By most accounts, the biggest winner of the U.S. midterm elections was Medicaid Expansion. On November 6, 2018, three states passed ballot measures to expand Medicaid, while the residents of two other non-expansion states voted in Democratic governors in favor of expanding Medicaid. This recent overt display of support for expansion comes on the heels of a number of additional states that have reconsidered, and expanded, Medicaid. (Read more...)  

On October 25, 2018, the Trump Administration released a proposed plan to modify the Centers for Medicare & Medicaid Service s (CMS) Medicare Part B payment model in an effort to control pharmaceutical spending, employing an International Pricing Index (IPI) model in contrast to the current model. Major concerns provoking the payment model adjustment include the considerable amount that Medicare spends on drugs, as well as the relatively low costs that other countries pay for the same drugs. (Read more...)  

On October 22, 2018, the Department of Treasury and the Department of Health and Human Services (HHS) released new proposed guidance regarding Section 1332 of the Patient Protection and Affordable Care Ac t (ACA), allowing states more flexibility than previous guidelines to lower premiums and increase choices for their health insurance markets. Section 1332, also known as a State Innovation Waiver or State Relief and Empowerment Waiver , permits a state to waive certain requirements of the ACA in order to pursue innovative strategies, with approval from the Secretaries of HHS and Treasury.  (Read more...)  

Demand for dialysis services is likely to increase significantly in the near future, primarily as a result of: (1) the increasing life expectancy for ESRD patients; (2) the disease-specific entitlement to Medicare coverage for ESRD patients, regardless of age; and, (3) the changing demographic trends in the U.S. From 2015 to 2016, the number of Medicare beneficiaries receiving dialysis treatments increased by one percent, while the number of dialysis treatments provided to Medicare beneficiaries, increased by approximately three percent. (Read more...)  

(Excerpted from November 2, 2018 Special Alert)

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) finalized the calendar year (CY) 2019 Medicare Physician Fee Schedule (MPFS), the Hospital Outpatient Prospective Payment System (OPPS), and the Ambulatory Surgical Center (ASC) Payment System . The finalized rules generally remained unchanged from their proposed versions, with a couple of exceptions.
Advanced Distance Education to Launch in 2019

The  Institute for Healthcare Valuation  (IHV) &  Consultants' Training Institute  (CTI) are pleased to announce premier healthcare valuation training through a distance education program, the Certificate of Educational Achievement (CEA) for Advanced Education in Healthcare Valuation. The program will launch in 2019 and will bridge the interdisciplinary nature of healthcare valuation to include: the Four Pillars of Healthcare (regulatory, reimbursement, competition, and technology); the market forces shaping the U.S. healthcare industry; and the valuation of healthcare enterprises, assets, and services. Legal professionals and healthcare providers, as well as those wishing to expand their scope of activities in healthcare valuation engagements and those seeking to enhance their current healthcare valuation service lines, will gain comprehensive knowledge through completing the expansive program. The program has been developed and is being presented by industry thought leader Health Capital Consultants , alongside a blockbuster faculty of healthcare subject matter experts from the legal, federal regulatory, and valuation professions.

HCC President, Todd Zigrang , and Vice President and General Counsel, Jessica Bailey-Wheaton , were recently interviewed by the National Association of Certified Valuators and Analysts (NACVA) , where they discussed the development of the distance education program along with the topics that will be covered. Click HERE to watch the entire interview.
HCC President,  Todd Zigrang , and HCC Vice President and General Counsel  Jessica Bailey-Wheaton , will be presenting on the topic of "Healthcare Reform In the U.S."

For More Information or to Register  CLICK HERE

To register for the Online Broadcast  CLICK HERE
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Health Capital Topics is a monthly e-journal written and published by the healthcare experts at Health Capital Consultants, featuring timely topics related to the reimbursement, regulatory, technology, and competition environments of the U.S. healthcare system.

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