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This week the NAMD newsletter welcomes new directors and covers LTSS, national health expenditures, Hill news on CHIP and tax reform, value based purchasing and Medicaid leadership.

Update
December 12, 2017
From the NAMD Desk
NAMD Welcomes Four New Medicaid Directors and a New Board Member!
Over Fall 2017, several states have welcomed new Medicaid Directors, including Blake Fulenwider from Georgia, Dennis Shraeder from Maryland, Josh Baker from South Carolina, and Stephanie Muth from Texas. We look forward to working with you all in the year ahead!
Congratulations, also, to Allison Taylor, who transitioned from acting to official Medicaid Director in Indiana and who has just been elected to the NAMD Board. Allison will join the Board effective immediately as one of our two representatives for the Midwest region. She will serve out the remainder of former Michigan Medicaid Director Chris Priest’s term, ending December 31, 2018. We look forward to her passion and commitment in helping lead the association forward!
NAMD Fall Meeting Materials Available!
Materials from our Fall 2017 Meeting – including videos of our five plenaries and presentation materials from our breakout sessions – can be found here.
 
In This Issue

Save the Date
 
NAMD Fall Meeting
November 12-14, 2018
Washington Hilton, Washington, D.C.
 

 

 

Reg Update

 

Money Follows the Person (MFP) Rebalancing Demonstration Report to the President and Congress
Last week, the Centers for Medicare & Medicaid Services (CMS) published the Money Follows the Person (MFP) Rebalancing Demonstration Report to the President and Congress.
The MFP Rebalancing Demonstration program was launched more than nine years ago.  As of September 2016, the 44 grantee states were awarded nearly $3.7 billion in grant funding. As of the end of calendar year 2015, grantee states had transitioned a total of 63,337 Medicaid beneficiaries from long-term institutional care to community residences and home and community-based LTSS.
When MFP participants transitioned to community living, Medicaid programs experienced cost savings. Costs of care for MFP participants transitioned through 2013 was reduced by $978 million during the first year after the transition to home and community-based LTSS. Further, MFP provides strong evidence of success at improving the quality of life of participants.
The report is available here.
CMS Informational Bulletin: 2018 Spousal Impoverishment Standards
Last week, CMS released an informational bulletin related to the 2018 Spousal Impoverishment Standards.
The informational bulletin can be accessed on Medicaid.gov here. The updated 2018 Spousal Impoverishment Standards can be viewed here.
“Part D PDE Data and the Opioid Epidemic” Webinar Materials Available
CMS’ Medicare-Medicaid Coordination Office is pleased to announce the availability of materials from the State Data Resource Center (SDRC) webinar entitled “Part D PDE Data and the Opioid Epidemic,” that occurred on August 30 and September 21, 2017. The webinar documents are posted to
SDRC Public website – Announcement & Webinars, and include the following:
For any questions regarding the webinar or inquiries about obtaining Medicare data, please contact the SDRC at
sdrc@econometricainc.com.

 

CMS Office of the Actuary Releases 2016 National Health Expenditures
Last week, the Office of the Actuary at CMS published its annual report on national health expenditures. It finds that
in 2016, overall national health spending increased 4.3 percent following 5.8 percent growth in 2015 while health care spending growth decelerated following Affordable Care Act (ACA) coverage expansion and significant retail prescription drug spending growth in 2014 and 2015. The report concludes that the 2016 expenditure slowdown was broadly based as growth for all major payers (private health insurance, Medicare, and Medicaid) and goods and service categories (hospitals, physician and clinical services, and retail prescription drugs) slowed in 2016.
The CMS Office of the Actuary’s report will appear on the CMS website here.
CMS Updates to Market Saturation and Utilization Data Tool
CMS updated its Market Saturation and Utilization Data Tool (fact sheet), formerly called the Moratoria Provider Services and Utilization Data Tool, that includes interactive maps and a dataset that shows national and local level provider services and utilization data for selected health service areas.

