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State highlights: Insurer drop-out to affect 22,000 on N.Y. Medicaid managed care; Texas slow to recover misspent Medicaid funds

Excellus BlueCross BlueShield says it's dropping out of public health insurance programs for the poor and disabled. The insurer has notified doctors and other providers it's withdrawing from the Medicaid managed care and Family Health Plus programs because it expects to lose about $100 million on those programs this year. The move will affect more than 22,000 central New Yorkers (10/15).

16 Oct 2013

Medicare open-enrollment begins: Seniors should carefully consider new options

Officials are cautioning seniors to stay away from the health law's new online marketplaces -- as open-enrollment season begins for Medicare managed care and prescription plans.

16 Oct 2013

First Edition: October 15, 2013

Today's headlines include reports about how the budget deal taking shape in the Senate would not derail the health law, but would include some tweaks.

15 Oct 2013

Measles-containing vaccines administered at 12-5 months of age associated with reduced risk of fever, seizures

Children receiving measles-containing vaccines at 12-15 months of age have a lower increased risk of fever and seizures than those who receive them at 16-23 months of age, according to a new Kaiser Permanente study published in JAMA Pediatrics.

15 Oct 2013

Medicare open enrollment starts Tuesday

Beneficiaries are encouraged to take a close look at their options during their upcoming enrollment period, which is separate from the sign-up in the health law's marketplaces.

15 Oct 2013

Study finds empirical evidence of external market factors that may facilitate or inhibit ACO formation

Accountable care organizations are rapidly being formed with the implementation of the Affordable Care Act, and they are being established in areas where it may be easier to meet quality and cost targets, researchers at The Dartmouth Institute for Health Policy & Clinical Practice said in a study published in the journal Health Services Research.

13 Oct 2013

State highlights: Calif. gov. signs bill allowing some non-physicians to perform early abortions; audit questions facts around N.C. Medicaid managed care

Giving California women more access to abortion, Gov. Jerry Brown signed a bill Wednesday that allows nurse practitioners and certain other non-physicians to perform the procedure during the first trimester of pregnancy.

11 Oct 2013

EOHHS selects BMCHP to provide health care coverage for MassHealth CarePlus members

The Massachusetts Executive Office of Health and Human Services has selected Boston Medical Center HealthNet Plan to provide comprehensive health care coverage for MassHealth CarePlus members in all five MassHealth regions of Massachusetts.

10 Oct 2013

New agreement gives Health Net's members access to 14 of Prime Healthcare's hospitals

Prime Healthcare Services is pleased to announce that it has contracted with Health Net of California for 14 of its hospitals.

10 Oct 2013

State highlights: Abortion coverage fight at a Catholic University In Calif.; N.C.'S Medicaid managed care plan attacts companies; some Calif. exchange rates uncertain

Trustees of the Jesuit [Loyola Marymount University] will decide on Monday whether to remove coverage for elective abortions from the faculty and staff health care plans. The coming vote has exposed a deep rift over just how Catholic a Catholic university should be in the 21st century -- and how to maintain that distinctive Catholic identity amid growing diversity on campus (Lovett, 10/6).

8 Oct 2013

Research roundup: Health law's effects on consumer spending; Mass. experience finds increased use of laparoscopic surgery

The authors find that average out-of-pocket spending is expected to decrease for all groups considered in the analysis, although decreases in out-of-pocket spending will be largest for those who would otherwise be uninsured.

5 Oct 2013

Shutdown to stop payments to D.C. Medicaid providers

The District of Columbia's payments to medical providers treating more than 200,000 poor people enrolled in Medicaid will stop until the federal shutdown ends, city officials said. In Virginia, GOP gubernatorial candidate Ken Cuccinelli called on Congress to reopen the federal government -- and then cut off funding for the health law.

5 Oct 2013

First Edition: October 4, 2013

Today's headlines include continued status reports on state and federal health exchanges as well as the ongoing Capitol Hill budget drama.

