelligence/news/cms-issues-guidance-to-help-states-better-serve-people-with-medicare-medicaid/

U.S. senator says Medicaid waste is a huge drain; income verification bill will combat that “Medicaid runs on fuel provided by the American taxpayer. Every misspent dollar is a dollar less for American families” https://www.theadvocate.com/baton_rouge/opinion/article_29523080-1b69-11e9-a5d9-cf974d5770e4.html