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On Tuesday, September 12 Governor Mike Leavitt testified before the Senate HELP Committee. During his testimony, he suggested creating a series of model waivers that states could choose from to help speed up the process. “By doing so, the federal government creates national standards but allows states to develop state solutions,” said Leavitt. He further explained, “There could be a set of standard waivers related to risk stabilization programs, redefining marketplace products or benefits, or alternative private exchange portals. This fosters collaboration and investment in the waiver process—as well as to expedite the application process.” Governor Leavitt said that he and Committee Chairman Lamar Alexander discussed the idea before the hearing. “What we’re suggesting here is rather than try to lay out 11 different categories, where everyone is exactly the same, the states have the flexibility to have actuaries determine if their benefit package is of equal value to those essential benefits,” Leavitt said. (Axios article entitled “Senate health care talks focus on state innovation waivers”; USA Today article entitled, “Sen. Lamar Alexander says patient protections will remain intact under short-term Obamacare fix”; The Washington Free Beacon article entitled “Insurers Say States Need More Flexibility to Stabilize Obamacare Marketplace”).
• HFMA article entitled “Increasing Physician Frustration with Lack of Models” references the Leavitt Partners “Medicare Alternative Payment Models: Not Every Provider Has a Path Forward” white paper and includes commentary from David Muhlestein. “It surprised me how some physicians have a number of options and others really don’t have options,” David said. “We know from those (models) that have been proposed that they are almost always specialty-focused because there is this recognition that there are so many specialists out there that are going to be subject to MACRA but there is not an APM option; they are stuck in MIPS for the time being,” Muhlestein said in an interview. The white paper was also highlighted in Rama Juturu – Healthcare Insights.
The Centers for Medicare and Medicaid Services (CMS) has shown significant support for the development of Alternative Payment Models (APMs). CMS’ development and testing of 45 payment models has led to the adoption of similar models by other payers. Initial reports indicate that APMs could be key to producing the health care delivery reform necessary to decrease health care costs and increase delivery quality. However, these models are only available to select provider types, and some providers, such as emergency physicians and audiologists, have no Medicare APMs in which they can participate. To realize the full benefits of APMs, additional collaboration between CMS leadership and providers is needed to develop new models for providers who do not currently have access to them.
Salt Lake City, September 11, 2017 – Alternative Payment Models (APMs) have gained bipartisan support as a medium to produce the health care delivery transformations necessary to decrease health care costs and increase the quality of care. Today, Leavitt Partners released a new white paper, “Medicare Alternative Payment Models: Not Every Provider Has a Path […]
More than 86 million American adults have prediabetes. That number alone is astounding, but perhaps what is even more concerning is that 9 out of 10 people with prediabetes don’t know they have it. Considering that, in the absence of any health intervention, 15‒30 percent of people with prediabetes will develop type 2 diabetes within five years, effective preventive measures are needed to mitigate a serious public health crisis. The Centers for Disease Control and Prevention (CDC) is proactively responding to this potential problem by developing and promoting the National Diabetes Prevention Program (National DPP) lifestyle change program.
An Arkansas Times article entitled “DHS announces ‘one-stop-shop’ for Medicaid providers” notes that Leavitt Partners helped to design a new division, called the Division of Provider Services and Quality Assurance, that will certify, license, monitor, and inspect all Medicaid providers for all of the DHS.
A Governing article entitled “The Best and Worst States for Medicaid Managed Care, According to Patients” and a Pharmacy Choice article referenced Leavitt Partners’ KanCare report. The article states, “But a report published last November by the Leavitt Partners consulting firm determined that KanCare had delivered on the cost savings, but not the quality metrics.” (Governing article here, Pharmacy Choice article here)
A Managed Care article entitled “ACOs Sit Like Gibraltar In Rough Seas of Change” references the Leavitt Partners “Growth Of ACOs And Alternative Payment Models In 2017″ Health Affairs Blog. The article states that “as of the first quarter of 2017 there are 923 active public and private ACOs that cover more than 32 million lives, or roughly 10% of the country’s population” and includes two of tracking charts. David Muhlestein also provided his insights regarding CMS’ announcement that the CJR program has been delayed and made nonmandatory.
The Leavitt Partners “Why patients readmit: Using a readmission curve to identify patients at risk for hospital readmissions following hip and knee replacement surgery” white paper was highlighted in a Provider magazine article entitled “New Joint Replacement Study Shines Light on Readmissions, PAC Opportunities.” Nathan Smith also provided commentary for the article. “Given that full risk [in the CJR program] doesn’t begin until Jan. 1, 2018, the providers in the 34 mandatory markets won’t notice any change from what was already coming, which is additional scrutiny from hospitals for patients being treated for hip and/or knee replacements,” Nathan said.
Governor Leavitt commented on the ACA repeal votes of Senators Collins, McCain, and Murkowski for a Modern Healthcare article entitled “Collins, McCain and Murkowski are Modern Healthcare’s most influential people in healthcare.” Governor Leavitt called the decision by the three GOP senators to block the repeal bill “highly significant” because it may nudge the Senate toward bipartisan action on a scaled-down healthcare bill.