Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Medicaid Spending

HHS Looks to Medicaid Demonstrations to Improve Mental Health

November 15, 2018 - Medicaid beneficiaries with mental health conditions are the targets of recent CMS efforts to boost health outcomes. In recent remarks to the National Association of Medicaid Directors in the national capital, HHS Secretary Alex Azar said “successful partnership between our leadership at HHS and the leaders of every state Medicaid program is vital to delivering on the mission of...


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CMS Demonstrations Target Mental Health Services Under Medicaid

by Chuck Green

Medicaid beneficiaries with serious mental illness (SMI) or serious emotional disturbance (SED) are the targets of recent CMS efforts to improve health outcomes. In a letter to Medicaid directors across the country, the federal agency...

Rhode Island Aims to Expand Value-Based Care in Medicaid Program

by Thomas Beaton

Rhode Island officials have requested an extension of a 1115 demonstration from CMS to expand the use of value-based care within the state’s Medicaid program. State Medicaid administrators are looking to add new value-based care...

Medicare, Medicaid Home Health Benefits Stabilize Care Costs

by Thomas Beaton

Providing extended home health benefits for Medicare beneficiaries is likely to stabilize care costs for public payer programs, according to a new analysis from the Commonwealth Fund. Researchers from the Hilltop Institute and Johns...

CMS to Develop New Medicaid Program Integrity Initiatives

by Thomas Beaton

CMS has announced a new set of Medicaid program integrity initiatives that leverage enhanced data sharing, claims auditing, and provider education to reduce the incidence of improper payments and help secure program finances. In 2016,...

CMS Offers Opioid Coverage, Health IT Guidance for Medicaid Plans

by Thomas Beaton

CMS has issued new opioid coverage strategies and health IT guidance to help states improve opioid safety within Medicaid plans. The guidelines include advice for state programs about treating infants with neonatal abstinence syndrome...

AR Medicaid Demonstration Adds 9-Month Re-Enrollment Block

by Thomas Beaton

Arkansas received approval from CMS for a 1115 Medicaid demonstration that adds work requirements for Medicaid eligibility and adds a nine-month block on member re-enrollment if individuals don’t find work. Arkansas’...

MI Requests Renewal of “Healthy Behaviors” 1115 Medicaid Waiver

by Thomas Beaton

Michigan is asking CMS for a renewal of its 1115 Medicaid waiver demonstration that increased the number of insured individuals in the state and led to a reduction in unhealthy behaviors. The demonstration, entitled the “Healthy...

2016 Healthcare Spending Growth Slowed, Totaled $3.3 Trillion

by Thomas Beaton

US healthcare spending totaled $3.3 trillion in 2016, representing a 4.3 increase in the spending growth rate since 2015. While spending continued to rise, the rate of increase was actually slower than the 5.8 percent growth rate...

Arkansas Slips Up on Supplemental Medicaid Payments

by Thomas Beaton

A lack of administrative oversight led Arkansas to miss supplemental Medicaid payments, make several payments to Medicaid-ineligible providers, and receive excess Medicaid dollars, found a report from the Office of the Inspector General...

Texas Requests Medicaid Waiver Extension for $6.2 Billion

by Jesse Migneault

Although Texas refused federal funds in the 2014 ACA Medicaid expansion, it has recently submitted documents requesting its second Medicaid waiver extension for $6.2 billion.   Originally approved in 2011, the 1115 Medicaid...

Healthcare Spending Growing at Slower Than Expected Rate

by Jesse Migneault

Expenditures on healthcare grew at a historically low rate between 2009 and 2013, according to a recent report, defying the conventional wisdom that healthcare spending has skyrocketed.  A Robert Wood Johnson Foundation report looked...

Flexibility and Innovation Needed To Control Medicaid Costs

by Jesse Migneault

As state and federal regulators debate the future of Medicaid spending, health researchers have identified the need for flexibility and innovation in Medicaid policies involving payment models, delivery of care and drug costs. The...

Maine Medicaid Waiver Would Increase Patient Responsibility

by Jesse Migneault

Maine will apply for a Section 1115 Medicaid waiver from the Centers for Medicare and Medicaid Services (CMS) to be granted flexibility to circumvent federal regulations and impose reforms on its Medicaid program. The state’s...

Proposed MA State Budget Targets Medicaid Program Funding

by Thomas Beaton

The Massachusetts House of Ways and Means Committee approved a state budget for fiscal year (FY) 2018 that funds MassHealth, the state’s Medicaid program, through new tax revenues. The committee budget follows the one proposed by...

Price, Verma Push for Better State Control of Medicaid Programs

by Jacqueline LaPointe

As one of her first actions as CMS Administrator, Seema Verma collaborated with the Department of Health and Human Services (HHS) Secretary Tom Price to detail how the federal government plans to improve its state partnerships to enhance...

Org Offers 25-Point Plan for NJ Medicaid Program Improvement

by Jacqueline LaPointe

The New Jersey Health Care Quality Institute (NJHCQUI) recently partnered with the Nicholson Foundation to release a 25-point plan for modernizing and improving New Jersey’s Medicaid program. “The current program has too often...

Children’s Health Insurance Program Enrollment Expands in Flint

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) announced earlier this month in a press release that it will be awarding $300,000 to the Greater Flint Health Coalition (GFHC) so that more children in Flint, Michigan will be...

Supreme Court Ruling on Medicaid Expansion Led to Coverage Gap

by Vera Gruessner

A Supreme Court ruling in 2012 determined that the Patient Protection and Affordable Care Act is Constitutional while Medicaid expansion is optional for individual states to pursue. This led more than two dozen states to postpone...

Payment Reforms in NY Medicaid Program Face Challenges

by Vera Gruessner

The state of New York has been working toward redesigning their Medicaid program and fixing the various problems plaguing this system. In particular, payment reforms within the New York Medicaid program are being implemented to advance...

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