I took advantage of the quieter work environment over the holidays to catch up on my policy reading. The Health Affairs top ten articles from 2019 included “The Forgotten Middle: […]

Medicaid spending accounts for about three percent of annual U.S. GDP and more than 20 percent of most state budgets. With a ten-year run of a strong economy, we may […]

70 million people receive health coverage through Medicaid. These programs receive federal & state funding and are administered by state agencies that follow broad federal standards. Eligibility varies across states […]

One of the fundamental objectives of Medicaid programs contracting out their sizeable budgets to managed care companies is to improve the quality of care for their beneficiaries. As we frequently […]

How hospitals and physicians get paid is changing as the U.S. healthcare system transitions from volume-based to value-based care. Reimbursement methodologies need to allow for a plan to control costs, […]

I attended the January 9, 2018 CMS Medicare Learning Network conference call covering the logistics of the settlement process offered by CMS for providers with pending appeals. This impacts: “The […]

With the unrelenting pressure to reduce unnecessary costs in healthcare delivery and despite (or maybe because of) the lack of clear direction from the federal government, Medicaid plans across the […]

While Congress is finding it difficult to reach consensus on how to improve health care in the United States, the one thing we all can agree on is that ever-rising […]

In a recent perspective piece in JAMA Forum, Dr. Ashish Jha of the Harvard School of Public Health argues that increased provider consolidation is threatening the financial viability of the […]

Value-Based Payment (VBP) is top of mind for all who work with a Medicaid population in states across the U.S. Through its Delivery Service Reform Incentive Payment (DSRIP) Program and […]

For the last decade, we have been fortunate enough to work with many state Medicaid programs and commercial payers on reform efforts incorporating outcomes targets for health care providers. The […]