Bob Atlas Quoted in “2016 Outlook: Medicaid Managed Care Will Grow Strongly Again, Aided by LTSS”

AIS Health Business Daily

Bob Atlas, Strategic Advisor and President of EBG Advisors, Inc., was quoted by AIS Health Business Daily, in “2016 Outlook: Medicaid Managed Care Will Grow Strongly Again, Aided by LTSS.”

Following is an excerpt:

The carve-in trend will continue in 2016, says Bob Atlas, president of the EBG Advisors unit of health care law firm Epstein Becker & Green, P.C. and a longtime Medicaid managed care consulting executive. He points out that one reason the pharmacy benefit had been carved out previously — because Medicaid managed care organizations (MCOs) weren’t allowed to receive Medicaid drug rebates — was eliminated in the Affordable Care Act (ACA).

Another big trend for this year is LTSS, which Atlas calls “the last frontier” remaining for Medicare and Medicaid programs. States have a huge stake in improving outcomes and controlling costs for these kinds of expenses not covered elsewhere, and many states are using home- and community-based services (HCBS) waivers in efforts to do so, he notes. But he adds that “there are limits” on how successful those efforts can be “because there’s no incentive for anyone except the state to move patients” into HCBS programs, for which there are only limited numbers of spots anyway.