Call for papers for MMCC

We are pleased to announce 22nd annual Medicaid Managed Care Congress, taking place on May 20-22 in Baltimore. After dozens of conversations with industry experts, we’re ready to start recruiting speakers for the event! The agenda is currently under development, and we are currently looking for health plan and state government speakers who can speak to the following topics:

• Best practices for LTC
• Who is enrolling in exchanges and what their needs are, based on the services being used once coverage begins
• Examples of payment reform
• New care delivery models, including ACOs and PCMH
• Medicaid expansion
• Lessons learned from duals demonstrations
• Strategies to improve quality measurements

If you are interested in speaking on any of these topics, or would like to suggest another topic, please email, SGordon@iirusa.com, the Program Director for the event. If you would like to get in front of our audience of health plan executives working on exchanges, please contact Sarah Scarry at SScarry@iirusa.com for sponsorship and exhibition opportunities.

We look forward to hearing from you soon!

Cheers,
The MMCC Team

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Obama Administration Sets Final Rules Regarding Essential Health Benefits

This week the Obama Administration announced the final rules and guidelines insures must follow regarding Essential Health Benefits. The wait is over, and insures and states are one step closer to implementing a concrete plan for their federal and state health exchanges. The Affordable Health Care Act was created to help individuals choose a program that best suits their needs, however there have been questions on what types of coverage will be provided for both mental health and substance abuse.

The essential health benefits include ambulatory patient services; emergency care; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and rehabilitative services and devices; laboratory services; preventive and wellness services, and chronic disease management; and pediatric services, including dental and vision care. 


Want to learn more about the Healthcare Reform and How the Delivery of Healthcare Will Change? Government Programs Summit will take place in just a few weeks! It's not too late to register. To view our program, download our brochure.

As a reader of this blog, you get a 15% discount off the standard rate when using code XP1851BLOG to register here. We hope to see you March 11-13, 2013 in Baltimore, MD.

Many states are rushing to create a health insurance exchange

The results are in! Now that the election is over the states that chose to 'wait and see' are rushing to create a health insurance exchange. They must decide whether or not they want to create an online marketplace or allow the federal government to run it for them. Currently, there are only 15 states that have created a blueprint for an exchange, the rest have until next Friday to decide.

The election came just 10 days before a critical deadline for states in carrying out the law, and many that were waiting for the outcome must now hustle to comply. Such efforts will coincide with epic negotiations between Mr. Obama and Congress over federal spending and taxes, where the administration will inevitably face pressure to scale back some of the costliest provisions of the law.  Although they've had years to start drafting a plan for their state, many wanted to wait to see the outcome of the election. Those states will now be the ones that are working down to the wire to create an efficient health insurance exchange for their residents.

Want to learn more about the health insurance exchange? Join us next week, November 13-14 in Chicago, IL for the Health Insurance Exchange Congress.

Who can you meet at the 2nd Annual Health Insurance Exchange Congress

With the future of healthcare appearing in the news daily, you need to know what your company needs to do now so you can take advantage of new opportunities. There is a lot at stake and the timelines are tight. We invite you to join us at the 2nd Annual Health Insurance Exchange Congress, taking place on November 13-14th in Baltimore.

Don’t let your company fall behind. Join top executives from the following companies to take a tactical approach to developing and implementing a successful health insurance exchange. Make sure you reserve your spot today!

2012 Attending Companies:

A Health Care Market Research Service, Inc. * Aetna Inc. * Allergan Inc. * Amerigroup Corporation * Amylin Pharmaceuticals Inc. * Blue Cross Blue Shield * Boehringer Ingelheim Pharmaceuticals * bswift * California Technology Agency * CareSource * Catholic Health Initiatives * Cognosante LLC * Colorado Health Benefit Exchange * D-Wise Technologies Inc. * Dynamic Healthcare Systems Inc. * EngagePoint * Governor Chris Gregoire’s Executive Policy Office * Health Alliance Medical Plans * Health Care For All * Health Connector Authority * HealthLeaders InterStudy * Health Management Associates * HealthPass New York * Highmark * Maryland Health Benefit Exchange * Massachusetts Health Insurance Connector * Mathematica Policy Research * Navigant * New England States Collaborative for Insurance Exchange Systems (NESCIES) * NCQA * Novo Nordisk * Office of Inspector General * OpenView Consulting * OptumInsight * Oregon Health Authority * Quality Health Strategies * Rosetta * State of Connecticut * State of Oregon * State of Rhode Island * State of Utah * Total Medical Management * UnitedHealthcare - Community and State* University of Massachusetts Medical School * University of Pennsylvania * UPMC Health Plan * US Army * Wakely Consulting * Wake Forest University Medical School * Walgreens

Ready to join these companies?  As a reader of this blog, when you register to join us at the Health Insurance Exchange Congress this  November 13-14, 2012 in Chicago and save 15% off the standard rate when mention code XP1710BLOG! If you have any questions about the program, feel free to email Jennifer Pereira.

Health Insurance Exchange Roundup: September 1

Healthcare Exchanges are the hot topic in today’s healthcare landscape as well as national news. With states mandated to have a plan in place by January 1, 2013, and a functioning system by January 1, 2014, the majority are trying to figure how they will implement this system. Check here every afternoon for the latest opinions and news on the health exchange.

