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Expanding Medicaid Through Section 1115 Waiver
An analysis of the Medicaid expansion plans of 6 states that have been granted Section 1115 waivers identified both the promise and limits that have emerged through these alternative expansion approaches.
The Section 1115 demonstration waiver allows states to tailor their Medicaid expansion plans to meet practical and political realities. An analysis of the Medicaid expansion plans of 6 states—Arkansas, Indiana, Iowa, Michigan, New Hampshire, and Pennsylvania—that have been granted the waivers identifies both the promise and limits that have emerged through these alternative expansion approaches.
States looking to expand Medicaid under Section 1115 must still demonstrate that the plan will be consistent with Medicaid objectives, specifically that it will extend coverage to low-income and vulnerable populations. While HHS can approve many of the changes under Section 1115, some need to be left up to Congress, experts wrote in a blog post for The Commonwealth Fund. There 3 specific areas of concern:
- Work requirements
- Higher premiums
- Low-income pools
Read more at The Commonwealth Fund: http://bit.ly/1dEUrSp
Health Care Utilization and Cost of Diagnostic Testing for Respiratory Infections
September 17th 2025Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
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AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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Infertility Coverage Boosts ART Use and Pregnancy Success: Richard A. Brook, MS, MBA
August 26th 2025In this episode, Richard A. Brook, MS, MBA, discusses his study showing that infertility treatment coverage increases assisted reproductive technology (ART) use and improves pregnancy outcomes.
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