 

The updated data tool provides metrics for the following health service areas: Home Health, Ambulance (Emergency, Non-Emergency, Emergency & Non-Emergency), Independent Diagnostic Testing Facilities (Part A and Part B), Skilled Nursing Facilities, Hospice, Physical and Occupational Therapy, Clinical Laboratory (Billing Independently), Long-Term Care Hospitals, Chiropractic Services, Cardiac Rehabilitation Programs and Psychotherapy. The metrics for the aforementioned health service areas include: number of fee-for-service beneficiaries; number of providers; average number of users per provider; percentage of users out of ffs beneficiaries; number of users; average number of providers per county; and total payments.

 

To access the tool, please click here.

 

FCC Issues Proposed Rule on Rural Health Care Program to Enhance Telehealth
The Federal Communications Commission (FCC) recently issued a
notice of proposed rulemaking and order (WC Docket No. 17-310) to refine its Rural Health Care (RHC) Program to enhance telehealth in rural America. The RHC Program provides funding to eligible health care providers (HCPs) for telecommunications and broadband services to improve the quality of and access to health care in rural communities (overview).

 

Of note, the FCC is considering an increase to the RHC Program’s $400 million annual cap, as well as “creating a prioritization mechanism in the event of demand exceeding the cap.” The accompanying order would waive, on a one-time basis, any unused RHC Program funds from prior funding years for use in Fiscal Year (FY) 2017.

 

The FCC also solicits comment on:
  • Establishing a process for evaluating outlier funding requests and reforming the calculation of urban and rural rates in the Telecommunications Program to improve fairness and transparency;
  • Re-defining the “cost-effectiveness” standard across the RHC Program to encourage price-sensitive purchasing and fair competitive bidding;
  • Ensuring sufficient funding for rural and Tribal healthcare providers, while maintaining the participation of rural-urban provider consortia; and
  • Simplifying program participation and enhancing oversight.
The proposed updates to the RHC Program are expected to be considered at an upcoming meeting of the FCC set for Thursday, December 14th.

 

CMS finalizes changes to the Comprehensive Care for Joint Replacement Model, cancels Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model
CMS has released a final rule that makes the Comprehensive Care for Joint Replacement (CJR) Model voluntary – instead of mandatory – for hospitals in 33 of 67 selected Metropolitan Statistical Areas (MSAs) as well as for rural and low-volume facilities in all of the selected MSAs. The CJR model remains mandatory in the 34 other MSAs.

 

Importantly, the rule also finalizes the cancellation of Center for Medicare and Medicaid Innovation’s (CMMI) Episode Payment Models (EPMs) for acute myocardial infarction, coronary artery bypass graft, and surgical hip/femur fracture treatment episodes and Cardiac Rehabilitation (CR) Incentive Payment Model, which most recently had been slated to begin in 2018, following administrative actions to delay implementation.
Finally, the rule includes an interim final rule with comment (IFC) period providing latitude on determining episode costs in the CJR model for facilities located in areas affected by “extreme and uncontrollable circumstances.” The agency mentions the 2017 hurricanes and California wildfires as examples. Comments on the IFC are due by Jan. 30, 2018.

 

The final rule takes effect on January 1, 2018. Please find a factsheet here, and a press release here.

 

CMS Expands Medicare Advantage Value-Based Insurance Design Model
CMS is expanding the Medicare Advantage value-based insurance design model to an additional 15 new states and will allow insurers greater flexibility in enrolling beneficiaries with chronic conditions. Starting in 2019, insurers in the selected VBID model states can expand the model to include more Medicare beneficiaries with chronic conditions than previously identified by CMS. This includes beneficiaries with lower back pain, chronic kidney disease, obesity/pre-diabetes, asthma, and tobacco use. It will also allow insurers to propose their own systems or methods for identifying eligible enrollees.

 

The 15 states will include Alabama, Arizona, California, Colorado, Florida, Georgia, Hawaii, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Montana, New Jersey, New Mexico, North Carolina, North Dakota, Oregon, Pennsylvania, South Dakota, Tennessee, Texas, Virginia, and West Virginia.

 

The VBID model will be available in 25 states in 2019.
To learn more information, please read here.

