Our Latest Thinking

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

Centers for Medicare and Medicaid Services (CMS)

Value-Based Payment in Medicaid: Signals for States

February 20th, 2018

During the first year of the Trump administration, states have grappled with many unanswered questions regarding the new administration’s views on value-based payments (VBPs) and how it would approach state-led or Medicaid based payment reform initiatives.

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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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Pace of 2018 Open Enrollment is Above Previous Years, But Is It Enough to Close the Gap?

December 11th, 2017

The latest information from the Centers for Medicare & Medicaid Services (CMS)[1] on the number of plan selections for the current Open Enrollment Period (EOP) has been a positive sign for stakeholders that are hoping for a large and stable enrollment cycle. While the number of plan selections has been higher than in the previous […]

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Medicare Alternative Payment Models: Not Every Provider Has a Path Forward

September 11th, 2017

The Centers for Medicare and Medicaid Services (CMS) has shown significant support for the development of Alternative Payment Models (APMs).

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Why Patients Readmit: Using a Readmission Curve to Identify Patients at Risk for Hospital Readmission Following Hip and Knee Replacement Surgery

August 24th, 2017

The Comprehensive Care for Joint Replacement (CJR) bundled payment model is a Centers for Medicare and Medicaid Services (CMS) initiative that is designed to incent hospitals to reduce the widespread cost variation in hip and knee replacements, and post-operative hospital readmissions throughout the United States.

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The Opioid Epidemic and State Responses

August 17th, 2017

According to the National Institute on Drug Abuse and the CDC, in 2015 over 33,000 people died from opioid overdose in the United States, and in 2013 prescription opioid abuse cost the U.S. economy approximately $78.5 billion in costs related to health care, crime, and loss of productivity. Opioid abuse and the related overdose deaths […]

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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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