Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Medicaid Spending

Medicare, Medicaid Home Health Benefits Stabilize Care Costs

July 5, 2018 - 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 Hopkins University reviewed healthcare costs and outcomes for Maryland’s Medicaid Community First Choice (CFC) Program, which provides supplemental behavioral...

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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, Medicaid...

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 (NAS) and...

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’ demonstration,...

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 Michigan...

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 between...

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 (OIG)....

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 Waiver was...

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 recommendations...

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 changes...

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 Governor...

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 state...

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 failed...

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 connected to...

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 Medicaid...

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 medical...

How CMCS Improved Managed Care in State Medicaid Programs

by Vera Gruessner

Earlier this week, the Centers for Medicaid and CHIP Services (CMCS) finalized its ruling on the managed care Medicaid reimbursement regulations. Soon afterward, the National Association of Medicaid Directors (NAMD) released a statement regarding...


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