« The Dual Agenda: January 27, 2016 Issue

State Highlights

Massachusetts

The Massachusetts Health Policy Commission (HPC) has released its 2015 Cost Trends Report, profiling health care spending in the Commonwealth. The report indicates that Massachusetts exceeded its targeted growth rate in per-capita health care spending by 1.2 percentage points, a disappointing result for policymakers. The HPC found two main drivers of cost growth: a temporary increase in the number of Medicaid recipients and high prescription drug prices. Simultaneously, the HPC released a Special Report on Provider Price Variation, which examines persistent variation in provider prices for the same services. The report finds that in large part, this variation does not reflect differences in quality or other measures of value. Rather, market power is the significant driver of higher prices.

In other news, the Disability Advocates Advancing Our Healthcare Rights (DAAHR) coalition hosted a successful community forum on Jan. 14. The forum was on the state Medicaid program’s shift towards Accountable Care Organizations (ACOs) and the impact it will have on people with disabilities and long-term services and supports.

Ohio

The Ohio Department of Medicaid recently hosted a MyCare Ohio Implementation Council Team (MCOIT) meeting to provide updates on the MyCare Ohio dual eligible demonstration project. Among the key information shared:

In related news, the latest blog from UHCAN Ohio highlights an important win for consumers in My Care Ohio, who will now be able to access durable medical equipment (DME) more quickly and will not have to wait as long in an appeals process for procuring DME. This great step forward for consumers came as a result of a survey conducted by OCVIC. In the survey, 80 percent of respondents reported that they require the use of DME, yet 73 percent stated they did not receive a needed upgrade or replacement in a timely manner.

Finally, the Ohio Governor’s Office of Health Transformation released a Patient-Centered Medical Home Model Overview. This blueprint explains how changes to delivery and payment systems could lead to better value in health care. Community Catalyst Value Advocacy Project partners at UHCAN Ohio are working to ensure the consumer voice is central to these conversations.

Oregon

The Oregon Health Authority, which oversees health-related programs and is responsible for the state’s Medicaid program, recently released Oregon’s Health System Transformation Coordinated Care Organization (CCO) mid-year report. This report, the eighth to date, lays out how Oregon’s CCOs performed on quality measures and, for the first time, shows a subset of measures reported for Oregon Health Plan members with disabilities and with severe and persistent mental illness or broader mental health conditions. Oregon also released an accompanying report highlighting the state's broader Health System Transformation goals.

Rhode Island

Community Catalyst partners from the Senior Agenda Coalition of Rhode Island and the Economic Progress Institute submitted comments on the state’s proposed administrative rule: “Medicaid Long-Term Services and Supports: Interim Rule.”  While the proposed rule is a step in the right direction, many details still need to be fleshed out such as clarity on eligibility, assessment and care coordination, and the list of services provided. In addition, advocates are concerned about proposed efforts to tighten eligibility for nursing home care without increasing capacity for Home and Community-Based Services.

Subscribe to

The Dual Agenda Newsletter

Support Our Work:

Donate