On July 1, Oregon launched a Basic Health Program (BHP) that offers comprehensive health care coverage, including medical, dental, and behavioral health care, with zero premiums and zero cost-sharing for eligible individuals...more
Introduction -
Welcome to the Manatt State Cost Containment Update, a digital publication produced with support from the Robert Wood Johnson Foundation and developed in coordination with the Peterson-Milbank Program for...more
In 2021, drug-related overdose deaths topped 107,000. Despite a nearly 50% decrease in opioid prescribing over the past decade, drug overdose mortality continues to trend in the opposite direction. In particular, drug-related...more
In late June, California’s Governor Newsom signed the California Health Care Quality and Affordability Act, establishing a new Office of Health Care Affordability (OHCA) within the Department of Health Care Access and...more
Cost growth benchmarking programs allow states to see a complete picture of total health care spending in their markets, and pinpoint cost drivers. They empower states with the information to exercise appropriate regulatory...more
As state leaders continue to grapple with unsustainable rates of health care cost growth, benchmarking programs have continued to proliferate across states as a strategy for better understanding health care cost drivers,...more
Editor’s Note: Welcome to the latest edition of the Manatt State Cost Containment Update, a digital publication produced with generous support from the Robert Wood Johnson Foundation and in collaboration with the...more
States have always been the primary regulators of their local health care markets and have increasingly used All Payer Claims Databases (APCDs) as one tool to help them make data-driven policy decisions. Like much state...more
President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more
2/16/2022
/ Alternative Payment Models (APM) ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Beneficiaries ,
Physicians ,
Public Health Emergency ,
Public Health Insurance Marketplace ,
Surprise Medical Bills ,
Telehealth ,
Webinars
The nation’s overdose and death epidemic continues to get worse, but policymakers and other stakeholders have yet to fully embrace evidence-based solutions to help those with a substance use disorder (SUD), patients with pain...more
1/24/2022
/ American Medical Association ,
Centers for Disease Control and Prevention (CDC) ,
Continuing Legal Education ,
Drug & Alcohol Abuse ,
Health Care Providers ,
Mental Health ,
Mental Health Parity Rule ,
Pain Management ,
Physicians ,
Substance Abuse ,
Suicide ,
Webinars
Executive Summary -
While most stakeholders agree on the need for more transparency in our health care system, there is substantial debate about how to make meaningful progress toward this goal in specific cases. This...more
In a New Webinar, Manatt and the Leukemia & Lymphoma Society Share the Obstacles Cancer Patients Face to Receiving Proper Treatment—and the Policies States and Plans Can Implement to Improve Network Adequacy and...more
8/2/2021
/ Best Practices ,
Cancer ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Insurance Regulations ,
Out of Network Provider ,
Out-of-Pocket Expenses ,
Patient Access ,
Physicians ,
State Health Plans ,
Webinars
In a new report prepared in partnership with the Leukemia & Lymphoma Society (LLS), summarized below, Manatt Health reviews policy challenges that may hamper patients’ ability to navigate and obtain proper treatment for their...more
Blood cancer takes a demanding physical, mental and emotional toll on the 1.3 million patients living with this disease in the U.S. Many blood cancer patients also face the daunting task of managing their own care—obtaining...more
As states grow increasingly concerned with rising health care costs, establishing health care cost growth benchmarking programs can provide a structure and process for increasing health system transparency and developing...more
Learn How States Are Using Cost Growth Benchmarking to Increase Health System Transparency and Contain Rising Health Care Costs at a New Manatt Webinar.
As states grow increasingly concerned over soaring health care costs,...more
Editor’s Note: The American Medical Association (AMA) and Manatt Health released a national roadmap in September 2019 to guide policymakers in taking action to help end the nation’s opioid epidemic. Based largely on in-depth...more
How Can Mental Health and Substance Use Disorder (SUD) Parity Laws Help Battle the Overdose Epidemic? Learn the Answers—and Catch Up on the Most Recent State and Federal Developments—at a New Webinar from the AMA and...more
1/14/2021
/ Best Practices ,
Department of Insurance ,
Enforcement ,
Health Care Providers ,
Health Insurance ,
Insurance Commissioners ,
Insurance Industry ,
Medicaid ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NAIC ,
NQTLs ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Regulatory Oversight ,
Self-Insured Health Plans ,
State Insurance Administrations ,
Substance Abuse ,
Webinars
Section 9 of Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of...more
On May 15, the House of Representatives passed the Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act (H.R. 6800, as amended by a manager’s amendment) along mostly party lines (208–199). While Senate...more
Editor’s Note: In a new toolkit prepared for the Robert Wood Johnson Foundation, summarized below, Manatt Health helps insurance regulators understand the wide range of transparency and competition strategies available to...more
3/5/2020
/ Anti-Competitive ,
Antitrust Provisions ,
Benefit Plan Sponsors ,
Competition ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Department of Insurance ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Horizontal Mergers ,
Hospital Mergers ,
Medicaid ,
Medicare ,
Transparency ,
Vertical Mergers
The focus on healthcare cost containment has grown dramatically since Massachusetts enacted the first cost benchmarking program in 2012. Since the program’s inception, commercial spending growth in Massachusetts has dropped...more
State insurance regulators play many roles in making health insurance more available and affordable to consumers. Two that stand out are enhancing transparency and promoting competition. Every state department of insurance...more
Editor’s Note: Seeking methods to better understand and control healthcare costs, many states are taking a careful look at a state-defined spending target, or “benchmarking” model, that originated in Massachusetts and has...more
State interest in healthcare cost containment has grown dramatically since Massachusetts enacted the nation’s first cost benchmarking program in 2012. At that time, most states were focused on coverage expansion through the...more