States continue to pursue Section 1332 State Innovation Waivers

With repeal of the Affordable Care Act (ACA) stalled, states are increasingly considering Section 1332 Waivers as a way to expand upon or customize the ACA to best address the unique circumstances within the state. Alaska and Oklahoma are the two most recent states to take formal steps toward State Innovation Waivers, both states following on the heels of the recent Section 1332 Waiver approval granted to Hawaii, which we summarized in the February edition of Health Policy News. [More]

What you need to know about modularity

If you work in state Medicaid or health information technology (HIT), chances are you have seen the term modularity discussed with increasing frequency lately. Countless articles have been written about it, and it has been a focus at some of the largest Medicaid and HIT conferences over the past year including MESC, HIMSS, and the Health IT Connect Summit. For all of the coverage it has gotten, defining what modularity truly means has been an ongoing debate among states, the Centers for Medicare and Medicaid Services (CMS), and the vendor community. [More]

CMS releases final Market Stabilization Rule

On April 13, 2017, the Centers for Medicare and Medicaid Services (CMS) released the final Patient Protection and Affordable Care Act; Market Stabilization Rule. The final rule is aimed at stabilizing the individual and small group markets by tightening enrollment standards and providing increased flexibility related to standards for Qualified Health Plans (QHPs), as outlined in detail below. The final rule also seeks to provide greater deference to state regulation of health insurance. [More]

GAO examines telehealth in federal programs

On April 14, 2017, the U.S. Government Accountability Office (GAO) released a report to Congress on coverage and payment rules for telehealth and remote patient monitoring under Medicare, state Medicaid programs, and health care programs operated by the Department of Defense (DOD) and the Department of Veterans’ Affairs (VA). The report examines rules across those agencies’ programs and outlines recent initiatives to improve care for high-risk patients. [More]

U.S. Supreme Court rejects West Virginia’s challenge to Obama administration’s decision not to enforce certain provisions of the Affordable Care Act (ACA)

On Monday, April 17, 2017, the U.S. Supreme Court declined to take up West Virginia’s challenge to the decision by the Obama administration not to enforce certain mandates of the ACA following the cancellation of millions of plans by insurance companies in 2013. (West Virginia, Ex Rel. Morrisey v. Dept. of H & HS, 16-721, 4/17/17). [More]

Making a positive impact

At PCG, we take Kidonomics seriously. All the research shows that making strategic investments in early childhood can pay big dividends in school, in the workplace, and throughout life. We were thrilled to talk about it at the Institute for Emerging Issues Focus Forum in February and SXSWedu in March, but even more pleased to back up those words with tangible actions. [More]

PCG sponsors LAUSD Focus Awards

For the past two years, Dr. Brenda Manuel of the Los Angeles Unified School District has joined PCG at a special session on community engagement during the iconic SXSWedu conference in Austin, TX. As she did last year, Dr. Manuel spoke about the Village Movement Mentoring Program where students are connected with members of the community who can serve as guides and cheerleaders for them, and then are expected to take the lessons they learn and mentor their classmates. [More]

Rural Areas – Sometimes It’s the Distance, Not the Journey

Providing services to children and families has always been a challenging and complex problem. Through agencies, these services are often contracted to local providers. Distance, travel, and method of transportation have always been a further complicating factor, especially in rural areas. As an Indiana governor suggested – “identify a problem, fix a problem, don’t embrace it.” [More]

Where the Research Meets the Road

Researchers know more about the brain development of young children than ever before. What should that mean for public policy? Some facts: After birth, new connections are made across neurons in babies’ brains at the rate of 700 to 1,000 per second. Three-quarters of young children who experience five or more types trauma measured by the Adverse Childhood Experiences test (ACEs) experience developmental delays. One in four young children live at or below the federal poverty level. Living in poverty can create biomechanical changes in the brain functioning of both children and adults, negatively impacting physical and mental health and executive functioning. Brain scientists know more now than ever before about what happens inside the heads of children during their first years of life, as well as what sorts of inputs help to facilitate desired outcomes. Still, translating this new knowledge into effective public policy often proves to be challenging. [More]