Newsletters

05.17.18

State Action on Market Stabilization

During the open enrollment period for the 2018 plan year, approximately 11.8 million people enrolled in Marketplace coverage and 74 million people enrolled in Medicaid, leading to an uninsured rate in the U.S. of 12.2 percent.


05.02.18

Leveraging Medicaid Managed Care to Advance Value-Based Payment

As healthcare costs continue to rise and stakeholders maintain focus on improving quality of care and outcomes, payors for healthcare services are turning to value-based payment (VBP) as one tool to inject greater value into the delivery of care.


03.28.18

Medicaid’s Critical Role in Addressing the Opioid Crisis

As the opioid crisis in the United States continues to deepen—with opioid overdoses claiming 42,000 lives in 20161—policymakers, providers, advocates and other stakeholders are seeking out all available resources in an attempt to fight back.


02.27.18

Efforts to Cut Drug Prices in Medicaid

Over the past five years, the budgets of state Medicaid programs have been challenged by the introduction of new high-cost drugs into the marketplace.


01.25.18

The Eight Key Elements of Effective Compliance Programs

Mandated compliance programs are not a new concept, but they have evolved over time.


01.10.18

What’s Ahead in 2018

Congress returned from recess with a large agenda for the new year.


12.12.17

North Carolina: Amended 1115 Waiver Application

On November 20, 2017, North Carolina submitted an amended 1115 waiver application to the Centers for Medicare & Medicaid Services (CMS) seeking authority to invest $1.2 billion over five years in a range of targeted initiatives that, taken together with a transition from fee-for-service to ...


11.28.17

CMS Administrator Highlights Medicaid Policy Goals and New Guidance

Since assuming office last January, the Trump administration has signaled a shift in Medicaid policy.


11.14.17

2018 Updates to the MACRA Quality Payment Program

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule with Comment updating the Quality Payment Program (QPP) under the Medicare and CHIP Reauthorization Act of 2015 (MACRA).


11.14.17

2019 Notice of Benefit and Payment Parameters

On October 27, 2017, the Department of Health and Human Services (HHS) released its annual proposed Notice of Benefit and Payment Parameters, containing proposed changes to the regulation of the individual and small group health insurance markets for 2019 and beyond (and in some cases, sooner).