On September 28, 2022, the Centers for Medicare & Medicaid Services (CMS) issued approval letters for Section 1115 Medicaid demonstration applications previously submitted by Oregon and Massachusetts. Section 1115 waivers...more
On December 3, 2020, Centers for Medicare & Medicaid Services (“CMS”) announced key details concerning a new value-based reimbursement and patient care model – the Geographic Direct Contracting Model (the “Model” or “Geo”)....more
A New Look at Digital Health Business Models - Editor’s Note: The Commonwealth Fund is developing an innovative digital health advisor (DHA)—an integrated suite of digital services that would provide consumers with health...more
I. INTRODUCTION AND CONTEXT - MassHealth, Massachusetts’ Medicaid program, is the largest payer of long-term services and supports (LTSS) in the Commonwealth and administers a number of LTSS programs, some in conjunction...more
President-elect Trump taps prominent conservatives with strong anti-ACA views for his healthcare transition team; House v. Burwell proceedings on cost-sharing reductions for Marketplace plans are delayed until the new...more
The President voices support for a public option; Vermont selects a Medicaid ACO; and Alabama ends enhanced primary care reimbursements....more
Real-Time Data Analytics in Government Investigations and Reducing Exposure - It is not every day that the words “innovative” and “nimble” are used when referring to an agency of the federal government bureaucracy. Yet,...more
Medicaid Accountable Care Organizations - On April 14, 2016, the Massachusetts Executive Office of Health and Human Services released new details on a proposed restructuring of the MassHealth (Massachusetts Medicaid)...more
As we start a new year, let’s take a look back at a few hot topics that emerged in the managed care industry in 2015 and will likely be drivers of developments in 2016. Industry Consolidation – The Changing Landscape - ...more
We are living in the most polarized society in recent American history. A recent study shows that the feeling of political partisanship has more than doubled over the past 2 decades. So since 1995, politically, America has...more