 

Hill Update

 

Short-Term CR Signed into Law; Includes CHIP Funding Adjustment Through End of the Year
Last Friday, both the House and the Senate passed a short-term Continuing Resolution (CR) to fund the federal government through December 22, which the President signed into law. The action averts a government shutdown for the next two weeks and buys additional time for funding negotiations to continue on several contentious topics. Observers expect that these negotiations will not be resolved within that window, and an additional CR to fund the government beyond the new year – likely into January, though potentially as late as February or March – is expected.

 

Included in the Friday CR is a provision granting CMS additional flexibility to distribute remaining CHIP funds to states that have exhausted current allotments. The provision does not allocate any new funding for CHIP, but does allow CMS to use existing funds to make states whole through December 31.

 

Tax Reform Conference Committee Negotiations Ongoing; Healthcare Issues Complicating the Discussion
The House and Senate continue to negotiate the differences in their respective chambers’ tax reform packages in conference committee. While the negotiations are not yet complete and will continue through the week, a reconciled package is expected to be released as soon as Tuesday. However, sticking points on assurances made to Senator Susan Collins (R-ME) regarding two ACA stabilization bills may complicate the effort. Sen. Collins conditioned her support for the Senate bill, which includes repeal of the ACA’s individual mandate, on a guarantee that the ACA stabilization bills would be considered alongside the completed tax reform package. Those bills would require bipartisan support, but House Republicans have not expressed interest in considering bipartisan ACA stabilization packages.
Should these packages not be considered, there is a possibility Sen. Collins could withdraw support for tax reform. Her opposition, alongside that of Sen. Bob Corker (R-TN) – who was the lone Republican vote against the Senate’s bill – would reduce the margin for error in the Senate to a single vote when the reconciled tax bill is brought to the floor.

 

House Ways and Means Announces Intent to Tackle Entitlement Reform in 2018
On December 6, House Ways and Means Republicans
held a meeting of the Secretaries’ Innovation Group to discuss welfare reform, and Speaker of the House Paul Ryan (R-WI) discussed entitlement reform more broadly on a radio talk show the same day. Speaker Ryan mentioned that health care entitlements “are big drivers of debt” and will be prioritized next year. While there is not yet a clear timeline, NAMD anticipates that hearings or other discussions on these topics will be on the House’s agenda in the first months of the new year. We will continue to monitor these conversations and keep members informed.

 

In the News

 

The New York Times: How Will Consumers Fare under CVS and Aetna Merger?
Last week, CVS Health and Aetna announced their $69 billion merger, representing the union of one of the country’s biggest pharmacies with one of its largest health insurers. With their merged data about people’s health and vast reach, the two companies assert that they have the opportunity to make real change in our convoluted, inefficient health landscape. “It’s not going to immediately shake up the world, but I think you have two behemoths – two battleships that are slow to turn – and it will at least create an environment by which information can be shared and innovation can take place,” said Nadina J. Rosier, the health and group benefits pharmacy practice leader at the consulting firm Willis Towers Watson. Whether this rosy future will become reality, writes the New York Times, is far from certain, however. Some skeptics worry that CVS and Aetna entered into the deal not to benefit consumers but to strengthen their competitive positions at a tumultuous time for the industry; meanwhile, others worry that the nation’s health care system will come to resemble a series of “kingdoms, where consumers are locked into separate ecosystems of pharmacies, doctors and health care clinics depending on their insurance provider.”
To read the full article, please click here.
Stat: Colorado Lifts Medicaid Restrictions for Treating Hepatitis C
Amid ongoing criticism that some states continue to curb access to hepatitis C drugs, Colorado officials have lifted restrictions
that determined when patients could receive treatment. Going forward, Medicaid beneficiaries will no longer have to demonstrate an advanced stage of liver disease to be treated. In explaining their decision, state officials pointed to declining costs for the medicines, which have dropped in price recently as more new drugs become available.
To learn more, please read the full article here.
Morning Consult: Providers See CMS Continuing Value-Based Care Push Despite Project Rollbacks
Though the Trump administration last week rolled back several Obama-era projects designed to shift the U.S. health care system away from fee-for-service care to models that pay doctors and hospitals based on the quality of care, industry groups believe the government is likely to continue with the push toward value-based care, reports Morning Consult. While CMS has officially scrapped the Obama administration’s mandatory hip fracture and cardiac bundled payment programs and scaled back the mandatory Comprehensive Care for Joint Replacement Model, provider groups believe the Trump administration is not abandoning the overall shift to value-based care, expecting the administration to take a more conservative approach to bundled payments (i.e., voluntary participation, fewer regulations, etc.).
To learn more, please read the full article here.
AP Analyzes Medicaid Beneficiaries’ Challenges, Motivation to Improve Health Status
On December 7, the
Associated Press published an article titled “A Medicaid Challenge: Poor Health, but a Drive to Improve.” The article highlights results from the Gallup-Sharecare Well-Being Index, which indicates that 40% of Medicaid beneficiaries indicate their health status is either fair or poor (compared to 11% for individuals with employer-sponsored insurance), but also indicates Medicaid beneficiaries prioritize healthy habits, including securing a personal doctor (4 out of 5 respondents); practicing healthy eating (3 out of 5 respondents); and exercising regularly (half of respondents). Additional findings show that Medicaid beneficiaries tend to have higher rates of health conditions and challenges, such as smoking, depression, and obesity, though these conditions don’t preclude beneficiaries from prioritizing health improvement.
NAMD Executive Director Matt Salo is quoted in the article. “The Medicaid population is not just an employer population with less income,” he said. “It is people who have health conditions. Depression is inextricably linked to physical health and the ability to effectively engage in the workforce.”

