Nevada & Oregon: Marketplaces Explore Partnership for Eligibility & Enrollment Functionality

Nevada's Marketplace director Bruce Gilbert had "very preliminary" discussions with Oregon about developing a joint call center and shared IT platform for both State-based Exchanges on the federal platform (SBE-FP), according to Politico Pulse. The directors of these Exchanges have said that the federal government's proposed 3% user fee on issuers selling qualified health plans in SBE-FPs would encourage states to explore alternatives to using the federal platform.

Vermont: All-Payer Health Care System Under Consideration

The Green Mountain Care Board briefed the Vermont House Health Care Committee on details of an emerging all-payer health care initiative—which would give the State control of rates paid under Medicare, Medicaid, self-insured health plans and commercial insurance, thereby creating opportunities for the State to standardize costs and influence quality of care. Negotiations with CMS are underway for a federal waiver to give Vermont authority over how Medicare pays providers, though details of the model have not yet been fully established. The Board proposes to hold annual per capita increases in healthcare spending to 3.5% over five years, with a maximum growth rate of 4.3%. Additionally, the all-payer initiative focuses on a "transformative care model" based on a single statewide accountable care organization, which providers would be encouraged to join. The only other state to implement a similar modelis Maryland, where an independent commission has been setting rates for hospital services since the 1970s. The State expects the terms of the all-payer Medicare waiver to be settled by the end of the year, which would lay the framework for negotiations with CMS to establish a more concrete plan by May 2016 in anticipation of January 2017 implementation.