Healthcare Costs

News & Analysis as of

Reforming Medicaid Could Become Toughest Job Ever for Baker Administration

Anyone who follows politics or government in Massachusetts has seen these numbers. They bear repeating: - ..Over the past seven years, spending on Medicaid (MassHealth) has increased 65%. ..Next year, total...more

CMS Announces Major Multi-Payer Comprehensive Primary Care Plus (CPC+) Model

CMS has launched a new “Comprehensive Primary Care Plus” (CPC+) model to improve how primary care is delivered and reimbursed. According to CMS, the CPC+ initiative (which builds on the ongoing Comprehensive Primary Care...more

State Efforts to Combat Drug Price Increases

Growth in health care costs has long been a source of political and administrative tension for public health agencies across the country. More and more, health officials, legislators, patient advocacy groups, and third-party...more

It’s an Election Year, So It’s Time for a Tort Reform Bill & Snappy Acronym

If it’s an election year, it must be time for someone in Congress to propose a tort reform bill and to come up with a snappy acronym—the more tortured, the better. And Rep. Trent Franks (R-Ariz.) has done just that, with...more

COPN Reform Efforts Delayed

Few legislative issues during the 2016 General Assembly have garnered more attention in the health care community than the efforts to reform Virginia’s Certificate of Public Need (“COPN”) process. Despite considerable effort...more

Proposed Changes to Methodology to Update ACO Benchmarks

The Medicare Shared Savings Program provides financial rewards to Accountable Care Organizations (ACO’s) that successfully manage overall health care costs for a defined population of beneficiaries while meeting quality of...more

Health Care Update - February 2016

Are Lawmakers and Stakeholders Ready for the Silver Tsunami? - Last week, the Congressional Budget Office (CBO) released a projection that shows Medicare enrollment will grow by more than 30 percent in the next decade...more

CMS Takes Action Against Network Transparency While New Jersey Legislation Hits a Snag

Just as the Centers for Medicare & Medicaid Services (CMS) began holding federal health care plans accountable for their provider network transparency obligations, the New Jersey legislature stalled in its bid to pass a law...more

Telemedicine Momentum Picking up Steam as New Legislation Introduced in U.S. Senate

On February 3, 2016, a bipartisan group of Senators led by Senator Brian Schatz (D-HI) and Senator Roger Wicker (R-MS) have unveiled legislation that would expand the use of telemedicine and remote patient monitoring under...more

CBO’s Budget Forecast and the Silver Tsunami

This week, the Congressional Budget Office (CBO) released a projection that shows Medicare enrollment will grow by more than 30 percent in the next decade alone, and the number of seniors will steadily grow from 55 million...more

Massachusetts Health Care Reform – Full Speed Ahead; Health Policy Commission 2015 Cost Trends Report

The Massachusetts Health Policy Commission (HPC) has issued its 2015 Cost Trends Report, based on the HPC’s annual health care cost growth hearings. The report contained 13 key recommendations across a wide range of health...more

Thirteen Ways to Contain Health Care Costs in Massachusetts: The Health Policy Commission Issues Its 2015 Report and...

In 2012 Massachusetts adopted the most recent in a series of comprehensive legislative approaches to health care reform, Chapter 224 of the Acts of 2012 (Chapter 224), which focused especially on addressing the drivers of...more

Virginia’s Certificate of Need Laws May Stay, Fourth Circuit Says

On January 21, the U.S. Court of Appeals for the Fourth Circuit upheld Virginia’s Certificate of Need (CON) laws, ruling that the scheme does not illegally discriminate against out-of-state health care providers. See Colon...more

FTC and DOJ Urge South Carolina to End Certificate of Need Laws

On January 11, 2016, the Federal Trade Commission (FTC) and Department of Justice, Antitrust Division (DOJ) submitted a letter to Governor Nikki Haley recommending that South Carolina repeal certificate of need laws (CON)...more

FTC and Pennsylvania Challenge Penn State Hershey’s Planned Merger with PinnacleHealth System

BNA has reported the planned merger of Penn State Hershey Medical Center with PinnacleHealth System will be challenged in federal court by federal and state officials. The Federal Trade Commission and Pennsylvania’s...more

Medicare Data Not Indicative of Overall Healthcare Spending Costs

In December 2015, a  research team at Carnegie Mellon published a paper titled “Examining the Variation in Health Spending and in Hospitals’ Transaction Prices” after receiving access to insurance claims data from Aetna,...more

ACA Update: Cadillac Tax Postponed!

The budget and tax package passed by Congress on December 18, 2015, and signed by the President, includes a two-year delay of the controversial excise tax on high-value health plans (a.k.a., the Cadillac Tax), part of the...more

Impact of Medicaid Expansion on the Kansas State Budget

Key Findings - The cost of Medicaid expansion in Kansas is projected to average just over $50 million annually between 2016 and 2020. Based on publicly available data and the experiences of states that expanded in 2014,...more

Consumerism Drives Employer & Retail Clinics' Telemedicine Adoption in 2016

In response to consumer demands for more personalized health care at a lower cost, employer onsite health clinics and retail clinics will continue to be on the rise in 2016, and telemedicine will be crucial to those clinics...more

Manatt on Health Reform: Weekly Highlights - December 2015 #2

A flurry of support for Medicaid expansion this week…with Virginia hospitals backing a provider assessment, Wyoming's Governor putting forth a budget initiative, and Arkansas announcing plans to extend its waiver. Meanwhile,...more

Minnesota has Budget Surplus

Minnesota Management and Budget (MMB) announced that the FY 16-17 budget has a $1.871 billion surplus. The bulk of this $1.871 billion surplus comes from $682 million carried over from the FY 14-15 biennium and $865 million...more

Manatt on Health Reform: Weekly Highlights - November 2015 #4

HHS proposes significant new network adequacy standards and surprise billing protections for 2017 QHPs; Louisiana's Governor-elect reiterates his intent to expand Medicaid on "Day One"; and California considers pursuing a...more

Payers Embracing Telemedicine Cost Savings, Ramping Up Reimbursement in 2016

Often considered the primary obstacle to telemedicine implementation, reimbursement changes are now better viewed as one of the most prominent drivers of telemedicine expansion. Payers are finally beginning to realize what...more

Three Pressing Challenges for Personalized Medicine

Personalized medicine can be described as the science of targeted therapies. Advances in diagnostic and molecular medicine have made it possible to more precisely identify alternative treatment options for patients based on...more

MA Health Policy Updates – Moves to Strengthen HPC and Expand Telemedicine

In a recent Alert, the Mintz Levin Health Law Practice and ML Strategies provided a comprehensive look at recent developments in Massachusetts health policy. In addition to a detailed report on recent Health Policy Commission...more

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