Please see the following information regarding availability of travel reimbursement f0r State staff attending the MESC 2016.

TYPES OF REIMBURSEMENT

  1. Poster Session Participant – Each state selected to participate in the Poster Session is eligible for reimbursement of the costs directly related to the MESC for one (1) state employee. Complete a MESC 2016 Reimbursement Form and a UMW9 Form.
  2. HITECH 90/10 Funding – States with available HITECH funds available are eligible to receive a ten percent (10%) reimbursement up to one thousand dollars ($1,000.00) per state reimbursement for costs directly related to the MESC. Complete a MESC 2016 HITECH Funding Reimbursement Form and a W9 Form.
  3. NESCSO Member States – Each New England NESCSO member state is eligible for reimbursement of costs directly related to the MESC for two (2) state employees. Complete a UMass Non-Employee Reimbursement Form and a UMW9 Form.

REIMBURSEMENT GUIDELINES FOR THE MEDICAID ENTERPRISE SYSTEMS CONFERENCE 2016 Final

033016 NESCSO Member State – Nonemployee reimbursement voucher 033016

NESCSO Nonemployee reimbursement voucher 041216

MESC 2016 90-10 Funding Reimbursement Request Form 033016

UMW-9

FOR IMMEDIATE RELEASE

September 19, 2016

Contact: Jennifer Rosinski

508-421-5869

Jennifer.rosinski@umassmed.edu

 

 For the first time, a regional effort is underway to analyze the cost of dispensing prescriptions to Medicaid beneficiaries. The New England States Consortium Systems Organization (NESCSO), a non-profit organized by the health and human service agencies of the New England states and UMass Medical School, has partnered with the accounting firm of Myers and Stauffer LC to survey pharmacies in the region.

State Medicaid agencies are being directed by the federal Centers for Medicare and Medicaid Services (CMS) to review the way they pay pharmacies for dispensing medications. New rules released in January require states to adopt fee-for-service pharmacy payment policies designed to pay pharmacies for the cost of acquiring the drugs as well as an additional professional dispensing fee. The results of this New England survey will help each state’s Medicaid program determine an appropriate professional dispensing fee.

Surveys are being distributed to Medicaid-enrolled pharmacies across New England in early September. Pharmacies will have approximately four weeks to complete the survey and return it to Myers and Stauffer. Independent pharmacies will receive surveys in the mail and most chain pharmacies will coordinate survey distribution through corporate or regional offices. Pharmacies will be able to learn more about the surveys by signing up for telephone and webinar presentations.

Submitted surveys will be reviewed and analyzed by Myers and Stauffer. A report and presentation of the survey results will be shared with NESCSO and participating state Medicaid programs.

NESCSO is managing and contracting this regional project through its relationship with UMass Medical School’s Commonwealth Medicine division on behalf of the departments of health and human services within New England.

About NESCSO

The New England States Consortium Systems Organization (NESCSO) is a non-profit corporation organized by the New England state health and human service (HHS) agencies and the University of Massachusetts Medical School. NESCSO’s Board is composed of the member states’ HHS secretaries or their designees. NESCSO’s mission is to foster communication and collaboration among its members through information sharing and joint projects. NESCSO seeks to support the needs of the state HHS Secretaries by providing a framework for knowledge exchange in order to maximize policy, program and cost effectiveness.

Annually NESCSO convenes the Medicaid Enterprise Systems Conference and markets “MAGI in the cloud” for states to use in determining income eligibility under the Affordable Care Act.

About Myers and Stauffer LC

Myers and Stauffer LC is a Certified Public Accounting firm with 18 offices nationwide and over 700 employees. The firm is strongly focused on assisting government health care agencies with audit, rate-setting, program integrity, consulting and other support services. Since the late 1970’s, Myers and Stauffer has performed over 100 Medicaid pharmacy cost of dispensing surveys in more than 20 states. The firm is also a leader in assisting state Medicaid programs with pharmacy reimbursement based on actual acquisition cost. In addition to working with state Medicaid programs directly on actual acquisition cost reimbursement, Myers and Stauffer has been the contractor to CMS since 2011 to develop and maintain the National Average Drug Acquisition Cost (NADAC) benchmark.

