In this annual data edition, The Hertel Report delivers the latest insights on plan enrollment, including detailed membership by county. But this year’s data goes beyond the numbers, revealing alarmingly poor performance among plans serving AHCCCS members across the state. This edition also covers the latest on the ALTCS contract award...
A new report by healthcare research firm ATI Advisory determined that the Centers for Medicare and Medicaid Services (CMS) is not doing enough to reconcile incongruities between the Medicare and Medicaid programs for dually eligible beneficiaries in long-term care.
The ATI Report found that the over one million full benefit...
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) announced that as part of its new oversight strategy, it will investigate each part of all Medicare Advantage and Medicaid managed care contracts, from creation to payment to renewal. The oversight strategy is part of the OIG's new program for...National News
This week, value-based care (VBC) is frequently seen as a method for primary care providers to best serve patients, but increasingly more facets of the healthcare industry are investigating how technology, data analytics and value-based insurance design can help swap volume for value and deliver results for their patients.
Hospitals...National News
The federal public health emergency (PHE) due to the COVID-19 pandemic is set to expire on January 16, 2022. Previously, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra extended the PHE during its prior three expirations under the Biden administration, but a lot of non-medical infrastructure for Medicaid...Top of The Day
This week, a study shows Medicaid enrollment trends during the COVID-19 pandemic, a neighboring state removes Planned Parenthood as a Medicaid provider and a Medicaid managed care insurer is accused of overcharging the state of Ohio.
A new study published by Kaiser Family Foundation looked at Medicaid spending and enrollment during...National News
This week, COVID-19 continues to impact the data collection and maintenance of Medicare Advantage and Medicaid Managed Care programs. MedPAC reasserts its findings that Medicare Advantage costs the government more than fee-for-service and Oklahoma asks "is now really the time to be privatizing Medicaid?"
Medicare Advantage
The...
The Trump Administration's rollout of its new Medicaid block grant policy, dubbed "Healthy Adult Opportunity" was met with backlash from House Democrats, who are moving to vote on a resolution next week that would disapprove the plan.
Block grants give states fixed federal grants to use toward Medicaid spending based on individual...
