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.

States

Senate HELP Committee

September 13th, 2017

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.

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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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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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Maryland and Vermont: Lessons in Health Care Reform

June 5th, 2017

Introduction During the 1970s, in an effort to limit rising health care expenditures, several states adopted various forms of all-payer rate-setting models, where all payers pay the same price for services at a given facility. Over time, most state models failed and only Maryland’s all-payer hospital rate-setting system remains. Recently, there is renewed interest in […]

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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-Based Health Care Innovation: What Flexibility Exists Under Section 1115 and 1332 Waiver Opportunities?

January 31st, 2017

While a significant amount of uncertainty surrounding the content and timing of a replacement still exists, some Congressional leaders have reached out to states to explore options that would encourage innovative health care solutions at the state level.

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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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Federal Flexibility Under Section 1115 Medicaid Demonstrations

October 7th, 2015

Many states have been forcefully arguing for the Department of Health and Human Services (HHS) to grant extensive flexibility in the state administration of the Medicaid program.

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