Ohio Launches Nest Generation Managed Care Plans
The Ohio Department of Medicaid recently launched its Next Generation managed care plans, following an overhauling process that began in 2019.
Value-Based Payment News
New Mexico Human Services Department Cancels Procurement for Medicaid MCOs
The New Mexico Human Services Department announced it will cancel the procurement process for the selection of managed care organizations to deliver services to Medicaid Centennial Care members in the state.
CMS Announces Changes That Will Improve Quality of Care for Medicare Beneficiaries in 2023
CMS recently announced that three innovative accountable care initiatives will grow and provide higher quality care to more than 13.2 million people with Medicare in 2023
CMS & HHS Working to Improve Medicaid’s Social Determinants of Health Endeavors
The Department of Health and Human Services (HHS) and CMS recently announced guidance for state Medicaid programs ILOS to boost the quality of Medicaid social determinants of health initiatives.
ACA Marketplace Enrollment Increased 18% From 2021
HHA announced that Affordable Care Act Marketplace enrollment continues to outpace previous years, with nearly 11.5 million people selecting a health plan nationwide in 2022.
Bipartisan Bill Calls for Extended VBP Incentives
Senators John Barrasso and Sheldon Whitehouse introduced a bipartisan bill that would extend value-based payment incentives for healthcare providers participating in Medicare’s alternative payment models APMs.
Aetna to Provide $9.3 Million to Support Behavioral Health of Youth in Foster Care
Aetna’s Medicaid plan in West Virginia has granted $9.3 million to 10 community-based organizations in a bid to support the behavioral health and social care needs for children in foster care.
Oklahoma Reissues Medicaid Managed Care RFP After OK Supreme Court Blocked First Attempt
On December 1, 2022, Oklahoma reissued an RFP to implement the Medicaid managed care for a program to be called SoonerSelect and the SoonerSelect Children’s Specialty Program.
Florida Starting Medicaid Managed Care Procurement Process
Florida recently released the Medicaid data book, which must be published at least 90 days before issuing the invitation to negotiate for the statewide Medicaid managed care program.
Despite New Programs, Major Payers Still Spending Less Than 1% on Income on Social Determinants of Health
A study from the Journal of General Internal Medicine found that the six payers with the largest market shares may have spent on average 0.67% of their income in 2021 on social determinants of health.