For justice-involved individuals, the lack of solid community-based relationships is among the most significant social determinants of poor health. Katharine London and Meaghan Dupuis share the benefits of collaborative relationships between health plans and community-based service organizations in this blog.
Marc Thibodeau, Director of Health Care Finance Solutions, explores the strengths and benefits of establishing a Medicaid-university partnership, and how doing so can help both parties achieve their cost and quality goals.
ACOs and CBOs: Don’t get lost in the gap! Process improvement expert Jessica Carpenter explains how the gap between your organization’s policies and everyday practices is where efficiency and compliance can fall or become lost. Read Jessica’s blog to learn the three key steps to achieve process improvement and deliver better results on a more consistent basis.
Even though most Medicaid Accountable Care Organizations (ACOs) are not responsible for the cost of dental office visits, they can still improve patient care and reduce their costs by focusing on oral health. Find out how in this blog post from Senior Associate of Health Law & Policy Rachel Gershon.
Want to know key facts about MassHealth, the Massachusetts Medicaid program that covers over 1.8 Million members? Read this blog to learn the three major themes of a Blue Cross Blue Shield Massachusetts Foundation report from our Health Law & Policy experts.
If Managed Care Organizations & Accountable Care Organizations invested in school nutrition programs now to ensure lunches are up to Health Hunger-Free Kids Act standards, it may cut healthcare costs tomorrow. Andrew Falacci blogs on the importance of instilling healthy eating habits in youth to “avoid costs and poor health in the future."
Would ending some drug rebates for PBMs lower list prices and patient out-of-pocket-costs? Our pharmacy experts Mckenzie Taylor & Stephanie Tran explore a proposed rule from the Department of Health and Human Services that would change the Medicare & Medicaid pricing system.
Pharmacists play a vital role in the patient care process that is often overlooked. Clinical pharmacy expert Ashley Chiara blogs about how they connect the dots between prescribers and patients, impacting clinical and economic outcomes.
Comprehensive care for children – including greater attention to behavioral health, socio-emotional development, and strong family relationships – may hold the key to lifelong health and well-being.
Prohibiting gag clauses could help lower consumer out-of-pocket pharmacy costs - if Pharmacy Benefits Managers don't raise prices to make-up the difference. Mylissa Price closes our blog series on President Trump's Blueprint to Lower Drug Costs in this final entry.
Decoding the critical differences between state Medicaid programs can be a frustrating task for policymakers & researchers alike. Health policy expert Rachel Gershon simplifies things by shedding light on helpful informational resources in a new blog post.
The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs calls for incentives to lower drug list prices, including removing rebates. Our clinical consultant Stephanie Tran continues our pharmacy blog series with an assessment of this potential change & its impacts.
Director of academic programs for the Health and Criminal Justice Program Warren Ferguson, shares the story of how he collaborated with Criminal Justice health experts from UMass Medical School & the Tufts Medical School to develop the first required curriculum on correctional health in the United States.
The health of vulnerable populations in Massachusetts, including children, could be affected by a proposed update to the Public Charge Rule. Senior Policy Analyst John Moreschi blogs about the impact as outlined in his issue brief for the Blue Cross Blue Shield of Massachusetts Foundation.
New Trump Administrations Section 1332 waiver guidance increases state ACA flexibility. Rachel Gershon & Catie Torri discuss what this could mean for health care policy.
Mckenzie Taylor continues our monthly conversation on the strategies presented in The Trump Administration Blueprint to Low Drug Prices and Reduce Out-of-Pocket Costs, discussing the ways new negotiations between payers and manufacturers are helping to reduce drug prices.
Community Health Workers have a unique understanding of the language, culture, and needs of the communities they serve. Our Jeremy Tourish and Enid Vélez believe they could be key in making a dent in the over $400 billion spent on childhood asthma and adult diabetes each year.
In this installment of our blog series on "President Trump's Blueprint to Lower Drug Prices and Reduce Out-Of-Pocket Costs," our pharmacy expert Youkavet Samih discusses how creating drug competition drives down prices for consumers.
After decades of struggle, workers with disabilities are beginning to move the needle, outpacing the employment gains of people without disabilities. Kathleen Petkauskos discusses this historic shift, and how employers around the country are taking notice of the benefits that come with hiring workers with disabilities.
