Manatt Health

In June, #CMMI released a notice of funding opportunity for Innovation in Behavioral Health (IBH), a new eight-year model focused on adult #Medicaid and #Medicare enrollees with moderate to severe #mentalhealth conditions and substance use disorders. It will provide funding for states to work with #behavioralhealth practices to develop and implement new care delivery models, with a focus on care management, that aim to integrate physical health, behavioral health and health-related social needs (#HRSN). The IBH care delivery model must be accompanied by a #VBP methodology. Manatt's Mindy Lipson, Tracy Johnson, Ph.D. and Zoe Barnard explore key features of IBH and considerations for state Medicaid agencies: https://lnkd.in/euEYXhZQ

#CMS recently made a first set of announcements about states set to join the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. The goals of the model are to improve overall population health of a state or sub-state region, reduce health disparities, and curb health care cost growth, using hospital global budgets as a key lever. CMS is setting the default for how Medicare reimbursement will work under a global budget, but states have choices to make with how Medicaid will implement a similar strategy. Manatt's Lora Kim, Edith Coakley Stowe and Anne Karl provide an overview of the model and top considerations related to Medicaid here: https://lnkd.in/emf8GzxE

Collaboration between #primarycare providers and specialized #mentalhealth care providers allows services that were historically delivered separately to be delivered in the same setting and ensures a patient’s “whole-person” health needs are met during care delivery. The Collaborative Care Model, a team-based model of care delivery, is a promising integration model with a substantial evidence base. Manatt's Alex Morin and Sydney McClendon summarize key elements of the model and lessons learned from provider implementation in North Carolina: https://lnkd.in/e6a7Zrz7

Manatt's Tony Fiori and Nathan Pauly co-authored a research article for the Journal of Managed Care & Specialty Pharmacy examining health care resource use, outcomes and costs for #Medicaid beneficiaries with hemophilia B receiving factor IX prophylaxis therapy. To learn more, click here: https://lnkd.in/e_pwtk2t

On July 16, Manatt Health’s Edo Banach and Steven Chiu will join Bloom Founder and CEO Sherman Rogers for a conversation on #CMS’ #MedicareAdvantage final rule, where they will discuss some of the hard questions on the minds of payer-industry professionals, including: What does the 2025 final rule say? What does it actually mean? How will the final rule affect my 2025 annual enrollment period season? Where might CMS be headed next? Together, they will decode the language within the final rule and provide valuable insights that can be applied to the decision-making process this AEP and beyond. Learn more and sign up here: https://lnkd.in/erg628Hk

Listen to Manatt Health’s Eric Gold share his insights on the Steward Health Care bankruptcy on WBUR’s Radio Boston and read more in the accompanying article here: 

Manatt's Harvey Rochman was quoted in Health Plan Weekly on how the overturning of #Chevron deference may impact health care rulemaking moving forward. To learn more, click here:

In recent years, growing evidence of the positive effects of #nutrition interventions on health outcomes and costs has contributed to policy change at both the federal and state levels—which, in turn, is creating new opportunities for health and nutrition services organizations to work together to improve health through the delivery of Medically Supportive Food and Nutrition services. Manatt's Max Blumenthal, Edith Coakley Stowe and Hailey Davis highlight some of these opportunities here:

Manatt's Edo Banach was quoted in Hospice News about #CMS' planned implementation of the Accountable Care Organizations Primary Care Flex Model. To learn more, click here: https://lnkd.in/euiiUQ8y

#Artificialintelligence is changing the landscape of the health care industry. To date, litigation in this space has largely centered on the use of #AI by health care payers in making coverage decisions, but we are beginning to see hints of litigation impacting providers and #lifescience companies. The Texas Court of Appeals recently weighed in on questions of pre-suit discovery in one such case. Manatt's Megan Thibert-Ind and Rebecca Finkel explain why this case matters: