February 19, 2025
Interoperability and Prior Authorization Rule Workgroup: Background Material
The Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule establishes new prior authorization requirements that apply broadly to “items and services” other than drugs. State Medicaid and CHIP programs and managed care plans must meet prior authorization policy requirements by 2026 and must implement new application programming interface (API) technologies […]
January 27, 2025
MERCI Blog Post on Milbank Memorial Fund Site
Susan Stuard from the Center recently authored a new blog on the Medicaid Evidence and Review of Cost Initiative (MERCI) project for the Milbank Memorial Fund. The article highlights issues with the FDA’s accelerated drug approval process affecting Medicaid coverage. Medicaid must cover all FDA-approved drugs, even with limited trial data, increasing risks for patients. […]
September 5, 2024
Washington State Health Plans in Support Primary Care Reform Work
With support from the Center for Evidence-based Policy, eight Washington health plans and the state’s Health Care Authority (HCA) signed a memorandum of understanding (MOU), committing to multi-payer primary care transformation. The MOU outlines individual and collective payer efforts to support the state’s Primary Care Transformation Initiative (PCTI). Under the initiative, health plans will align their plan […]
August 20, 2024
New Scorecard Reveals Wide Differences From State-to-State in Women’s Health and Reproductive Care
A new Commonwealth Fund scorecard comparing state health system performance on women’s health and reproductive care reveals big differences across the U.S., with particularly wide gaps on measures of mortality among reproductive-age women and access to essential health services. The 2024 State Scorecard on Women’s Health and Reproductive Care was completed with analytic support from researchers […]
July 16, 2024
Evidence-based Innovation Award
This Award recognizes a team or State official for using evidence to innovate and achieve improvements for their State populations.
July 3, 2024
Washington State Health Technology Clinical Committee Report on Bariatric Surgery
We recently completed a systematic review of metabolic and bariatric surgeries for individuals with a BMI ≥ 25 kg/m2 (BMI ≥ 23 kg/m2 in some Asian populations). This work was presented to the Washington State Health Technology Clinical Committee to assist in their coverage determination. The report and associated documents are available on the Washington […]
May 21, 2024
Role of Clinicians in Medicaid Agencies: Policy Brief
The 2023 Medicaid Evidence-based Decisions Project (MED) policy brief, Role of Clinicians Within Medicaid Agencies, uses interviews with clinical staff from 6 state Medicaid agencies and other experts in Medicaid operations to provide insight into how states use their clinical staff. The brief examines different clinical leadership roles and disciplines, the range of responsibilities and […]
May 10, 2024
Early Career Achievement Award – Moira Ray
Moira Ray, M.D. was recently honored with an OHSU School of Medicine 2024 Alumni Award! Throughout her career, Moira Ray has pursued two passions: direct patient care and public health. “I’ve always liked thinking about the needs of the public versus the needs of the individual,” Ray says. “I’m a physician working in a patient-centered […]
April 24, 2024
2023 Annual Report