Second Half Kickoff: The Outlook for Medicaid – 2018

Thomas Johnson

This has shaped up to be an extremely active year for Medicaid. From fighting off proposals to cutting funding from the program, to the Trump Administration’s efforts to change Medicaid administratively as we know it, to active state legislatures and, in a couple of cases, citizen referendums, to changing their states approach to Medicaid, this is arguably the most active time since the fallout of the NFIB vs. Sebelius case, which decided the federal government could not mandate state participation in Medicaid expansion.

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Is Your Organization on Track to Achieve a 4-Star Rating?

Melissa Smith

As the Healthcare Effectiveness Data and Information Set (HEDIS®) and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) …

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Azar Testified on Drug Pricing. Industry Yawns.

John Gorman

Health and Human Services (HHS) Secretary Alex Azar  was in front of the US Senate Health Committee for a …

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CMS’ Venture Into the Direct Contracting Model

David Sayen

In business school, they taught me that humans are naturally risk averse. Makes sense from an evolutionary perspective. …

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Three Costs of Marketing Material Errors

Regan Pennypacker

Now that bids have been submitted and the Centers for Medicare & Medicaid Services (CMS) is in the …

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CMS Releases a Policy Statement of Pharmacy Network Gag Clauses

Wayne Miller

A bipartisan group of U.S. senators introduced legislation on Wednesday, March 14, that would prohibit pharmacy benefit managers …

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Insights for a Smooth RADV Season

Jessica Smith

Risk adjustment audit season is upon us. Some health plans are already in the thick of retrieving charts …

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