HHS report shows Medicaid expansion affects QHP premiums

On August 25, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE), released a report showing that premiums for qualified health plans (QHPs) offered through Exchanges were on average about seven percent lower in 2015 for states that had expanded Medicaid for persons with incomes up to 138 percent of the Federal poverty level (FPL) versus states that had not. As actuarial risk pools, hence premiums, vary based on many local area factors, the report focuses on QHP benchmark premiums in 94 paired counties on opposite sides of borders between expansion states and non-expansion states that had used Federal exchanges in 2015. [More]

Bridging the electronic health information highway and promoting interoperability for Medicaid providers

The Centers for Medicare and Medicaid Services (CMS) recently expanded the scope of the Health Information for Economic and Clinical Health Act (HITECH) 90/10 funding available to encourage the adoption and promote the use of electronic health record (EHR) technology and health information exchange (HIE). This new funding source provides Medicaid agencies with the ability to accelerate the exchange of information across the continuum of Medicaid providers and gather important clinical and administrative data elements for robust program planning; improvements in quality of care; and managing costs. [More]

Consumer assistance for open enrollment 2017

This year, for the first time since the health insurance marketplace began, states will not have the support of consumer assistance funding from the Centers for Medicare and Medicaid Services (CMS) to educate the public about marketplace plan offerings. Without federal funding, many states are scrambling to find ways to assist consumers in the upcoming open enrollment period. [More]

Pepper featured in Santa Cruz Tech Beat

Santa Cruz-based non-profit O’Neill Sea Odyssey (OSO) – an organization founded by Jack O’Neill, the man who revolutionized the world of surfing when he invented the wetsuit – provides outdoor educational programs to teach students about science and the environment, using lessons aligned with the Next Generation Science Standards (NGSS) and the Common Core. Small groups of students (grades 4-6) engage in hands-on learning aboard a sailing catamaran; after the field trip, students supplement their learning with in-classroom curriculum. [More]

CMS releases report on ACA health insurers’ payment trends

The Centers for Medicare and Medicaid Services (CMS) released a report on August 11, 2016, entitled, “Changes in ACA Individual Market Costs from 2014 to 2015: Near-Zero Growth Suggests an Improving Risk Pool.” The report states that per member per month (PMPM) paid claims for health insurers in the individual market under the Affordable Care Act (ACA) fell 0.1 percent on average from 2014 to 2015, perhaps due to a broader, healthier ACA risk pool in 2015 than in 2014. [More]

Proposed rule clarifying limit on Medicaid DSH Payments

In the August 15, 2016 Federal Register, the Center for Medicare and Medicaid Services (CMS) published a proposed rule (81 Fed. Reg. 53980) clarifying that Medicaid Disproportionate Share Hospital (DSH) payments under section 1923(g)(1)(A) of the Social Security Act (SSA) should be limited to uncompensated care costs. [More]