Softheon

Blog

Search results: "1115" (page 1 of 2)

1115 Waivers Signal a Bright Future for Medicaid

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

Whether through analyzing social determinants, increasing engagement, or creating patient-centered approaches, it’s clear that the key to health issuers’ future success lies with the people they serve and the future of Medicaid Expansion.

The Affordable Care Act (ACA) opened the door to an improved Medicaid Managed Care system. With over 74,550,529 Medicaid and CHIP beneficiaries across the country, Medicaid programs have evolved to become highly complex, multibillion-dollar enterprises. Today, some states are implementing a wide range of initiatives to coordinate and integrate care beyond traditional care. One such method is the Section 1115 waiver, which focuses on improving care for populations with chronic and complex conditions, align payment incentives with goals, and drive accountability for quality care and coverage.

Continue reading

Does the Healthy Indiana Plan 2.0 have national aspirations?

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

For the last six years, the Healthy Indiana Plan (HIP) has delivered quality care, encouraged the use of preventive services, and received measurable results. By incorporating the essence of a high deductible health plan and health savings account (HSA), the Medicaid expansion project became the first in the nation to adopt – and successfully demonstrate – the linkage of personal responsibility with subsided health protection to low-income individuals.

Continue reading

10 States move to impose Medicaid work requirements; Kentucky HEALTH becomes first to implement

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

Earlier this week, we examined a major shift involving states’ proposals to impose work requirements for Medicaid recipients through Section 1115 waivers. The move, which was announced by the Trump Administration on January 11, would affect nearly 70 million low-income people receiving benefits.

According to CMS, ten states – Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah, and Wisconsin – have already sent in proposals to add work requirements for Medicaid. On January 12, Kentucky became the first to gain CMS approval. Mississippi has also submitted a waiver proposal to CMS, but it has not yet been certified as complete.

Continue reading

CMS signals support for Medicaid work requirements

Sean Kirschner

Sean is a Business Analyst at Softheon. His objective is to provide insight into the current state of the healthcare landscape through research on both business and policy. He is also responsible for assisting the research team through creating and maintaining research briefings on various industry topics. He earned his bachelor’s degree in economics from Boston College.

Latest posts by Sean Kirschner (see all)

Earlier this month, the head of the Centers for Medicare and Medicaid Services (CMS), Seema Verma, made an announcement conveying that CMS would approve waiver applications from states that would require Medicaid enrollees to participate in “community engagement” activities, otherwise known as work requirements. This follows a letter co-authored by Verma that encouraged state Medicaid directors to use these waivers to modify their Medicaid programs to empower consumers. To advocates, work requirements are a way to empower Medicaid enrollees by encouraging them to be independent, self-sufficient consumers of healthcare.

Here’s what you should know about the proposed work requirements for Medicaid:

Continue reading

Major changes to 1332 waivers could be coming

Sean Kirschner

Sean is a Business Analyst at Softheon. His objective is to provide insight into the current state of the healthcare landscape through research on both business and policy. He is also responsible for assisting the research team through creating and maintaining research briefings on various industry topics. He earned his bachelor’s degree in economics from Boston College.

Latest posts by Sean Kirschner (see all)

1332 waivers, or state innovation waivers, allow states to apply to the federal government to waive certain provisions of the Affordable Care Act (ACA) and pursue innovative strategies for providing residents with access to quality, affordable insurance while retaining the law’s basic protections. However, there are two developments currently in motion that could make significant changes to these waivers.

One is the Alexander-Murray bill, which is indirectly connected to the Congressional tax bill currently in the process of reconciliation between the Senate and the House. The other is a bill currently being drafted by Senators Orrin Hatch (R-UT) and Mike Crapo (R-ID) that would overhaul the 1332 process, altering many of the original stipulations laid out by the ACA.

Continue reading

What Health Plans Can Do Today to Build Strategies for the Future

Hamoon Hadavand

Hamoon Hadavand

Senior National Account Executive at Softheon
Hamoon has more than 10 years of experience working with healthcare payers, strengthening existing client relationships and identifying new market opportunities across the country. He joined Softheon in 2012, after working as a Director of Business Development at America’s Health Insurance Plans (AHIP). Hamoon is passionate about working with payers to learn their business challenges and finding innovative technologies to enhance their operational efficiencies. He can be reached by phone at (202) 615-9222 or email hhadavand@softheon.com.
Hamoon Hadavand

In the industry’s era of uncertainty stemming from Washington, D.C. and what the future has in store for healthcare is at the top of everyone’s mind. But, the truth is that no one really knows, and any prediction saying otherwise are merely guesses. This was the general consensus at this years’ 2017 TAHP Managed Care Conference.

Despite this uncertainty, we can focus our attention on what is more certain; what health plans can do today to build strategies for the future. According PwC Health’s report, The health insurer of the future: Consumers’ advocate, providers’ parter, there are three primary areas where health insurers can make choices now to be positioned for a more prosperous future:

  • shift towards value-based care
  • consumer-focused initiatives
  • the advancement of technology

Continue reading

At a Glance: Kentucky’s Medicaid Managed Care System

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

The Affordable Care Act (ACA) opened the door to an improved Medicaid Managed Care system. However, while the health law fundamentally transformed the health insurance policy landscape, the Commonwealth Fund concludes that state Medicaid programs still carry a heavy burden, since the Medicaid population is poorer and faces high health risks. Because of these risks, the likelihood for challenges such as reaching medically underserved communities, unstable eligibility and enrollment, developing effective payment incentives, organizing coverage, aligning managed care with health, education, and social services, as well as those relating to information technology (IT) is likely. In this blog, we examine the impact of Medicaid Expansion in the state of Kentucky, its current reform initiatives (e.g. 1115 Waivers), and recommendations to resolve common challenges faced by MCOs across the country.  

Continue reading

Senate Hearings Day 3: Advocates Shed Light on State Flexibility

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

The Senate Committee on Health, Education, Labor, and Pensions (HELP) conducted its third hearing today, offering testimony of 5 advocates for state flexibility: Governor Michael O. Leavitt (R-Utah), Allison Leigh O’Toole, CEO at MNsure, Tarren Bragdon, CEO at the Foundation for Government Accountability, Bernard J. Tyson, Chairman and CEO at Kaiser Foundation Hospitals and Health Plan, Inc., and Tammy Tomczyk, Senior Principal and Consulting Actuary at Oliver Wyman.

With extensive experience in helping states offer insurance and addressing concerns around rising costs and healthcare accessibility, each witness shed light into innovate ways of addressing concerns within the individual health insurance market.

Continue reading

« Older posts

© 2018 Softheon

Theme by Anders NorenUp ↑