4 Oct 2013

Research roundup: Managed care for dementia patients; bundled payments after the hospital; disparities among Medicare beneficiaries

Dementia is a leading cause of death in the United States; however, patients dying with this disease may not receive optimal end-of-life care. ... many of these [nursing home] residents commonly experience burdensome and costly interventions, such as hospital transfers, tube-feeding, and intravenous antibiotics. ... Nursing home reimbursement policies are among the factors that incentivize more aggressive care. ... This study linked unique prospective clinical data with Medicare claims to describe and compare patterns of care between nursing home residents with advanced dementia enrolled in a Medicare managed-care insurance plan and those with fee-for-service Medicare.

30 Sep 2013

State highlights: N.M. officials seek less Medicaid money next year

The agency managing New Mexico's largest health care program is asking for less -- not more -- state money to operate in the upcoming budget year. It's the first time in more than a decade the Human Services Department isn't seeking an increase in state aid for Medicaid, which provides health care for a fourth of New Mexico's population (Massey, 9/24).

26 Sep 2013

Michigan's Medicaid expansion could act as model for bipartisan health care reform in other states

Michigan's newly expanded Medicaid program could act as a model for other states to achieve bipartisan health care reform even in a heated national political climate, says the head of the University of Michigan's health policy institute in an article published online today by the New England Journal of Medicine.

26 Sep 2013

State highlights: N.C. Medicaid director resigns, heads to private sector; Ohio readies funding for new Medicaid computer system

Carol Steckel, the state's Medicaid director, is leaving after eight months on the job. Her departure is the latest in a string of high-profile departures from the Department of Health and Human Services, which has been plagued of late by personnel issues (Hoban, 9/23).

25 Sep 2013

AHCA intents to award contract for MMA program to Centene's Florida subsidiary

Centene Corporation announced today that the Florida Agency for Health Care Administration posted its notice of intent to award a contract for the Managed Medical Assistance program to Centene's Florida subsidiary Sunshine State Health Plan.

24 Sep 2013

Primary care services may result in less costly care for residents with advanced dementia: Study

Nursing home residents with advanced dementia commonly experience burdensome, costly interventions that do not improve their quality of life or extend their survival. Now a new study suggests that providing intensive primary care services may result in less burdensome and less costly care for these terminally ill residents.

24 Sep 2013

Inovalon, Walgreens sign agreement to bring innovative solutions to healthcare marketplace

Inovalon, Inc., a leading provider of data-driven healthcare solutions, and Walgreens, the nation's largest drugstore chain, today announced that they have entered into a multi-year agreement to provide Inovalon's data-driven encounter support platform, Electronic Patient Assessment Solution Suite within Healthcare Clinic at select Walgreens to support improvements in managed care quality and performance.

19 Sep 2013

Managed Care News and Research

State highlights: Insurer drop-out to affect 22,000 on N.Y. Medicaid managed care; Texas slow to recover misspent Medicaid funds

Medicare open-enrollment begins: Seniors should carefully consider new options

First Edition: October 15, 2013

Measles-containing vaccines administered at 12-5 months of age associated with reduced risk of fever, seizures

Medicare open enrollment starts Tuesday

Study finds empirical evidence of external market factors that may facilitate or inhibit ACO formation

State highlights: Calif. gov. signs bill allowing some non-physicians to perform early abortions; audit questions facts around N.C. Medicaid managed care

EOHHS selects BMCHP to provide health care coverage for MassHealth CarePlus members

New agreement gives Health Net's members access to 14 of Prime Healthcare's hospitals

State highlights: Abortion coverage fight at a Catholic University In Calif.; N.C.'S Medicaid managed care plan attacts companies; some Calif. exchange rates uncertain

Research roundup: Health law's effects on consumer spending; Mass. experience finds increased use of laparoscopic surgery

Shutdown to stop payments to D.C. Medicaid providers

First Edition: October 4, 2013

Research roundup: Managed care for dementia patients; bundled payments after the hospital; disparities among Medicare beneficiaries

State highlights: N.M. officials seek less Medicaid money next year

Michigan's Medicaid expansion could act as model for bipartisan health care reform in other states

State highlights: N.C. Medicaid director resigns, heads to private sector; Ohio readies funding for new Medicaid computer system

AHCA intents to award contract for MMA program to Centene's Florida subsidiary

Primary care services may result in less costly care for residents with advanced dementia: Study

Inovalon, Walgreens sign agreement to bring innovative solutions to healthcare marketplace

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