Congress addresses impact of methamphetamine and opioid abuse on child welfare systems

Congress took action this week to highlight the significant impact parental abuse of methamphetamines and opioids is having on children across the country. On February 23, 2016, the Senate Finance Committee held a hearing, “Examining the Opioid Epidemic,” with presenters from the child welfare community, health care community, and law enforcement. In his introduction, Sen. Ron Wyden (D-OR) referred to the issue of opioid use as one of requiring a three-prong approach – more prevention, better treatment and tougher enforcement – for successful eradication. [More]

Current state of CMS quality rating programs

For Marketplace plans, quality is coming to the forefront as Quality Rating System (QRS) and Quality Improvement Strategy (QIS) requirements are rolled out for Qualified Health Plans (QHPs) starting in 2017. In short, pending the approval of proposed regulations, the following changes are coming for 2017:
• CMS will be publicly displaying QHP quality rating information on HealthCare.gov;
• QHP issuers will be allowed to include 2016 QRS and QHP Enrollee Survey results in marketing materials;
• QHP issuers must adhere to guidelines, including the QRS Technical Guidance and User Guide for the 2017 Coverage Year, established by Federal Department of Health and Human Services in consultation with health care quality experts and stakeholders.
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Research centers examine national congregate care trends

Two research centers, Chapin Hall and the Chadwick Center, recently collaborated to examine nationwide patterns of congregated care placements (i.e., group homes, residential treatment facilities, psychiatric care institutions and emergency shelters). The research findings, which were published in a policy brief titled Using Evidence to Accelerate the Safe and Effective Reduction of Congregate Care for Youth Involved with Child Welfare, are quite timely since the Senate Finance Committee’s legislation addressing congregate care is still in-development. [More]

CMS and AHIP announce alignment in physician quality measures

On February 16, 2016, the Centers for Medicare and Medicaid Services (CMS) and America’s Health Insurance Plans (AHIP) announced multi-payer alignment and simplification of core quality measures to be used in calculating quality-based payments for seven physicians’ services specialties. Multi-payer alignment is expected to reduce the reporting burden for providers and to accelerate the nationwide shift to value-based payment. [More]

CMS proposes changes to Medicare ACO rules

On February 3, 2016, the Centers for Medicare and Medicaid Services (CMS) proposed regulations in the Federal Register on Medicare payments to accountable care organizations (ACOs) under the Medicare “shared savings” program (MSSP), which currently includes 434 ACOs, serving 7.7 million Medicare beneficiaries nationwide. Under the MSSP, Medicare Part A and Part B fiscal intermediaries and carriers pay ACOs on a traditional, fee-for-service basis. An ACO may qualify for a “shared savings” bonus if the ACO achieves CMS-specified Medicare savings targets while meeting CMS-specified quality of care performance metrics. [More]

Workforce expert: Healthcare jobs will change but the field remains 'hands on'

RALEIGH, N.C. — Healthcare workers are hardly immune from the threat of a jobless future as being explored in this week's Emerging Issues Forum "Future Work" conference. But as one of the speakers explains opportunities will remain available for humans in healthcare.

Ahead of the Institute for Emerging Issues event, WRAL TechWire sought analysis about how technology continues to disrupt the healthcare industry and what workers today and tomorrow can do to better prepare themselves for future jobs.

Reg Javier is associate manager of Boston-based Public Consulting Group. He will be speaking on Tuesday.

"Automated records have made file clerk jobs all but disappear," Javier explained. "All across the professional continuum, healthcare now requires tech competency. [More]

Supreme Court rules mandatory life sentences for juveniles unconstitutional

Last week, advocates for youth involved with state juvenile justice systems celebrated when the United States Supreme Court ruled it unconstitutional for people to serve mandatory life sentences in prison for crimes of murder committed as children. The high court made retroactive a 2012 ruling that banned mandatory life sentences without parole for juveniles. Justice Anthony Kennedy stressed that “the decision to impose life without parole should never be invoked.” Youth should be able to contemplate the possibility of a life on the outside again. The issue was brought forth by the Juvenile Law Center in Philadelphia. [More]

CMS finalizes new Medicaid drug reimbursement rules

On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published final regulations in the Federal Register on Medicaid upper payment limits (UPLs) for covered outpatient drugs, as well as rebates that drug manufacturers must provide to states. State Medicaid agencies must take into account “average manufacturers’ prices” (AMPs) and other factors in calculating state Medicaid payments for covered outpatient drugs and dispensing fees to pharmacies that purchase medications, usually from wholesalers. Based on data in reports generated by state Medicaid agencies, drug manufacturers must calculate rebates to states under methods specified in the rule. [More]

States risk penalties for failing to meet data reporting requirements

PCG has an opportunity to counsel state Health and Human Services departments on how to reduce the financial risks of failing to meet extensive reporting requirements of the National Youth in Transition Database (NYTD).

Following the establishment of the John H. Chafee Foster Care Independence Program (CFCIP) at section 477 of the Social Security Act (SSA), the Administration for Children and Families (ACF) established requirements for allowing states to issue for the benefit of qualified youth a Chafee Foster Care Independent Living grant. [More]

Massachusetts Health Policy Commission issues 2015 Cost Trends Report

On January 20, 2016, the Massachusetts Health Policy Commission issued its “2015 Cost Trends Report,” pursuant to Chapter 224 of the Acts of 2012. The report contains comprehensive data on the Commonwealth’s health care spending across all private and public payers, detailed analyses of multi-year spending trends, and key insights about the strengths and weaknesses of the health care delivery system across Massachusetts’ communities. [More]