 

To learn more, please read the full article here.
 
New York Times: As Walmart Buys Online Retailers, Their Health Benefits Suffer
In little more than a year, Walmart has spent nearly $4 billion acquiring e-commerce companies with thousands of workers, who find that their employer-sponsored health coverage has suffered significantly. Last month, many of these workers learned that their potential out-of-pocket costs for medical expenses would increase in 2018 at a rate far exceeding the overall rise in health care costs, reaching thousands of dollars in many cases. For example, a policy offered via Walmart will cost an individual about $750 more per year in premiums and a family nearly $4,000 more than a policy offered via Bonobos, an online men’s wear retailer that Walmart bought in June for $310 million. Both plans will also feature a deductible that is 50 percent higher than the current one.

 

Some economists are concerned that as Walmart amasses such companies, its practices could put pressure on benefits throughout the e-commerce sector, which has been a relative bright spot for low-wage workers. Yet according to Blake Jackson, a Walmart spokesman, however, the giant retailer now “offers more than what we’ve had in the past.” In addition to its standard health insurance benefits, Walmart covers 100 percent of the cost of certain types of major surgery, like transplants, at a top facility.

 

To read the full article, please click here.

 

Modern Healthcare: CMS moves to reduce Medicaid spending on medical equipment
CMS has asked the White House for permission to impose a new data collection requirement on Medicaid agencies that will help it reduce their spending on medical equipment. In a Federal Register notice published last week, CMS said the new program would require Medicaid agencies to submit data showing they are not paying a higher rate than Medicare for durable medical equipment. If the White House approves of the plan, states would send their reimbursement rates for the products to a new CMS online database. The change, according to Modern Healthcare, will mean providers of medical equipment will see additional cuts on top on what they’ve already seen under Medicare’s competitive bidding program (projected to save the CMS nearly $26 billion on durable medical equipment over 10 years).

 

The competitive bidding program has taken a toll on medical equipment providers and Medicare beneficiaries, with the reduction in reimbursement leading to a 41% decrease in the number of medical equipment providers since 2013, according to the American Association for Homecare; more than half of beneficiaries surveyed by the association, moreover, report problems accessing medical equipment, while nearly 90% of case managers surveyed report an inability to obtain the products quickly. “It’s a very challenging time in the medical equipment community and with the new announcement it’s about to become more so,” said Thomas Ryan, the association’s CEO.

 

To read the article, please click here.

