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.
The National DPP Coverage Toolkit: Timely Tools for Payers Addressing Prediabetes
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.Read More >
The Opioid Epidemic and State Responses
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 […]Read More >
Maryland and Vermont: Lessons in Health Care Reform
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 […]Read More >
The Future of Medicaid
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, […]Read More >
State-Based Health Care Innovation: What Flexibility Exists Under Section 1115 and 1332 Waiver Opportunities?
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.Read More >
State Innovation Waivers, the Next Wave of Health Care Reform?
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.Read More >
Federal Flexibility Under Section 1115 Medicaid Demonstrations
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.Read More >