Josh LaRosa M.P.P.

Director

B.A., The University of Virginia; M.P.P., The University of Virginia

703-309-4248
josh@wynnehealth.com

Josh LaRosa joined the Wynne Health Group in November 2018, bringing with him over three years of federal health care policy consulting experience. The majority of his experience in the federal consulting space has been with the Centers for Medicare and Medicaid Services (CMS), and he in particular has worked heavily with the agency’s Center for Medicare and Medicaid Innovation (CMMI).

With CMMI, Josh worked to implement, monitor, and spread learning garnered from the center’s high-profile demonstration projects, most recently including the national primary care redesign effort, Comprehensive Primary Care Plus (CPC+). Josh has also assisted a multitude of provider organizations participating in CMMI’s Health Care Innovation Awards Round One and Two to implement their innovative health care delivery and payment models. Through such experiences, Josh has been exposed to a wide array of innovations in health care delivery, and is deeply interested in how changing provider, patient, and payer incentives can result in a higher quality and more cost-effective health care delivery system.

Josh holds a Master of Public Policy from the University of Virginia’s Frank Batten School of Leadership and Public Policy, where he had the opportunity to work with a D.C.-based non-profit and explore policy options for addressing the behavioral health needs of military and veteran families. Josh also completed his undergraduate studies at the University of Virginia, graduating cum laude with a B.A. in Political Philosophy, Policy, and Law.

The Benefits of Telehealth During a Pandemic — and Beyond

Commonwealth-Fund 400x200Medicare began including telehealth as a benefit nearly 20 years ago, but has used it only on a limited basis. This was in large part because of statutory restrictions that limited coverage to rural beneficiaries who received care by certain practitioners in designated sites, which did not include the beneficiary’s home. Now, in the wake of the COVID-19 outbreak, policymakers are looking to telehealth as critical to ensuring that Medicare beneficiaries can still access care while reducing the risk of coronavirus transmission....
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You’re Doing It Wrong: What Changes In Medicaid And SNAP Reveal About The Trump Administration’s Investment In The Social Determinants Of Health

The Department of Health and Human Services (HHS) defines the social determinants of health as the “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” The concept, which comes from the global public health field, is at its best when it is understood to encompass an individual’s social location—their race, ethnicity, sex, class, ability, orientation, culture, and how each of these identities impact them in their community context. It was created to identify and serve the most vulnerable among the world’s populations and to address the inequities that disproportionately impact their lives and their health. ...
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CMS Releases Advance Notice For Medicare Advantage And Part D Plans

Last week, the Centers for Medicare & Medicaid Services (CMS) released Part II of its Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies for Calendar Year (CY) 2021 (fact sheet). The agency also released its proposed rule on policy and technical changes to MA and Part D for CYs 2021 and 2022 (fact sheet). A press release for both developments is available here. This post focuses on summarizing the Advance Notice component of this package of policies....
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A Look Inside The Hospital Transparency Final Rule

On November 15, 2019, The Centers for Medicare & Medicaid Services (CMS) finalized a controversial set of requirements for the disclosure of hospital pricing data to degrees heretofore not seen. Stemming from the recent transparency Executive Order (EO), the final rule reflects the current administration’s overall push to increase pricing and cost transparency throughout the health care system. While the original proposal faced substantial backlash from stakeholders, CMS’ final decision is nearly identical to what the agency originally proposed....
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Proposed Stark Law, Anti-Kickback Reforms Aim To Facilitate Value-Based Care

On Wednesday, October 9, the Department of Health and Human Services (HHS) announced highly anticipated proposed reforms to current regulations implementing the Physician Self-Referral Law (the Stark Law) and the Federal Anti-Kickback Statute (AKS). Also addressed were related civil monetary penalties (CMPs) for inducements to beneficiaries to utilize services. HHS identified the regulations as they stand now as potential impediments to value-based purchasing arrangements for providers and suppliers participating in federal health care programs, as well as in the commercial sector....
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Medicare for All: What it Means, and Where it’s Headed

Medicare for All is the titular banner carrying the promise of comprehensive healthcare coverage for every U.S. resident and, along with it, reduced costs, improved quality, and patient-focused care. While phrases like “universal coverage” and “single-payer” have traditionally been reserved to the fringe of American politics, the idea of a single, government-run insurance plan is now taking center stage. But what does it really entail? And can we reasonably expect its fruition? We seek to provide some clarity on both questions. ...
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Accelerating Primary Care Redesign: CMS’ Innovation Center Announces Five New Transformative Models

On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced the Primary Cares Initiative (PCI), a suite of five voluntary payment models aimed at overhauling primary care. Marking the Trump Administration’s latest investment in Medicare value-based reform, PCI focuses on the role of primary care providers as the central coordinators of patient health, with the goal of enhancing patient care while lowering overall Medicare fee-for-service (FFS) costs. Once implemented, CMS estimates that more than a quarter of all Medicare FFS beneficiaries – nearly 11 million individuals – will be included in these transformative primary care delivery models....
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A Tell-All on Telehealth: Where Is Congress Heading Next?

Commonwealth-Fund 400x200The Centers for Medicare and Medicaid Services (CMS) recently enacted modest but important expansions in Medicare’s telehealth policy. Telehealth, which uses telecommunications to support virtual health care delivery to improve access to and quality of health care, is moving from promise to reality. The benefits are appealing: Patients can interact with their providers remotely, which improves access to care and can help providers manage chronic conditions from afar....
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The Drug Pricing Debate Part II: The Many Acts of Congress

Commonwealth-Fund 400x200As we outlined earlier this spring, congressional action on drug pricing continues to intensify. Key committees have advanced an array of reforms, demonstrating Congress’ intent to finalize legislation this year. We aim to clarify what that might include....
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The Drug Pricing Debate: Sizing Up Recent Actions and What May Come Next

Commonwealth-Fund 400x200What goes up must — or rather, should — come down. Such is the thinking of the Trump administration when it comes to prescription drug pricing, at least. Over the past five years, 12 of the 20 most commonly prescribed brand-name drugs have seen price increases of more than 50 percent. To date, most of what we’ve seen from the federal government is messaging and some initial proposals, with the majority coming from the administration. Congress, for its part, has initiated a series of drug pricing hearings and begun introducing meaningful legislation. The result is a wide array of policy alternatives, some of which stand a chance of being enacted....
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