Mar 22, 2018 | Medicare, MedPAC, Part D, Payers
On March 15, the Medicare Payment Advisory Commission (MedPAC) released its March 2018 Report to Congress assessing Medicare payment policy. The report includes analyses of payment adequacy in fee-for-service (FFS) Medicare, reviews the status of Medicare Advantage (MA) and the prescription drug benefit (Part D), and includes a mandated report on telehealth in Medicare. This brief includes all of MedPAC’s recommendations submitted to Congress as part of the report. Click to read more
Mar 21, 2018 | Behavioral, Hospitals, IDD, Medicaid
In March, the Medicaid and CHIP Payment and Access Commission (MACPAC) continued its conversation on the substance use disorder treatment continuum of care and IMD exclusion. The commission also discussed tailoring managed long-term services and supports (MLTSS) programs for individuals with intellectual and developmental disabilities (IDD), along with the role of Medicaid base and supplemental payments to hospitals. Click to read more.
Mar 21, 2018 | Legislation/ Budgets/ Macro
HHS actuaries project US spending on healthcare will increase by 1 percentage point faster than GDP from 2017 to 2026, rising to 19.7% of GDP by 2026 from 17.9% in 2016.Click to read more.
Mar 20, 2018 | Medicaid, Medicaid Managed Care, Medicare Advantage
A recent CMS report observed enrollment trends in managed care from 2006 through 2016 and found that the proportion of dual eligibles in managed care had tripled. In this brief, we’ll highlight the report’s findings and use CMS data to examine characteristics of the dual beneficiary population. Click to read more.
Mar 16, 2018 | Managed Care Friday
1. $1.6 Trillion: If you had to guess, what you would think is the largest single source of economic burden in the world? If you guess cancer, diabetes, respiratory disease or heart disease you’re wrong. The estimated global cost of mental health problems is higher than all of those. 2. Talk Is Cheap, But Does It Work? A therapist messaging app called ‘Talkspace’ has serviced over one million people and is trying to help solve issues of access, stigma and cost for those suffering from mental health conditions, says app cofounder Roni Frank MD. The new solution has implications for therapy...
Mar 14, 2018 | Drugs, Medicare, Part D, Payers, Products
In mid-February, the USC-Brookings Schaeffer Initiative for Health Policy hosted 2 panels that discussed the policy issues surrounding patient drug cost sharing. The first panel discussed options around restructuring the Medicare Part D benefit design, and the second panel discussed mechanisms to reduce cost sharing for commercially insured patients. In this brief, we’ll discuss the policy issues surrounding prescription drug patient cost sharing. Click to read more.
Mar 12, 2018 | Drugs, Products
Efforts to curb drug prices will remain a main topic of debate in 2018, but the potential policies and actions taken to address the issue may begin to take a different shape than in the past. In the past few years, much of the blame has been on drug manufacturers. In 2018, however, many believe that lawmakers will target pharmacy benefit managers (PBMs) and the supply chain. In this brief, we’ll discuss the ongoing policy debate and what we expect going forward. Click to read more.
Mar 9, 2018 | Managed Care Friday
1. 1,504. The number of children under age 17 admitted into hospitals for opioid overdoses from 2012 and 2015, up from 797 from 2004-07. Researchers at the Comer Children Hospital in Chicago determined these underage overdoses occurred from children getting their parents prescription medication, and particularly children under six years of age who were consuming methadone, a treatment for opioid withdrawal symptoms. 2. Rocky MLR: When meeting quality outcomes targets, 26 physician practices in Colorado earned a share in savings from the Rocky Mountain Health Plan during a recent Medicaid...
Mar 8, 2018 | Drugs, Substance Abuse
Attorney General Jeff Sessions recently announced the Department of Justice’s new Prescription Interdiction and Litigation (PIL) Task Force. The task force will coordinate all available criminal and civil law enforcement tools to fight the opioid crisis, with a focus on manufacturers and distributers. The Justice Department will file a statement of interest in a multidistrict lawsuit against several opioid manufacturers and distributers for the substantial costs the federal government has suffered from opioid addiction. The creation of this new task force reflects the national commitment to...
Mar 7, 2018 | Behavioral, Drugs, Products, Substance Abuse
As part of an initiative to expand access to medication-assisted treatment (MAT), the FDA plans to allow drug companies to sell medications that do not completely stop addiction but rather help alleviate cravings. The agency will put forth guidance and recommendations later this month. This move to expand access reflects the ongoing support for MAT.Click to read more.