Jessica Carpenter discusses the importance of crafting a utilization management plan when developing an efficient managed long-term services and supports program, and explains how this can lead to substantial cost savings for state Medicaid programs.
Bonnie Greenwood, PharmD, BCPS, gives an overview of the Trump Administration's blueprint to tackle the issue of rising drug costs in the United States, part of a new blog series in which our pharmacy team will address each strategy and its progress to date.
Jody Simpson of Disability Evaluation Services synthesizes the complex process of performing a comprehensive medical review and shares how the DES onsite team of 75 licensed clinical professionals can support public retirement systems throughout the medical review process.
Jay Flanagan of the Southern New England Practice Transformation Network joined clinical experts from across the country at the CMS Transforming Clinical Practice Initiative 2018 National Expert Panel to answer the question “What does an exemplary clinical practice look like?”
Senior Director of the Health and Criminal Justice Program, Julie White discusses the concerning state of criminal justice in the United States today. With over 2.2 million people incarcerated, she believes new approaches to criminal justice are imperative for creating safer communities and reducing rates of crime.
Over two million Americans are in either federal or state prison or local jail facilities. Despite this high population, the attention paid to the quality of the medical care inmates receive is often minimal. Dyana Nickl discusses the areas for improvement she sees in how health care is delivered in our nation's correctional facilities.
Some of the Commonwealth’s most underserved populations—the elderly, people with disabilities and their caregivers— now have simplified access to the long-term services and supports (LTSS) they need, thanks to MassOptions, an innovative collaboration between UHealthSolutions, the nonprofit business affiliate of UMass Medical School, and the Massachusetts Executive Office of Elder Affairs.
Regional Operations Director of the Health and Criminal Justice Program, Robert Delanders implores lawmakers to take a closer look at the quality of healthcare for women in the correctional setting and shares the proven positive effects improved care and increased visitation has had on inmate health and recidivism.
Jay Flanagan of the Southern New England Practice Transformation Network shares how optometry practices across the country are saving thousands of dollars in healthcare costs by giving patients a more affordable alternative to the emergency room for eye emergencies.
Warren J. Ferguson shares his experience and thoughts on presentations and discussions that took place at the 11th Academic and Health Policy Conference.
Jessica Carpenter, Senior Director of Disability and Community Services, explains the history of Pre-Admission Screening and Resident Review and gives a brief overview of it's processes.
Skilled nursing facility use has declined, but the number of beds has not dropped at the same rate. Rebecca Laes-Kushner discusses this issue of "over-bedding" and how Medicaid agencies can act now to lower costs by maximizing policies that eliminate unneeded beds.
Ongoing quality management and review of disability benefit evaluation processes and procedures is critical for state and municipal retirement systems. Working with a partner skilled in assisting organizations with all aspects of medical review needs can ease the burden, says Jody Simpson of Disability Evaluation Services.
Building a successful Long Term Services and Support program starts with creating strong clinical guidelines, says Jessica Carpenter, Senior Director of Disability and Community Services. The goal is ensuring individuals receive the right service, in the right setting, and at the right time.
Robert Seifert of the Center for Health Law and Economics discusses the Indiana Medicaid Waiver, which was recently approved for a three year extension by the federal government.
Extensive evidence shows that Community Health Workers (CHWs) can help health systems meet the triple aim: improve population health, improve quality of care and contain costs, while also promoting health equity and community engagement. Katharine London discusses how new payment methods and delivery system reforms give health care providers flexibility to provide sustainable funding for CHWs.
Kentucky’s 1115 Medicaid Waiver, approved by CMS on January 12, 2018, uses small financial incentives and punishments to try to change the behavior of enrollees. Rebecca Laes-Kushner explains this new Medicaid setup.
Disability evaluation can be a challenge for state and municipal retirement system administrators. Jody Simpson of Disability Evaluation Services explains how Commonwealth Medicine, UMass Medical School is uniquely equipped to help support systems through all components of the medical review process.
Jessica Carpenter discusses why states should guarantee contracts for Managed Long-Term Care plans include requirements for policies, guidelines, and processes that will provide the appropriate services to members, manage utilization, and ensure the state’s funding is used appropriately.
As the elder population continues to grow, it becomes more important to consider the future of health care. By 2050, the population over the age of 65 will double and the population over the age of 85 will triple; and many will need long-term services and supports (LTSS).