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Wednesday, May 27 · 61 stories
- State Policy
States Implement National Family Caregiver Support Strategy Through Service Integration
States are implementing a national strategy to support family caregivers through enhanced services, protections, and care integration initiatives. The strategy focuses on better coordination between formal care systems and family caregivers who provide unpaid support to Medicaid beneficiaries. Implementation varies by state but includes caregiver assessments, respite services, and training programs. This matters for Medicaid MCOs because family caregivers are critical partners in long-term services and supports delivery, and better caregiver support can improve member outcomes while potentially reducing institutional care costs.
- Federal Policy
NASHP Hosts Rural Payment Reform Learning Session for States
The National Academy for State Health Policy (NASHP) is hosting a collaborative learning session on rural payment and delivery reform for state officials on Thursday, May 21 from 2-3 p.m. ET. The session will focus on innovative payment models and delivery strategies for rural healthcare providers. State Medicaid directors and managed care organizations operating in rural markets may gain insights into emerging payment reform approaches and delivery innovations that could inform future contract negotiations and provider network strategies.
- State Policy
State Medicaid Coverage of Certified Nurse Midwives Expands Maternal Care Access
States are increasingly using Medicaid reimbursement for certified nurse midwives (CNMs) to expand access to maternal care services and improve perinatal outcomes. This coverage strategy allows states to address provider shortages in maternal health while potentially reducing costs compared to physician-delivered care. The approach is particularly relevant for rural and underserved areas where obstetricians may be limited. For Medicaid managed care organizations, CNM coverage presents opportunities to expand provider networks and develop innovative maternal health programs while managing costs.
- Industry
FDA Extends Decision Deadline for AstraZeneca Breast Cancer Drug After Advisory Panel Opposition
The FDA has extended the decision deadline for AstraZeneca's experimental breast cancer pill following an advisory panel's negative vote on the drug's approval. The delay affects potential formulary decisions for Medicaid managed care organizations that cover cancer treatments. Medicaid MCOs should monitor the FDA's final decision timeline as it will impact prior authorization protocols and specialty pharmacy networks for oncology services. The extension creates uncertainty for health plans developing 2024 drug coverage policies.