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CEO Update | 50

CEO Update | 50

Centene Will Acquire WellCare for $17.3 billion
Centene Corp. will acquire WellCare Health Plans, Inc. for $17.3 billion in a deal the two companies announced this week will create a new venture focused on government-sponsored healthcare programs that will have about 22 million members across all 50 states and combined revenue of about $100 billion.

News outlet Politico reported that while Centene’s major focus is Medicaid managed care—where it had about 14 million members at the end of 2018—the health insurer has also emerged as a significant player in the Obamacare markets, with about 2 million members across 21 states, or nearly one in five exchange enrollees nationwide, at the start of this year. In 2016, Centene acquired Health Net, another Medicaid managed care plan, for $6.3 billion.

Centene and WellCare said in a joint news release the board of the combined company will consist of 11 members, including nine members from Centene’s board and two from WellCare’s board. Centene’s Michael Neidorff will lead the combined company as chairman and chief executive officer, while Ken Burdick and Drew Asher from WellCare are expected to join Centene’s senior management team in new positions as a result of the acquisition.

The National Academies Says Medications to Treat OUD Are Effective, but Barriers Prevent Access and Use
Three U.S. Food and Drug Administration (FDA)-approved medications to treat opioid use disorder (OUD) are both safe and effective, but most people who would benefit from these treatments do not receive them and access is inequitable, according to a new report from the National Academies of Sciences, Engineering, and Medicine.

According to Medications for Opioid Use Disorder Saves Lives, withholding or failing to have available these medications to treat OUD in any care or criminal justice setting is denying appropriate medical treatment. The report identified misunderstanding and stigma, inadequate education and training, current regulations, and the fragmented system of care for people with OUD as the barriers to treatment.

“The United States is experiencing a public health crisis of almost unprecedented scale — an epidemic of opioid use disorder and related overdose deaths,” Alan Leshner, chief executive officer emeritus of the American Association for the Advancement of Science, and chair of the committee that conducted the study, said in a news release. “The factors impeding full use of FDA-approved medications to treat OUD must be addressed, including stigma surrounding both addiction and the medications used to treat it as well as counterproductive ideologies that consider addiction simply a failure of will or a moral weakness, as opposed to understanding that opioid use disorder is a chronic disease of the brain that requires medical treatment,” he continued. “Curbing the epidemic will require an ‘all hands on deck’ strategy across every sector — healthcare, criminal justice, people with OUD and their family members, and beyond — in order to make meaningful progress in resolving this crisis.”

ASTHO Recommends Approaches to SUD Prevention and Treatment
The Association of State and Territorial Health Officials (ASTHO) and the National Academy for State Health Policy (NASHP) have released four recommendations on how public health and Medicaid agencies can engage in cross-agency work to prevent and treat substance use disorder (SUD).

In 2018, the two groups convened the Cross-Agency Leaders Roundtable—a group of 10 Medicaid and public health officials—to develop the recommendations. The roundtable included representatives from the state health departments in Alaska, California, Massachusetts, New York, Ohio, Oregon, Pennsylvania, Virginia, and Washington.

According to the report, the leaders recommend that public health and Medicaid agencies determine an appropriate mechanism to catalyze cross-agency collaboration and create a unified administrative structure; optimize the use of state resources, including funding and staff, to maximize reach and impact; align policies across agencies for prescribing, treatment, training, and use of evidence-based best practices among providers; and utilizes a range of data sources to measure progress, inform state leadership and the public, and develop policy. Click here to learn more.

Veterans Affairs Partners with Objective Zero Foundation on Suicide Prevention
The Veterans Affairs Department announced this week that it has partnered with the not-for-profit Objective Zero Foundation to connect veterans with suicide prevention support and resources.

The new partnership, which became formal in early December, provides a shared goal to prevent suicide among service members and veterans, and focuses especially on service members transitioning out of the military.

Objective Zero offers a free mobile app that connects veterans, service members, their families and caregivers—instantly and anonymously—to suicide-prevention resources and a nationwide community of peer supporters via text, voice, and video chat.

“At VA, we are working to prevent veteran suicide by using an approach that looks beyond our traditional health care settings,” VA Secretary Robert Wilkie said in a news release. “Our partnership with Objective Zero is an integral part of reaching veterans where they live, work, and thrive, and we are looking forward to working more closely with them.”

NQF and AHA Release Telebehavioral Health Guide
The National Quality Forum (NQF) and the American Hospital Association (AHA) have developed a guide to help hospitals and health systems deliver innovative, high-quality telebehavioral health services.

Released at the NQF’s annual conference this week, Redesigning Care: A How-To Guide for Hospitals and Health Systems Seeking to Implement, Strengthen and Sustain Telebehavioral Health focuses on six “success factors,” including leadership commitment; organizational policies and clinical workflows; staff education and training; patient, family, and caregiver engagement; measurement, and community partnerships.

Click here for more information and to purchase the guide.

Center on Addiction Study Reviews and Compares Addiction Benefits in ACA Plans
More than half of the states offered Affordable Care Act (ACA) plans in 2017 that did not comply with the 2010 healthcare law’s requirements for covering SUD benefits, according to Uncovering the Gaps II: A Review and Comparison of Addiction Benefits in ACA Plans, a new report from the Center on Addiction.

Meanwhile, about 20 percent of the states offered ACA plans that year that violated parity requirements. The 79-page report highlights the coverage gaps in ACA plans sold to Americans in 2017 and compares the benefits in these plans to the benefits in 2017 Essential Health Benefit (EHB) benchmark plans.

“Once again, our research demonstrates the need to improve insurance coverage for addiction treatment,” the report noted. “Commercial insurers tout their role in addressing the opioid epidemic, but most of their initiatives have addressed inappropriate prescribing of prescription opioids,” it added. “This is important but insufficient. Too many patients continue to be denied access to life-saving care, and their families are forced to battle with their insurance companies in a time of crisis.”

Vista Research Group Releases Report on State of Addiction Treatment
Vista Research Group, which focuses on improving treatment outcomes, has released The State of Addiction Treatment, a report that provides an overview of addiction treatment in the United States and also examines both commercial payer and regulatory trends, measurement outcomes, and the evolving landscape of SUD mergers and acquisitions.

According to the report, in a small, informal study of 73 addiction treatment center leaders, 23 percent reported that they’re concerned about their ability to stay in business. When asked to identify their respective treatment center’s biggest challenge, respondents reported a range of issues, such as being paid sufficiently to cover their costs; keeping their census up; finding qualified staff; managing regulatory requirements; and dealing with rapid growth or acquisitions.

CMS’ Medicaid Innovation Accelerator Program to Host SUD Webinar on April 3
The Centers for Medicare & Medicaid Services (CMS) Innovation Accelerator Programs Reducing Substance Use Disorder program area will host a national learning webinar on Wednesday, April 3 from 3 p.m. to 4 p.m. ET.

The webinar is meant to help participants identify and treat complex conditions, the unique challenges and needs of the SUD population with these conditions, and reasons why customizing approaches for this population is necessary.Click here to register.

IPF PEPPER Review Webinar Scheduled for April 24
A webinar to review the release of the Inpatient Psychiatric Facility (IPF) PEPPER (version Q4FY18)—which is scheduled for April 5—will be held on Wednesday, April 24 at 3 p.m. ET.

Click here to register. For those unable to participate, the session will be recorded and posted on in the “Training and Resources” section.

For questions or comments about CEO Update, please contact Jessica Zigmond.