CMS proposes changes in Medicare home health programs

On June 27, 2016, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the Medicare home health prospective payment system (HH-PPS), the home health quality reporting program (HH-QRP), and the home health value-based purchasing program (HH-VBP). The net effect of the proposed changes on home health agencies in 2017 would be to reduce aggregate Medicare payments on behalf of 3.4 million Medicare beneficiaries to 11,400 HHAs by about $180 million, about one percent of Medicare HHA expenditures. [More]

CHADD and Public Consulting Group Partner to Enhance Teachers' Capacity for Supporting Students With ADHD

BOSTON, June 30, 2016 -- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), the leading national resource for individuals with Attention-Deficit/Hyperactivity Disorder (ADHD), and Public Consulting Group (PCG), leading national provider of web-based tools for educators, including Pepper, the online, interactive professional development platform, today announced their new strategic partnership and the creation of CHADD's first ADHD online learning platform for teachers, parents and providers. [More]

Innovative approaches to Medicaid expansion within the Medicaid managed care delivery system

Much attention has been paid to innovative approaches to coverage of the Medicaid expansion population that leverage the private commercial insurance market for coverage through “premium assistance” programs. However, other states have turned to the Medicaid managed care delivery system as the vehicle for implementing innovative coverage designs for the newly eligible population. As outlined below, these states have received 1115 Medicaid Demonstration waivers to gain flexibility in the coverage offered to this population via managed care plans. [More]

Alabama’s Regional Care Organization 1115 waiver approval

In May 2013, Act-2013-261, Ala. Code §§ 22-6-150 was passed, advancing the move from a fee-for-service (FFS) system to a managed care program. According to the Alabama Medicaid Advisory Board report issued in January 2013, based on 2011 data, 22 percent of Alabama’s population was Medicaid eligible for a portion of the year. Additionally, Alabama’s Medicaid program covered 53 percent of births, 47 percent of children, and two-thirds of nursing home residents. In 2009, Medicaid accounted for 16.3 percent of all health care expenditures in Alabama. In order to contain costs associated with the substantial Medicaid population, managed care in the form of regional care organizations (“RCOs”) were established with little guidance other than the Act 2013-261 itself. [More]

CMS announces the release of $22 Million in Health Insurance Enforcement and Consumer Protections grant funding

On June 15, 2016, the Centers for Medicare and Medicaid (CMS) announced the release of $22 million in grant funding for State planning and implementing of the health insurance market reform provisions of the Affordable Care Act (ACA). The grants are aimed at helping States ensure their laws, regulations and procedures are in line with Federal requirements and that the States are able to effectively monitor and enforce health insurance market reforms and consumer protections under the ACA. States must submit a letter of intent by July 6th. Grant applications are due August 15th at 3:00 pm. [More]

KFF estimates significant increases in Exchange premiums for 2017

On June 15, 2016, the Henry J. Kaiser Family Foundation (KFF) released a report entitled, “Analysis of 2017 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces.” The report estimates that premiums on Federal and State-based Exchanges will rise in 2017 at about twice the rate of increase for 2016 and that insurer participation in Exchanges will decline. KFF compared final 2016 premiums versus proposed 2017 premiums for major cities in 13 states and the District of Columbia (the geographic areas for which KFF could access complete 2017 rate filings for all insurers planning to participate in Exchanges in 2017). Insurers’ proposed 2017 premiums will be subject to review by state insurance departments and may be adjusted following state review. [More]

Michigan district aims to build leadership with Principal’s Playbook

On June 20, 2016, an article in highlighted one Michigan school district’s efforts to build its principals’ leadership and data literacy skills. PCG’s Education Consulting team partnered with the Saginaw School District to support this professional development initiative by implementing PCG’s blended learning platform, Principal’s Playbook. [More]