Managed Care Friday

41,000: The number of members in health insurer Highmark’s 2019 claims data diagnosed with alcohol use disorder (AUD), leading to more than $4 million in spending and there are assumptions these numbers are rising, and quickly, as recent data suggests more adults than ever are drinking excessively. Highmark is offering its members new ways to treat alcohol disorder. One new option is Ria Health, a technology-enabled telehealth medical practice that focuses on treating AUD by combining medically assisted treatment with digital tools to help members track and record progress. The Ria Health...

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to:IL:   Coverage of new diabetes prevention and management programsMA: Temporary rate increases for certain HCBS servicesSC:  Intellectual Disability and Related Disabilities waiver renewal includes new servicesClick to read more.

Quarterly Commission Recommendations

The June 2021 MedPAC report includes Commission recommendations for a variety of topics, which we have summarized in three briefs. A summary of MedPAC's recommendations on the skilled nursing facility (SNF) value-based purchasing program, access for rural beneficiaries, and clincal lab fee schedule (CLFS) rates can be found here. MedPAC recommendations on alternative payment models (APMs) and findings on Medicare spending for clinician services can be found here. MedPAC recommendations on Medicare Advantage (MA) benchmarks, vaccinations, and drugs administered in hospital outpatient...

Managed Care Friday

50: The number of new medical centers Anthem is opening in partnership with CareMax, a senior healthcare provider focused in the Florida market. The medical centers will primarily be in areas where Anthem is focused on value-based care efforts, including Indiana, Texas, Kentucky, Wisconsin, Georgia, Connecticut, and Virginia. Self Insured Strategy: Aetna is rolling out virtual primary care services to self-funded employers across the country. By partnering with Teladoc, the new Aetna Virtual Primary Care service will be available to members at no cost, and includes access to in-person visits...