October 22 Update: Drug prices in TV ads; Medicaid population with serious mental illness; Rural context for adverse childhood experiences

The Centers for Medicare & Medicaid Services (CMS) proposed this week requiring drug manufacturers to include the price of drugs in television ads. Under the proposed rule, prescription drug manufacturers would be required to post the Wholesale Acquisition Cost for drugs covered in Medicare or Medicaid in direct-to-consumer television advertisements. Kaiser Health News has an article that details the proposal. Updates follow.

  • Illinois –  The Department of Insurance released its on-Exchange health care rate and plan analysis for plan year 2019 which shows that rates have stabilized for the first time in recent years. Average rates for the 2019 lowest cost silver plans decreased four percent and the lowest cost gold plans decreased by six percent from last year.
  • Minnesota –  MNSure, the state’s official health insurance marketplace, released a new online plan comparison toolthat consumers can use to compare plans in advance of open enrollment for 2019. The new tool will provide shoppers with the means to compare plan options, estimate cost, and financial assistance.
  • New York
    • Governor Andrew M. Cuomo announced the members selected to join the Task Force that will advise the state on its Hepatitis C Elimination Plan. The creation of the Task Force is the next step toward finalizing the Elimination Plan and builds on recommendations presented by community stakeholders at the New York State Hepatitis C Elimination Summit in 2017.
    • Three New York state agencies publicized the creation of a new program that will help New Yorkers access their insurance coverage for substance use disorders and mental health services. The Community Health Access to Addiction and Mental Healthcare Project will educate individuals, families, and health care providers on their legal rights to coverage, help them to access treatment and services and will investigate and resolve complaints regarding denial of health insurance coverage.
  • Oregon – The Oregon Health Authority (OHA) is developing contracts for the next five years of coordinated care for Oregon Health Plan members and is holding a technical forum to solicit public comments on how to best define service areas for current and potential new applicants. The forum will be held this coming Monday, October 22 and will also be live-streamed.
  • Pennsylvania –  Insurance Commissioner Jessica Altman announced the approval of 2019 individual and small group health insurance rates under the Affordable Care Act (ACA), highlighting rate decreases for many Pennsylvania consumers. The final approved rates for the individual market will result in an aggregate statewide decrease of 2.3 percent.
  • Virginia –  Governor Ralph Northam and the Medical Society of Virginia will host the Health Care Provider Opioid Summit in Roanoke on Saturday, which will bring together regional, state, and national experts to discuss how states, stakeholders, health care providers, and physicians can partner together to address this opioid epidemic.
  • Washington –  A public-private safe prescribing initiative, Better Prescribing, Better Treatment, has resulted in significant reductions in Medicaid (Apple Health) opioid prescriptions in less than a year, according to the partners involved in the initiative. The Washington State Health Care Authority issued a press release announcing that the initiative has reduced opioid prescriptions exceeding new state Apple Health program prescribing guidelines by nearly 70 percent and has reduced total Apple Health opioid prescriptions for acute (non-chronic) pain by nearly 30 percent.

Upcoming Webinar—Save the Date!

Safeguarding Financial Stability of Provider Risk-Bearing Organizations

Tuesday, October 23, 2018 3:30 to 4:30 pm ET

An increasing number of provider organizations are entering into risk-based contracts with payers where they are accepting the financial risk of care. This financial liability is often shared with payers, and maximum risk exposure is typically capped. SHVS is hosting a webinar that will explore state options for regulating provider risk-bearing organizations. During the webinar, technical experts from Bailit Health will review approaches states could take to overseeing their risk-bearing organizations and highlight examples from states that have elected to regulate to protect against provider insolvency.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e6b147943035f6608768d09afd4a2c562

Using Data to Better Understand the Medicaid Population with Serious Mental Illness

The Medicaid Innovation Accelerator Program (IAP) just released a new technical resource, Using Data to Better Understand the Medicaid Population with Serious Mental Illness (SMI), which outlines preliminary steps that state Medicaid agencies can use to identify Medicaid adult beneficiaries with SMI. The resource can help state agencies gain a better understanding of this population to inform future decision-making and provides examples of potential data outputs that can be replicated using a state’s Medicaid claims and encounters data.

Exploring the Rural Context for Adverse Childhood Experiences

The National Advisory Committee on Rural Health and Human services will host a webinar on October 29 that will examine the rural landscape of adverse childhood experiences (ACEs) and explore the role that health and human services play in mitigating and preventing ACEs and their related outcomes. The webinar will also feature a community and grassroots rural initiative developed in upstate New York, and highlight the Committee’s policy recommendations to the Secretary of the Department of Health and Human Services.

Health Care in America: The Experiences of People with Serious Illness

The Harvard T.H. Chan School of Public Health, the New York Times, and the Commonwealth Fund recently published findings from a survey they conducted examining the experiences of Americans with serious illness. Through the survey, the authors note the emotional and financial burdens these individuals and their families often face when seeking care and highlight key themes related to health insurance coverage, care coordination, experiences in both hospitals and physicians’ offices, and how their illness has impacted their life overall. The authors also recommend strategies policymakers can implement to improve the U.S. health care system and better meet patient needs.