Health care was a central issue in this year’s midterm elections. In the days after the election, many have speculated on what the results mean for U.S. health care policy. Since the Republicans maintained control of the Senate, while the Democrats took control of the House, some see the next two years as a time […]

As we noted in July, CMS declined Massachusetts’ Medicaid 1115 demonstration request to establish a closed formulary.  The proposed program would have given Massachusetts the ability to exclude certain FDA-approved drugs from coverage and thereby given the state additional leverage in negotiating rebates.  The state and drug manufacturers would have otherwise continued to be subject […]

Salt Lake City, September 27, 2018 –Today, Leavitt Partners released “Evaluating the Performance of State Individual Markets Using the Individual Market Effectiveness Index,” a white paper that provides a more evidence-based approach for evaluating the performance of each state’s individual market. Since the Affordable Care Act’s passage, health care stakeholders, politicians, and consumers have scrutinized […]

Current efforts to effectively understand the individual market are often limited because they take a national rather than state view of the individual market. The individual market’s performance can vary significantly by state and meaningfully evaluating its performance requires a state-by-state examination. We developed the individual market effectiveness index (IMEI) to provide a more nuanced […]

Andrew Croshaw provided commentary on Utah’s Medicaid expansion ballot initiative for a New York Times article entitled “Medicaid Expansion Finds Grass-Roots Support in Conservative Utah.” “Polls suggest that the ballot measure is likely to pass,” said Andrew Croshaw, the chief executive of Leavitt Partners, a health care consulting firm founded by former Gov. Michael O. […]

A Provider article entitled “Medicaid ACOs on the Rise, but Differ Greatly Amongst States” presents key findings and provides a brief overview of the four different types of Medicaid ACOs as described in the Leavitt Partners “Medicaid ACOs: Understanding Different State Approaches” white paper.

As the United States continues to move toward a value-based health care system, significant challenges slow down our progress. Political pressure exists from all sides, incentives have yet to be appropriately aligned, and the pressing need to change stakeholder behavior remains a time-sensitive imperative. Solving these challenges requires going beyond admiring the challenges to implementing […]

Medicaid accountable care organizations (ACOs) differ from state to state. To understand these differences, Leavitt Partners developed a framework that explains four approaches states take to establish ACO programs. The framework considers the level of state engagement with the ACO based on whether a Medicaid managed care organization (MCO) exists in the state and the MCO’s degree of involvement. The framework can […]