Contributor: Lyda Phillips
Topic: Exchanges, Medicaid, Utah

Utah is one of only two states with an operational health insurance exchange. One might think that would be put Utah ahead of the curve on exchanges under the Affordable Care Act.

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Contributor: Jane DuBose
Topic: Healthcare Reform, Medicaid, M&A, Medicare

At the beginning of 2012, HealthLeaders-InterStudy released an Executive Briefing outlining what we thought would be the 10 top trends for 2012. Now that we’re midway through the year, we have revisited those trends to see how clear our crystal ball was.
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Contributor: Bill Melville
Topic: Medicaid, healthcare reform

On the heels of the Supreme Court’s healthcare reform ruling, WellPoint’s planned acquisition of Amerigroup shook up the healthcare market. The move also brought a previous WellPoint purchase into better focus.

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Contributor: Ric Gross
Topic: Medicaid, healthcare reform

Political theater often bears striking similarities to the staged world of professional wrestling–zany characters, outlandish claims and over-the-top bickering. And in the weeks following the Supreme Court’s ruling to make Medicaid expansion optional, a full-fledged political battle is brewing between states and the federal government.
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Contributor: Chris Lewis
Topic: Pharmacy Benefits

How could the biggest pharmacy benefit manager in the country continue to exclude the nation’s biggest drug store chain from its network? As a former Walgreens customer, I was dismayed at first, but then I got over it and went on with my life. I had choices.
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Contributor: Betsy Dooley
Topic: Exchanges, Pharmacy Benefits, Medicaid

The multibillion-dollar question for the pharma industry is what kind of prescription drug coverage will be offered under the state exchanges. For states with strong Medicaid MCOs, all signs point toward aligning benefits more with the state’s Medicaid model than with Medicare or commercial benefits. The strongest rationale is that it would help with continuity of coverage for people dropping off Medicaid and going into an exchange plan or vice versa.

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Contributor: Jane DuBose
Topic: Dual-eligibles, Medicare, Medicaid

Managed care plans have long been part of the landscape of commercial health benefits and over the past decade have moved into Medicaid and Medicare programs. Now they are poised to conquer the dual-eligible world.
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Contributor: Ric Gross
Topic: Pharmacy benefits, Couponing

Massachusetts often prides itself on being a maverick. After all, the state implemented near-universal healthcare reform in 2006, when no other state was even considering such a move. At the same time, it enforced an individual mandate, now quite the catch phrase, but relatively unheard of at the time. And it took a hard stance against pharmaceutical companies, being the only state to maintain a circa-1988 law which prohibited the use prescription drug coupons. However, with a stroke of Gov. Deval Patrick’s pen, that domino has now fallen.
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Contributor: Laura Beerman
Topic: Accountable care organizations

Just over a week after the Supreme Court’s ruling to uphold the Affordable Care Act, the Centers for Medicare & Medicaid Services has announced 89 new shared-savings Medicare accountable care organizations, bringing the overall Medicare ACO total to more than 150. The new group of shared savings ACOs was already in the works and, with an official start date of July 1, 2012, it’s unlikely that the ruling would have nixed plans to launch these newest players. CMS reports that the 89 ACOs will include 1.2 million Medicare beneficiaries living in 40 states and Washington, D.C.

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Contributor: Sheri Sellmeyer
Topic: Medicaid, dual eligible, WellPoint

If you were looking for signs on whether or not states will choose to expand Medicaid, check out today’s announcement that WellPoint is acquiring Amerigroup, one of the largest Medicaid plans in the country.

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