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Healthsperien Summary Available: Prior Authorization and Interoperability Final Rule

Healthsperien released its comprehensive summary of the Centers for Medicare and Medicaid Services’ (CMS) Advancing Interoperability and Improving Prior Authorization Processes final rule, which applies to Medicare Advantage (MA) organizations, Medicaid and CHIP fee-for-service (FFS) programs, Medicaid managed care plans, Childrens Health Insurance Program (CHIP) managed care entities, and qualified health plans (QHPs) on federally facilitated exchanges (FFEs). 

Read the Summary.

Healthsperien and UHC Publishes New Report on Advancing Technology in Medicaid

The role of technology within the Medicaid program is at an inflection point. The time is now for state Medicaid programs to work with their stakeholder partners, including managed care organizations (MCOs), and intentionally integrate the full capabilities of technology solutions as part of a broader concerted strategy to advance program goals.

United Healthcare and Healthsperien recently released a report, Advancing technology to meet the greatest challenges in Medicaid: access, workforce, and equity. The paper explores how states can advance technology within their state Medicaid programs to address challenges related to ensuring access to coverage, addressing workforce shortages, and promoting health equity.

Download the Report.

Healthsperien Supports a New Report Published by the MLTSS Association Addressing Direct Care Workforce Issues 

The National MLTSS Health Plan Association (MLTSS Association), with support from the Healthsperien policy team, published a report capturing emerging best practices for managed long-term services and supports (MLTSS) plans and providers to address the shortage of direct care workers (DCWs) who provide care to older adults and individuals with disabilities served by MLTSS plans. While workforce shortages have been a longstanding issue in the long-term care industry, the COVID-19 pandemic heightened the challenges and the current crisis. The report examines issues and innovations across five domains: recruitment; retention; data collection, monitoring and evaluation; workforce alternatives; and elevating the social value of direct care workforce’s impact. Across each of these themes, policy recommendations were identified for how state and federal lawmakers can facilitate and scale these practices more broadly, as well as opportunities to incorporate informal caregivers, technology, and flexible funding models to support innovation. 

Read the report here

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