 

Kaiser Health News Examines the Rise in Surprise Ambulance Bills
In this article, Kaiser Health News explores the issue of surprise bills for ambulance rides, which consumers often face. It notes that these bills often result because ambulance companies don’t join provider networks, which results in high out-of-network charges for consumers. Individuals in the ambulance industry suggest these higher charges are necessary to account for low reimbursement from Medicare and Medicaid.

 

The article is available here.

 

Kaiser Health News Highlights Pneumococcal Vaccine Cost Increase
As the nation debates the rising cost of drugs, Kaiser Health News looks at another cost increase in the pharmacy space: the pneumococcal vaccine. Manufacturers argue that the steady increase in price for this widely used vaccine support research for new immunizations. However, others in the article argue that the cost increases, which are primarily bone by payers, are not justified.

 

The article is available here.

Take Note

 

McKinsey Focuses on Medicaid Leadership
Increasingly, Medicaid agencies are playing a multi-part role, fulfilling their traditional responsibilities (i.e., payer-purchaser, operator) and taking on new ones (i.e., market shaper and innovator). And while they are doing this, the agencies must address an array of competing priorities, as well as uncertainty about future funding levels. To perform well in these new roles, the agencies must develop new, next-generation capabilities so they can address the needs of their state’s citizens.
In a new article, McKinsey explores how “state Medicaid agencies will need to strengthen their capabilities if they are to meet the demands of the future.” Reviewing several trends that are shaping what Medicaid agencies need to do to prioritize the direction of their efforts, such as spending growth and an awareness of social determinants, McKinsey introduces what it calls “the Medicaid agency of the future.” This agency, write McKinsey, will be shaped by states’ ability to, among other things:
  • Chart a strategic direction;
  • Strengthen their approach to managed care;
  • Redesign payment;
  • Enhance their special needs categories;
  •  Measure public health return on investment;
  • Assess provider market roles;
  • Consider interactions between Medicaid and other state healthcare markets;
  • Executive efficiently and effectively; and
  • Strengthen MCO rate setting and performance management.
To read the article, please click here.
Kaiser Family Foundation Fact Sheet: State Plans for CHIP as Federal CHIP Funds Run Out
Federal funding for the Children’s Health Insurance Program (CHIP) expired on September 30, 2017. CHIP covers 8.9 million children in working families who earn too much to qualify for Medicaid but cannot afford or access private coverage. This fact sheet provides an overview of state plans for CHIP as they grow closer to exhausting federal funds amid continued delay of Congressional action to extend funding. It is based on data collected from state Medicaid and CHIP officials by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA) during November 2017, which updates data earlier reported in Summer 2017.
The findings show that about three-quarters of states anticipate exhausting funding by the end of March 2018 and that several states have begun or will begin notifying families about coverage reductions before the end of 2017.
To read the fact sheet, please click here.
Kaiser Family Foundation Report & Video: Voices from Puerto Rico: Reflections from Two Months After
A new Kaiser Family Foundation report and video
find residents across Puerto Rico facing a wide range of daily and long-term challenges as they struggle to rebuild their lives after Hurricane Maria swept across the island Sept. 20 as a powerful category 4 storm.
Based on focus-group and individual interviews with 40 Puerto Ricans from 10 different regions of the island conducted in San Juan and Ponce in November 2017, the Voices from Puerto Rico: Reflections Two Months after Maria project reveals that residents still face incredible challenges and life is far from normal. Common themes include:
  • The storm had significant negative effects on people’s physical and mental health, and many participants continue to experience depression, stress, and anxiety.
  •  Participants continue to face challenges meeting basic needs, and daily life remains extremely challenging due to lack of electricity and limited work options.
  • Participants feel that recovery efforts have been slow and insufficient.
  • Despite these challenges, many believe Puerto Rico will recover, although they recognize recovery will likely take many years and believe that the people themselves have an important role to play in recovery.
The report and video are part of KFF’s ongoing work looking at the impact of the powerful hurricanes that hit the United States this year, including Hurricanes Irma and Maria in Puerto Rico and the U.S. Virgin Islands, and Hurricane Harvey in Houston and coastal Texas.
New Toolkit from CHCS: Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment
State Medicaid programs are facing increasing pressure to reform their LTSS systems to both improve care quality and contain program costs in ways that allow older adults and adults with disabilities to live full and satisfying lives. To help address this challenge, CHCS and partners at Manatt Health are pleased to introduce a new toolkit, Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment.

