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Does the Healthy Indiana Plan 2.0 have national aspirations?

Yvonne Villante
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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
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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.

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Trump Administration releases guidance on Medicaid work requirements

Matt Cummings

Solutions Architect at Softheon
Matthew is a Solutions Architect at Softheon. He works closely with Product and Development teams to design products and solutions to help Health Plans and other entities to excel in the marketplace. He received his bachelor's degree in Applied Psychology and Business Management from Stony Brook University in Stony Brook, New York.

What happened?  

In a major shift that could affect millions of low-income people receiving benefits, The Trump Administration announced Thursday, January 11, that it will open the door for states to require work requirements for Medicaid recipients.  

The guidance was published in a letter from CMS Deputy Administrator Brian Neale to State Medicaid Directors Thursday morning. In the letter, Deputy Administrator Neale stated that the move would help “improve Medicaid enrollee health and well-being through incentivizing work and community engagement.” 

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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:

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Hidden benefits of medicaid expansion

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)

Although there is still an ongoing debate in many states over whether or not to expand Medicaid, in the 33 states that have, unexpected benefits are starting to surface.

When the Patient Protection and Affordable Care Act (ACA) laid the framework for Medicaid Expansion, it allowed states to expand the income level needed to qualify for Medicaid. This gave a large number of Americans access to coverage. But it turns out this wasn’t the only benefit.

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A Victory for Maine Medicaid Could Be an Inspiration to Others

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)

What happened?

In a first-of-its-kind vote, Maine residents elected to expand the state’s Medicaid program through a state-wide referendum on Tuesday, November 7.

The expansion easily passed with 59% of voters in favor. These results place a majority of Maine residents in opposition to the stance of their Governor, Paul LePage, who has vetoed five bills to expand Medicaid.

Maine was one of 19 states that did not initially expand Medicaid in reaction to the Patient Protection and Affordable Care Act (ACA) in 2010. The state previously expanded the program in 2003, increasing the eligible population and subsidizing private coverage, but LePage dismantled much of this framework when he took office in 2011.

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1115 Waivers Signal a Bright Future for Medicaid

Yvonne Villante
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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
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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.

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At a Glance: Kentucky’s Medicaid Managed Care System

Yvonne Villante
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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.  

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Graham-Cassidy: A Closer Look

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)

There is a major effort in Washington to push healthcare reform through before the end of the September.

The new bill drafted by Sen. Lindsey Graham (R-SC) and Sen. Bill Cassidy (R-LA) is appropriately known as the Graham-Cassidy bill. It is lauded by its sponsors as a proposal to return power to the states after the centralization of the ACA. Under the Graham-Cassidy bill, money made available for Medicaid Expansion effort and health plan subsidies would be pooled and allocated to states as block grants, which the states can then use to build their own health care plans. The block grants will be based on the number of individuals with incomes between 50-138% of the Federal Poverty Line (FPL) in the state, but this is only initially. Starting in 2024, enrollment levels will also be factored in to determine the level of funding available through the grants. Block grants are only provisioned through 2026, though, with nothing legislated to take their place after that year.

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