Friday Five – April 6, 2018

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April 06, 2018

In this week’s Friday Five, MAXIMUS is reading about moves states may make to stabilize the ACA market, the impact work requirements will have on adults with disabilities, Texas’s streamlined doctor credentialing system, a waiver request to restrict drug coverage and control prices, and how marijuana legalization could impact the opioid epidemic.

1. 4 ways states may address health coverage

States are exploring different ways to help stabilize the Affordable Care Act individual insurance markets. According to Modern Healthcare, this could include introducing association health plans and farm bureau models (both of which are expected to offer lower-cost, lower-coverage plans that do not meet ACA requirements), Medicaid expansion/buy-in, or state markets that could provide reinsurance and require coverage mandates.

2. How might older non-elderly Medicaid adults with disabilities be affected by work requirements in Section 1115 waivers?

Work requirements in most states will apply to non-elderly adults on Medicaid. The Kaiser Family Foundation examines the impact on the more than half of adults who report a disability which may impede their ability to work, but does not qualify for Social Security. More than 80% of this population are not currently employed.

3. Health plans simplify doctor credentialing to boost Medicaid participation

Texas has launched a new doctor credentialing system that all Medicaid plans in the state can use. Forbes reports this system will allow doctors to provide background information for credentialing once, rather than for each of the 19 Medicaid plans offered in the state. The hope is that this change will increase the number of doctors serving the Medicaid population.

4. Massachusetts, a health pioneer, turns its focus to drug prices. It’s in for a fight

According to the New York Times, Massachusetts has submitted a Medicaid waiver that would limit the number of drugs covered by the program. The state says the waiver would allow them to negotiate better deals with drug companies and thus lower prices, but opponents are concerned that it will limit health care options for patients.

5. Association of medical and adult-use marijuana laws with opioid prescribing for Medicaid enrollees

How does marijuana legalization impact the number of opioid prescriptions? Research published in JAMA finds that legalization lowered the rates of opioid prescriptions for Medicaid participants, and posits that marijuana may be part of addressing the opioid epidemic, since it has a lower risk of addiction and virtually no risk of overdose.