Here's today's news:

Fox Illinois: Few want state to run Illinois’ health-care exchanges  
WRDW-TV Augusta (Georgia): Gov. Haley says she will not apply for healthcare funds
LA Times: South Carolina Gov. Nikki Haley rejects health insurance exchange funds
The Bismark Tribute (North Dakota): Crowd gives mixed take on insurance exchanges
Peninsula Clarion (Alaska): State moving ahead with health exchange plan

The Health Insurance Exchange Congress is the only place for states and health plans to come together as one and discuss the current challenges and opportunities associated with health insurance Exchanges. For more information about joining us, visit our webpage.

Health Insurance Exchange Roundup: Wednesday, August 31

Healthcare Exchanges are the hot topic in today’s healthcare landscape as well as national news. With states mandated to have a plan in place by January 1, 2013, and a functioning system by January 1, 2014, the majority are trying to figure how they will implement this system. Check here every afternoon for the latest opinions and news on the health exchange.

Here's today's news:

Des Moines Register: Wellmark undecided on insurance exchange

Becker's ASC Review: Kansas Signs $135M Contract to Build Alternative to Health Insurance Exchange

Saint Louis Today: Missouri needs a strong health insurance exchange

The Greater Lansing Monthly Business: Major Healthcare Policy Changes: What Employers Need to Know

The Health Insurance Exchange Congress is the only place for states and health plans to come together as one and discuss the current challenges and opportunities associated with health insurance Exchanges. For more information about joining us, visit our webpage.

HHS releases clearer guidelines for exchanges

With January 2013 quickly approaching, the government released clearer guidelines that will help many consumers and patients participate in Healthcare Insurance Exchange models by way of promising tax credits and funding grants.

The government view this program as what should be a one stop shop for consumers to see what policies they are eligible for and tax credits they will receive upon enrolling in that specific program.  Small businesses and individuals will be able to work together in order to secure better rates along with the tax breaks they are eligible to receive.

The government also announced that 16 states and Washington, DC are receiving $185 million help build the exchanges.  Another desire of HHS is that all exchanges are required to have smooth connections between the state run and federal systems.  The New York Times reports that states have already received $50 million last year, and seven states received extra incentive as early innovators on the project.

The Healthcare Insurance Exchange Congress, taking place this November 9-11, 2011; will host an IT workshop entitled Examine the IT Infrastructure Requirements of Health Insurance Exchanges to examine how to identify how to create a user-friendly experience with the online health exchanges.  For more information on this program and the rest of the HIX Congress, download the brochure.

What are the other guidance do states need from HHS to move forward in establishing exchanges?

HHS Releases Proposed Regulations for Health Exchanges

Today, HHS released their proposed regulations for how states should run their health insurance exchanges as part of the PPACA. For 75 days, industry groups, consumer advocates, as well as the general public have the opportunity to comment on the draft before the government releases their final regulations. The 200+ pages outlines the rules that must be in place for each exchange, but the question remains: Will states and plans be ready in time?

With an estimated 24 million newly eligibles, we’ve heard of states and health plans scrambling to put together their strategies to comply with the federal law. Your best resource will be to attend the Health Insurance Exchange Congress where health plans, states and the federal government are addressing the opportunities and challenges presented by the implementation of Health Insurance Exchanges. You will learn key strategies from states and plans with existing exchanges and hear firsthand what works and what doesn’t.

Register online to join us today. Receive 25% off the standard registration rate with Priority Code XP1610BLOG when registering online.

To read the complete draft regulations, click here.

Government to start "Secret Shopper" Calls to Primary Physicians

With the new Affordable Care Act, Obama has promised more Americans access to primary care.  This puts a strain on the already stretched system where there aren't enough primary care physicians to treat the patients they are already seeing.  A problem has arisen where doctors are currently refusing to accept new patients from the government due to continual threats to reduce or stop payments for the Government patients.

In order to get a grasp on how many physicians are doing this, the government has announced a "Secret Shopper" program where they will be calling primary physicians to see if they can visit the doctor, confirming whether doctors will or will not take new patients from the government.  States with doctors scheduled to receive call according to the New York Times are Florida, Hawaii, Massachusetts, Minnesota, New Mexico, North Carolina, Tennessee, Texas and West Virginia.

How do you ensure your provider network is strong enough to handle a huge newly eligible population? Attend the Health Insurance Exchange Congress to learn strategies to ensure a sufficient choice of providers to consumers and include essential community providers that serve predominately underserved individuals.

Do you think doctors will receive this well?  What are some of the arguments that could be used to support both the US Government and the primary care physicians?

Texas Governor examining Healthcare Exchange

Governor Rick Perry of Texas is anti-Obamacare. This, however, won't stop his state from having to comply with the Health Insurance Exchange that has to be set up by 2014. While Gov. Perry and a few other Republican Governors are openly opposing healthcare reform (including the governors from Mississippi, Indiana and Wisconsin) they have begun to take the steps to create a Healthcare Exchange in their states. According to the New York Times, Perry believes that a state health insurance exchange is too broad for a state as large and diverse as Texas. He'd like to leave the decisions of healthcare up to local governments so policies can be catered to the local demographics and not just a generic "One Size Fits All" exchange.

At the Healthcare Insurance Exchange, taking place November 9-11, 2011, in Baltimore, Maryland, professionals in this space will come together for the panel debate Room for Debate: Understand the Political Undertone of Exchanges and the ACA where you can hear health plans and state and federal government officials debate as to whether or not this is legal.

Whether or not a state wants an exchange, all states need to comply with federal rulings. Do you think the quality of a state exchange will suffer if a state is “anti-Obamacare”?