« The Dual Agenda: June 10, 2015 Issue

Noteworthy News

Kaiser Report on Early Results of Virginia Dual Eligible Demonstration

Following its recent report on the progress of the dual eligible demonstrations in California, Massachusetts and Ohio, Kaiser has issued a report on early lessons learned from the duals demonstration in Virginia. Virginia was among the earliest states to launch a three-year capitated financial alignment demonstration. Findings in the Kaiser report are based on interviews conducted with a diverse group of state leaders, including representatives from state agencies, medical, behavioral health, and social services providers, consumer advocates and health plans. The report also includes data on enrollment in the Virginia program.

Research on Health Disparities Points to Structural Racism

An article from New America Media highlights the important and provocative research findings of Professor James Jackson, Co-director of the Michigan Center for Urban African American Aging Research at the University of Michigan and Wayne State University. Professor Jackson used his keynote address at the Resource Centers for Minority Aging Research conference in April at the University of California, Davis to describe research findings that challenge the very basis of racial categories in research on health disparities. Professor Jackson’s thesis is that persistent health disparities between African Americans and non-Hispanic whites result both from structural racism in the United States and how people respond differently to pervasive stresses that difficult social and economic conditions engender. Jackson sharply criticizes the health research community for perpetuating the notion that genetic differences account for health disparities between racial groups, and instead points to social and economic factors as crucial determinants of health, with disparities increasing between groups as the lifespan progresses.

California Pushes the Envelope in Enhancing Care for Medicaid Beneficiaries

As dual eligible demonstration projects and other health system transformation efforts nationwide explore innovative ways to use health care dollars to improve health outside of a clinical setting, California’s effort to use Medicaid money to pay for housing is particularly interesting. CA is asking the federal government for permission to spend Medicaid dollars to put medically fragile people in stable housing. In addition, California is working to enhance access to palliative care for its Medicaid beneficiaries. A bill enacted in 2014 requires CA Medi-Cal managed care plans to include a palliative care benefit, and state officials are working to develop a regulatory framework for the law that would include providing those services to Medicaid beneficiaries.

Analysis of New CMS Medicaid Managed Care Rules

Health Management Associates provides a first take on the Medicaid Managed Care Rules   recently released by the Centers for Medicare and Medicaid Services. Topics examined include new Medical Loss Ratio Requirements, rate setting requirements, quality rating, long-term services and supports, and access to care for those with severe mental illness.


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