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We are constantly scanning the health care market for new and interesting developments; then we write about them here. Check out our latest thinking.

Medicaid

Leavitt Partners Releases White Paper on “Value-Based Payment in Medicaid: Signals for States”

February 20th, 2018

Salt Lake City, February 20, 2018 –Today, Leavitt Partners released “Value-Based Payment in Medicaid: Signals for States,” a white paper that outlines the Trump administration’s key signals to date and how they might impact state value-based payment (VBP) efforts in 2018 and beyond.

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The National DPP Coverage Toolkit: Timely Tools for Payers Addressing Prediabetes

August 30th, 2017

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.

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Adding Complexity to an Already Complex Process

August 15th, 2017

Given the well-publicized challenges with the individual market, carriers’ product development and pricing process for 2018 has been particularly difficult. In an effort to give insurers some reprieve, last week the Centers for Medicare and Medicaid Services extended the deadline for issuers to make changes to their rate filings from August 16 to September 5.[1]  However, […]

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The Medicare-Medicaid ACO Model: Addressing Dual Eligibles’ Costs

July 17th, 2017

Dual eligibles, individuals enrolled in both Medicare and Medicaid, are among the highest-need, highest cost patients in the United States. Although it is difficult to determine the exact number of dual eligibles, a 2012 Kaiser Family Foundation report estimates that dual eligibles comprise 21 percent of the Medicare population and 15 percent of the Medicaid […]

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The MACRA All-Payer Advanced APM Pathway: System-Wide Implications

May 3rd, 2017

Background The Quality Payment Program (QPP) under MACRA is now more than three months underway into the first payment year. However, there are still many nuances of the program, specifically under the multi-payer Advanced APM option, that payers —including commercial, Medicare Advantage, and Medicaid — and clinicians need to understand before they can begin collaborating, […]

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The Future of Medicaid

May 1st, 2017

The Affordable Care Act turned Medicaid into America’s largest public health care coverage program. While the volume associated with this growing program created increasing opportunities for providers, health systems, health plans, and vendors, these same stakeholders shouldn’t write off opportunities in Medicaid now simply because of the change in direction at the federal level. Instead, […]

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State Innovation Waivers, the Next Wave of Health Care Reform?

November 17th, 2016

One potential ACA replacement strategy could include punting health care reform to the states. The incoming administration could accomplish this is by significantly relaxing the 1332 innovation waiver requirements.

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CMS Proposes New Mandatory Bundled Payment Models: 4 Observations

July 29th, 2016

On July 25, 2016, CMS announced a proposed rule to provide additional incentives for hospitals to provide higher quality care at a lower cost. The proposed rule seeks to increase coordination of care and decrease costs for heart attack and bypass surgery patients, creates a new Surgical Hip/Femur Fracture Treatment model (SHFFT), and outlines a […]

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