Dec 20, 2018 | Legislation/ Budgets/ Macro
A Texas District Court Judge’s recent decision, declaring the entire ACA is unconstitutional and must be invalidated, is very unlikely to be upheld on appeal. This brief discusses the court case and the broad and significant changes, should the ruling stand upon appeal. Click to read more.
Dec 18, 2018 | Post-Acute Care, Skilled Nursing Facilities (SNF)
Skilled nursing facility payments are adjusted in FY 2019 based on their hospital readmissions, as part of the SNF Value-Based Purchasing program. Only about 1/4 of SNFs will receive an incentive bonus payment, and over 10,000 facilities will see a 1-2% cut to their payments in FY19. Click to read more.
Dec 10, 2018 | Drugs, Medicare Advantage, Part D, Payers, Products
On November 26th, CMS released a proposed rule with several policies that would affect the Medicare Part D drug program, as well as Medicare Advantage plans. These proposals are largely in line with the Trump administration’s previous pricing proposals to lower drug prices and reduce out-of-pocket costs for enrollees. This brief discusses major provisions included in the proposed rule. Click to read more.
Dec 4, 2018 | Medicaid, Medicare
With 2019 approaching, our team has put together a quick reference for investors and industry professionals to turn to for a point-in-time overview of healthcare policy. We provide an outlook on Medicare and Medicaid policy, managed care, and data analytics. Click to read more.
Nov 19, 2018 | Medicaid Managed Care, Payers
CMS recently proposed changes to the Medicaid and CHIP managed care programs, increasing flexibility in actuarial soundness and network adequacy standards requirements. While CMS Administrator Seema Verma had promised to revise a managed care rule finalized under the Obama administration that she deemed restrictive, the proposed changes are more of a tweak than an overhaul. This brief highlights key provisions of the proposed rule. Click to read more.
