On January 23, 2023, the Federal Communications Commission issued an important ruling that provides states with new flexibility to support enrollee outreach and communication efforts as part of their processes to unwind the Medicaid continuous coverage requirement. The ruling permits state agencies and their partners to send text messages and make phone calls to individuals about enrollment-related issues not only for Medicaid but for other state-run health insurance programs, including marketplace coverage. This expert perspective reviews the ruling and implications for states.
Reference Pricing: An Overview and Suggested Policy Considerations
Kayla Connor and David Cusano, Georgetown Health Policy Institute, Center on Health Insurance Reforms
Reference pricing is intended to reduce medical costs both for insurers and for purchasers of health care services, encouraging enrollees to obtain services from lower-cost providers and motivating higher cost providers to lower their reimbursement rates for those same services. This issue brief, prepared by the Georgetown Health Policy Institute’s Center of Health Insurance Reforms, provides an overview of this pricing method and federal guidance that has been issued to date. There are a number of factors that state and federal regulators should consider when reviewing plans that apply the pricing method, which are summarized in the issue brief, along with other policy considerations.