Friday Five – March 9, 2018

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March 09, 2018

In this week’s Friday Five, MAXIMUS is reading about Arkansas’ Medicaid waiver, the move toward value-based payments, Medicaid managed care plans, ineffective waiver evaluations, and a bipartisan move to stabilize the health insurance market.

1. CMS issues split decision on Arkansas Medicaid waiver

Earlier this week, the Center for Medicaid and Medicare Services approved the portion of Arkansas’ Medicaid waiver allowing work requirements. But they deferred their decision on lowering the income limits that would qualify for Medicaid back to the federal poverty level. According to Kaiser Health News, nine other states currently have pending requests to implement work requirements.

2. Accelerating the value-based payment transition top HHS priority

Alex Azar recently announced that speeding up the move to value-based payments would be a major focus of the Department of Health and Human Services, according to RevCycle Intelligence. Value-based payments, as compared to fee-for-service arrangements, are one of the ways officials are hoping to control health care costs while improving outcomes.

3. Medicaid managed care plans and access to care: Results from the Kaiser Family Foundation 2017 survey of Medicaid managed care plans

The majority of Medicaid beneficiaries in the United States receive care through a managed care organization. In this article, Kaiser Family Foundation reports the highlights of their recent survey of these managed care plans and their approaches to providing care.

4. As Trump pushes Medicaid testing, the grading falls short

Medicaid waivers are designed to be ways for states to test and evaluate different approaches, such as covering individuals or services that would not typically qualify for funding. This article from the New York Times argues that according to a report from the GAO, many waivers aren’t being evaluated effectively and have become long-term changes rather than demonstration projects that provide proof of their results.

5. Congress races the clock in quest to bring stability to individual insurance market

Kaiser Health News reports that a bipartisan group of lawmakers is running out of time to finalize a package of health care fixes designed to stabilize the individual health insurance market, since many insurance companies are expected to begin making preliminary decisions about participating in April. Without action, prices are expected to rise for policies, affecting costs for the government and the approximately 18 million people who purchase individual policies.