 

Developed with support from The SCAN Foundation and the Milbank Memorial Fund, this toolkit offers a menu of LTSS reform strategies adopted by state innovators that may be replicated by other states. It identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance their LTSS reforms. It also highlights opportunities and challenges that states faced in designing and implementing these programs.

 

To access the toolkit, please click here.

 

MACPAC: Work as a Condition of Medicaid Eligibility – Key Take-Aways from TANF
A recent brief from MACPAC examines the key design features of waiver proposals in the eight states-Arkansas, Arizona, Indiana, Kentucky, Maine, New Hampshire, Utah, and Wisconsin-that seek to implement work requirements in their Medicaid programs. It also discusses key considerations and lessons learned from TANF. Overall, the research suggests that TANF and its work requirements:
  • Led to a caseload decline driven by increased employment as well as sanctions;
  • Helped increase employment, including for single mothers and individuals with significant barriers to employment, though effects diminished over time;
  • Had a mixed or limited effect on income growth; and
  • Created administrative challenges for states.
To read the brief, please click here.

 

New CHCS Brief on Integrated Care Programs for Individuals Dually Eligible for Medicaid and Medicare
Developed through support from The SCAN Foundation and The Commonwealth Fund, a new CHCS brief, Advancing Medicare and Medicaid Integration: Key Program Features and Factors Driving State Investment, describes key features of effective integrated care programs and presents top policy considerations driving state investment in Medicare-Medicaid alignment based on the experiences of 10 states who have pioneering programs in this area. It was developed as part of Implementing New Systems of Integration for Dually Eligible Enrollees, a national CHCS initiative that has connected states, federal partners, health plans, and providers as they work together to improve care for dually eligible populations.

 

To read the brief, please click here. A related infographic can be found here.

 

Centers for Disease Control and Prevention MMWR’s E-Book on HIV Testing: Vital Signs: Human Immunodeficiency Virus Testing and Diagnosis Delays – United States
The Centers for Disease Control and Prevention (CDC) has released a Morbidity and Mortality Weekly Report (MMWR) on HIV testing and diagnosis delays. According to the CDC, persons unaware of their human immunodeficiency virus (HIV) infection account for approximately 40% of ongoing transmissions in the United States, representing substantial missed opportunities to improve health outcomes and prevent HIV transmission. The report finds that an estimated 15% of persons living with HIV in 2015 were unaware of their infection. Among the 39,720 persons with HIV infection diagnosed in 2015, the estimated median diagnosis delay was 3.0 years; furthermore, diagnosis delay varied by race/ethnicity (from 2.2 years among whites to 4.2 years among Asians) and transmission category (from 2.0 years among females who inject drugs to 4.9 years among heterosexual males).

 

To read the report, please click here.

 

ICRC Brief: Value-Based Payment in Nursing Facilities – Options and Lessons for States and Managed Care Plans
This brief by the Integrated Care Resource Center (ICRC) describes value-based payment approaches currently used in select states and managed care plans, including the quality and performance measures they use, benchmarks or targets for those measures, and incentives that reward facilities. It also describes approaches to designing, administering, and evaluating state programs.

 

To read the brief, please click here.

 

SHVS: Value-Based Innovation by State Public Employee Health Benefits Programs
In late March 2017, the Robert Wood Johnson Foundation’s State Health and Value Strategies (SHVS) program convened a meeting of public employee purchasers from multiple states to share strategies and learnings to promote value through their purchasing and benefit design work. The meeting participants described innovations in three areas: value-based payment; incentivizing selection of high-value providers; and incentivizing use of high-value services.