About the University of Massachusetts Medical School

The University of Massachusetts Medical School, one of five campuses of the University system, is comprised of the School of Medicine, the Graduate School of Biomedical Sciences, the Graduate School of Nursing, a thriving research enterprise and an innovative public service initiative, Commonwealth Medicine. Its mission is to advance the health of the people of the Commonwealth through pioneering education, research, public service and health care delivery with its clinical partner, UMass Memorial Health Care. In doing so, it has built a reputation as a world-class research institution and as a leader in primary care education. The Medical School attracts more than $249 million annually in research funding, placing it among the top 50 medical schools in the nation. Commonwealth Medicine provides a wide range of care management and consulting services to government agencies and health care organizations.

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NESCSO is pleased to co-sponsor the annual CTC-RI Learning Collaborative to help share information across the region. Follow the link to download the meeting flyer: CTC-2016 Learning Collaborative Flyer 091916.

When:

Thursday, October 20, 2016

7:30 a.m. – 12:00 noon Morning Session;

1:00 – 5:00 p.m. Using Data to Increase Value

Location:

The Radisson Hotel

2081 Post Road

Warwick, RI 02886

Additional Information:

For more information please contact the RI Care Transformation Collaborative at CTCRI@umassmed.edu

On October 15, 2016 NESCSO, in partnership with the New Hampshire Department of Health and Human Services and the Milbank Memorial Fund, hosted a forum on the current state and potential future of our region’s hospitals.  Participants included the New England HHS Secretaries and Commissioners, State Legislators, and NESCSO Board representatives.

The forum focused on:

  • Hospitals as they are major economic drivers, federal and state budget items, and assets in our communities.
  • The passage of the ACA, state budget pressures, and other policy reforms which have heightened the focus on their various roles and altered the environment within which they operate.
  • Providing a better understanding of the trends in the hospital operating environment and levers available to policymakers.
  • A primary goal of the meeting was to provide participants with a deeper understanding of the various ways in which hospitals are responding to these pressures and the ways state governments can impact the direction in which hospitals are moving.

Presentations and a white paper authored for the forum are available below:

Hospitals in the Post-ACA Era: Impacts and Responses (PPT) Gary Young 101516

Healthcare in Northern New England (PPT) Richard Slusky 101516

Deeper Dives into Regional Aspects: MA and Southern New England (PPT) David Seltz 101516

White Paper: Hospitals in the Post-ACA Era Impacts and Responses White Paper 101516

The Institute for Clinical and Economic Review (ICER) has released a Final Evidence Report and Meeting Summary titled Diabetes Prevention Programs: Comparative Clinical Effectiveness and Value. The Final Report reviews the comparative clinical effectiveness and value of CDC-recognized diabetes prevention programs (DPPs) and provides an in-depth review of the policy landscape for these interventions. The report includes a summary of votes taken during a public meeting of one of ICER’s core programs, the California Technology Assessment Forum (CTAF), as well as key policy recommendations stemming from discussion with a panel of experts during the meeting.

A key goal of ICER’s reports is to ensure that patients, providers, insurers, and policymakers have the information they need to support efforts to improve the quality and value of care. The Final Report is accompanied by an Action Guide, which highlights the report’s policy recommendations and provides external resources to support their implementation.

“Type 2 diabetes is a major health concern for patients and our health care system,” Steven D. Pearson, MD, MSc, President of ICER, reflected. “There are different approaches to designing and implementing programs to prevent diabetes, and we believe that the evidence review and policy recommendations in our Final Evidence Report will help guide health systems and other stakeholders in figuring out how to move forward based on the strongest evidence of effectiveness and overall value.”

The report reviews the evidence on three key DPP delivery models that were developed to improve the scalability of the individual, in-person counseling intervention studied in the original DPP clinical trial. The CTAF Panel took votes on each of the three models: in-person programs with group coaching, digital programs with human coaching, and digital programs with fully-automated coaching.

In-person, group coaching

The CTAF Panel voted unanimously that in-person programs with group coaching have a net health benefit that is superior to that of usual care. Panel members noted that weight loss is an appropriate indicator of program success, and that even a relatively short, two-year delay in the onset of diabetes is meaningful and important to patients. When voting on the care value, a measure which incorporates comparative clinical effectiveness, incremental costs per outcomes achieved, contextual considerations, and added benefits or disadvantages of the intervention, a majority of members voted for a high value.

Digital, human coaching

A majority of Panel members voted that digital programs with human coaching offer a net health benefit superior to that of usual care. Half of the members determined that these programs represent an intermediate care value, primarily because of uncertainty due to the existence of fewer, lower-quality studies of this approach. This uncertainty was balanced with the potential advantages of this model for participants, including increased access to DPPs in geographic areas that have few in-person programs and the flexibility to access lessons on-demand.

