State Health Policy Blog
Colorado Develops New Payment Method for Physician-Administered Drugs – with the Potential to Save Millions
The National Academy for State Health Policy (NASHP) provided a grant to the Colorado Department of Health Care Policy and Financing to develop a new payment methodology for physician-administered drugs (PADs). PADs are drugs delivered by intravenous infusion or injection in clinical settings. The category includes costly drugs, such as chemotherapy and other specialty medications. […]
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How the President’s Proposed Budget Impacts Critical State Health Programs
The President’s 2020 budget request proposes a 12 percent reduction in the US Department of Health and Human Services (HHS) budget, compared to 2019 federal fiscal year (FFY) funding levels. The following highlights some of the key components of the President’s proposed $87.1 billion HHS budget proposal that could impact state health programs. Affordable Care […]
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Highlights of States’ ‘Surprise’ Medical Balance Billing Laws
Surprise balance bills occur when patients receive unanticipated charges for health care services because they were unaware that care was delivered by an out-of-network provider or facility. In some cases, surprise balance bills can amount to hundreds if not thousands of dollars in medical expenses. A growing number of states have passed or are proposing […]
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State-based Exchange Directors Share their Marketplace Successes with Congress
On March 5 and 6, 2019, state-based exchange directors convened in Washington, DC for peer-to-peer discussions and meetings with Congressional staff and federal officials, hosted by the National Academy for State Health Policy (NASHP). The meeting has become an important annual event for the state-based exchanges – which provide the infrastructure, websites, and customer support […]
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Considerations for States Crafting Budgets to Support Children’s Coverage
After months of uncertainty and a three-month federal funding lapse, in early 2018 Congress passed the HEALTHY KIDS and ACCESS Acts, which appropriated federal funds for the Children’s Health Insurance Program (CHIP) through federal fiscal year (FFY) 2027. While the HEALTHY KIDS and ACCESS Acts’ long-term funding stabilizes CHIP programs and helps states develop forward-focused […]
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Oregon’s Accountable Health Model Addresses Health Equity and Health-Related Needs: Four Lessons from CCO 2.0
States developing accountable health models often look to Oregon for inspiration. Oregon established its Coordinated Care Organizations (CCOs) in 2012, pursuant to a Medicaid Section 1115 demonstration waiver. CCOs are local networks of all types of health care providers — including physical, behavioral, and oral health providers — that the state pays a global capitated […]
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Hospital Price Transparency: The Next Frontier
The Centers for Medicare & Medicaid Services (CMS) took an important first step toward increasing the transparency of hospital finances when it required hospitals to post their charge information, effective January 2019. But, these charges are not prices paid — they are typically the starting point against which commercial payers negotiate discounts. States with all-payer […]
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What’s Brewing with Medicaid Expansion?
With many new governors in office and state legislatures in session, policymakers in nearly all of the 14 states that have not implemented the Affordable Care Act’s Medicaid expansion are considering various proposals to broaden coverage on their own terms. Additionally, states that recently expanded Medicaid through ballot initiatives are taking different approaches toward implementation, […]
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Montana Explores a New Approach to Regulating Pharmacy Benefit Managers
State legislatures across the country continue efforts to address the opaque business practices of pharmacy benefit managers (PBMs) to protect consumers and lower prescription drug prices. Montana is taking a new approach by leveraging its insurance department’s regulatory authority over insurance carriers by proposing a bill that tasks insurers with responsibility for overseeing that PBMs […]
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The State of States: How Governors Plan to Address Health-Related Social and Economic Factors in 2019
Governors’ state of the state and inaugural addresses provide critical insights into their policy proposals that impact the health of their residents. Last week, the National Academy for State Health Policy (NASHP) highlighted the health care issues governors raised in their 2019 addresses. This week, NASHP examines the social and economic issues raised – such […]
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