 

This issue brief provides an overview of three areas of value-based innovation and then affords a deeper examination into specific examples of state employee purchaser activity in California, Connecticut, Massachusetts, Minnesota, Tennessee, and Washington. Despite their differences in size and scope, these state health care purchasers found they could learn from their colleagues in other states as they strive to improve the value of care.

 

To access the brief, please click here.

 

National Academy of Medicine Panel Issues Highly Anticipated Recommendations on Prescription Drug Prices
The National Academies of Sciences, Engineering, and Medicine has released a new report, Making Medicines Affordable: A National Imperative, in which it examines how best to address prescription drug prices. The report was developed by the Ensuring Patient Access to Affordable Drug Therapies consensus panel. The Senate Health, Education, Labor, and Pensions (HELP) Committee, which already has held two hearings on drug pricing this year, has signaled that the report would be the basis for a third hearing in that series.

 

The report makes a range of recommendations, including authorizing federal negotiation of drug prices, precluding “pay for delay” arrangements, prohibiting co-pay coupons unless no competing therapy is available, and requiring transparency from plans and manufacturers. It also makes recommendations on the role of generics and biosimilars, intellectual property, drug advertising, 340B oversight, insurance benefit designs, reform of orphan drug exclusivity, adoption of site-neutral policies for drug payment between hospitals and physician offices, transition of Medicare Part B drug payment to a fixed-fee add-on, and exclusion of drugs from Medicaid coverage, among other topics.

 

The report addresses a range of participants in the biopharmaceutical sector, which it defines as including “researchers, physicians and other care providers who can prescribe medications, public and private payers, intermediaries such as pharmacy benefit managers, health care organizations, and patient advocacy organizations.”

 

To read the report, please click here. Other resources can be found here:
AHRQ’s Updated State Snapshots Show Variations in Health Care Quality
Wisconsin, Massachusetts, Pennsylvania, Maine, and North Dakota ranked highest among 50 states and the District of Columbia in updated assessments of health care quality, according to the Agency for Healthcare Research and Quality (AHRQ)’s online
State Snapshots. The interactive resource evaluates states based on more than 250 measures of health care quality and access. Drawn from the most recently available data in AHRQ’s
2016 National Healthcare Quality and Disparities Report (QDR), the State Snapshots show how each state fared according to prevalence of diseases and conditions; health status of priority populations; insurance status; access to care; type of care and setting of care. While the 2016 QDR shows that overall quality of health care continues to improve gradually each year, the State Snapshots reveal substantial variations across states and sizable disparities related to race, ethnicity, income and other factors. Access a new AHRQ infographic for State Snapshots highlights.

 

Jobs
NAMD Program Coordinator
The National Association of Medicaid Directors (NAMD) seeks a program coordinator to support the Association’s growing portfolio of programs that support state-to-state learning and problem solving among state Medicaid leaders. The Program Coordinator is a junior position that will support NAMD’s growing portfolio of grant-funded programs that provide Medicaid Directors and Medicaid agency staff with opportunities for state-to-state learning and problem solving. NAMD’s programs also support the partnership between Medicaid Directors and Medicaid’s federal partners at the Centers for Medicare and Medicaid Services (CMS).

 

To learn more about the position and how to apply, please click
here.

 

Nevada Chief IT Manager

This position is with the Division of Health Care Financing and Policy (DHCFP / Medicaid) and is responsible for the executive oversight of the Division’s Information Services unit which includes IT operations, application development, project management and oversight of the fiscal agent’s contract. This position will also be responsible for the direct oversight of the Health Information Exchange (HIE)/Electronic Health Records (EHR) unit which includes professional staff who perform provider recruitment and onboarding for the EHR and HIE and oversees the budget related to health information technology (HIT) efforts. This position is responsible for compliance with Centers for Medicare and Medicaid (CMS) Medicaid Information Technology Architecture (MITA) requirement, must understand modular acquisition, the role of Systems Integrator, and information security compliance. The position works closely with leadership across the Division and the Department of Health and Human Services Director’s Office on shared IT projects and has direct authority for the IT operations budget.

For more job opportunities, please check out
NAMD’s State Jobs page!

 

 

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