Weekly Medicaid Update

Mar 10, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: GA:  House budget proposal focuses on behavioral health services IL:    HFS carves out emergency ground ambulance services from managed care MA:  AG files lawsuit against MassHealth orthodontist TX:   State publishes proposed rates for new autism services, effective February 2022 Click to read more.

Shared Savings ACO Participation Declines Slightly in 2021

Mar 9, 2021 | Medicare

ACOs offered through the Medicare Shared Savings Program declined in 2021 to 477, an -8% decrease from 2020.  Aligned beneficiaries decreased -4% to 10.7 million. The decrease is due in part to more stringent risk-taking arrangements required by the Trump Administration, as well as a freeze for 2021 in new participants due to COVID-19. Click to read more.

Managed Care Friday

Mar 5, 2021 | Managed Care Friday

200,000: Highmark’s increase in membership now that state regulators approved an affiliation agreement with HealthNow New York last week. They will be the primary Blue plan in western and northeastern NY, plus in central and western Pennsylvania, West Virginia and Delaware. If you’re doing managed care contracting and looking to expand your healthcare business in this region, Highmark matters – it can help you take a young model to another state, or on the flip side put pressure on payment and utilization. Cancer Care Bundle: Memorial Sloan Kettering in New York is partnering with Carrum...

Weekly Medicaid Update

Mar 3, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: MA:  Gov. Baker releases FY22 budget proposal NC:  DOJ announces Medicaid fraud cases TX:   Medicaid agency's Executive Director delivers budget presentation to legislature VA:   Legislature passes amended FY21-22 biannual budget Click to read more.