Digital, fully-automated coaching

A majority of the Panel voted that evidence is not adequate to demonstrate a net health benefit of digital DPPs with fully-automated coaching due largely to an absence of long-term studies of program efficacy. The panel emphasized that the model may have potential benefits, including high scalability, but noted that further study is required to conclusively demonstrate that the model is as effective as programs with human coaches.  Due to the “no” vote on clinical effectiveness, a value vote was not taken.

Following the votes on the evidence, the CTAF Panel was joined by a policy roundtable of experts in the field, including a patient representative who had previously participated in a DPP, payer representatives, and experts in clinical practice and public health. Based on this discussion, a number of key policy recommendations emerged. These recommendations are summarized briefly below and are explained in greater detail in the full report.

  • Payers are encouraged to cover CDC-recognized DPPs in a variety of formats across all plans with no copay. Payers should establish pay-for-performance contracts with DPP providers based on patient participation, retention, and weight loss.
  • Clinicians should screen eligible patients for prediabetes using established clinical measures. When prediabetes is identified, clinicians should immediately refer patients to a local or digital DPP.
  • DPP Providers should apply for CDC recognition for their programs, and should tailor their programs to include culturally-appropriate curricula for diverse populations. DPP Providers should collaborate with payers in developing pay-for-performance reimbursement strategies.

The Final Evidence Report and Meeting Summary, which includes a detailed explanation of all of the policy recommendations, is available on the ICER website. The Final Evidence Report is accompanied by an action guide that provides resources to support implementation of the policy recommendations. A full video recording of the June 24, 2016 meeting is also available on the website.

Medicaid is now the largest coverage plan in the US, consuming almost 20% of state budgets and straining health systems. CSG-ERC states are leading the nation in driving innovative Medicaid reforms. This meeting of state health policymakers from across the region will allow in-depth discussions with policy experts and leading states about opportunities, challenges and lessons learned.

Date: June 29 — 10 am to 4 pm

Where: Massachusetts State House, Boston, Room 428

Speakers:

  • Medicaid Value-based Purchasing in the states, Marge Houy and Megan Burns, Bailit Health Solutions
  • System support for state Medicaid programs, Elena Nicolella, NESCSO
  • MassHealth Accountable Care Organization Planning, Daniel Tsai, Assistant Secretary for MassHealth

Click here for the flyer and registration directions: flyer-dft-copy

Opioid Crisis: Thinking Outside the Box  

Opioid abuse has risen to epidemic proportions in Massachusetts and across the nation. There are evidence-based interventions and new federal and state policies aimed at ameliorating the crisis, yet the mortality rate remains extraordinarily high. This Forum will focus on innovative harm reduction strategies, approaches to racial and ethnic disparities in access to treatment, and state-of-the-art prevention and early intervention programs.

Presented by

William James College

Tuesday, April 5, 2016

8:30 am – 12:30 pm

Back Bay Events Center, Boston

Registration is required 

Register Here!

OC16 | 4 CE credits | $75. Recovery Coaches & Recovery Specialists | $37.50 Graduate Students, General Public, Other Professionals | No CE Credits | FREE
Pre-Registration is REQUIRED | Seating is limited.

Program

Opening Remarks

Marylou Sudders – Secretary, Executive Office of Health and Human Services

Keynote Speakers 

  • Carl Hart, PhD – Associate Professor of Psychology in the Departments of Psychiatry and Psychology at Columbia University, and Director of the Residential Studies and Methamphetamine Research Laboratories at the New York State Psychiatric Institute
  • Andrew Kolodny, MD – Chief Medical Officer of Phoenix House; a senior scientist at the Heller School for Social Policy and Management at Brandeis University; a research professor at the Global Institute of Public Health, New York University and Executive Director and co-founder of Physicians for Responsible Opioid Prescribing (PROP)

Moderator

  • Martha Bebinger – WBUR reporter and expert in communications on the opioid crisis

Panelists 

  • Leonard Campanello – Chief of Police, Gloucester, Massachusetts
  • Jessie M. Gaeta, MD – Chief Medical Officer, Boston Health Care for the Homeless Program Assistant Professor of Medicine, Boston University School of Medicine
  • Haner Hernández, PhD, CADAC II, LADC I – Brown University’s Center for Alcohol and Addiction Studies
  • Mary McGeown – President and CEO, Massachusetts Society for the Prevention of Cruelty to Children
  • Joanne Peterson – Founder and Executive Director, Learn to Cope, Inc.

Closing Remarks

  • Charles D. Baker – Governor of the Commonwealth of Massachusetts