State Health and Value Strategies (SHVS), in partnership with Manatt Health, Georgetown’s Center on Health Insurance Reforms (CHIR), State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB developed this resource page to serve as an accessible “one-stop” source of COVID-19 information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, especially high-risk and vulnerable people, during the COVID-19 pandemic. SHVS will update this page frequently with new resources as they become available.
|If you have materials you are willing to share with other states through this page, or if there are topics of particular concern that you would like addressed, please contact SHVS.|
HHS released preliminary data on states’ reported use of the 150 million Abbott rapid point-of-care (POC) SARS-CoV-2 diagnostic tests distributed by HHS beginning in late September. Per preliminary reports from states, allocations are largely being deployed to local health departments, K-12 schools and institutes of higher education, nursing homes, hospitals and correctional facilities. Of the 150 million test kits acquired by HHS, 100 million test kits are reserved for weekly shipments to Governors, who have discretion to allocate test kits as they see fit. The remaining 50 million tests are reserved for direct shipments to congregate care settings such as nursing homes, assisted living facilities, home health, hospice, the Indian Health Service, and historically black colleges and universities (HBCUs).
This expert perspective provides an update on states’ reporting of health equity data related to cases, mortality, hospitalizations, and testing and new state activity related to data collection, including examples of collecting additional data measures and creating taskforces to advance health equity. The post also provides a summary of CARES Act reporting requirements related to testing.
HRSA published updated data regarding providers that received reimbursement from the HRSA COVID-19 Uninsured Program and agreed to HHS’s terms and conditions. As of October 14, $566.1 million has been paid for testing claims and $957.2 million for treatment claims.
HHS published updated data regarding providers that have received Provider Relief Fund General Distribution (Phase 1 or Phase 2) and/or Targeted Distribution payments (which includes allocations for high impact areas, safety net hospitals, rural providers, tribal facilities, clinics and urban health centers, and skilled nursing facilities); attested to receiving payment; and agreed to HHS’s terms and conditions as of October 12. As of this cut-off date, 358,598 providers have attested to receiving $90.6 billion in Provider Relief Fund payments.
CMS issued a memo updating its COVID-19 reporting requirements for hospitals, hospital labs, and acute care facilities. The guidance also codifies new enforcement discretion related to these reporting requirements; in its September 2 interim final rule with comment period (IFC), HHS tied these reporting requirements (as specified by the HHS Secretary during the COVID-19 public health emergency) to conditions of Medicare participation for hospitals and critical access hospitals (CAHs). As part of this update, HHS published a Hospital Mandatory COVID-19 Reporting Enforcement Workflow, which outlines the steps HHS has taken and will take to implement its enforcement discretion.
The October 6 update made optional certain data elements that were previously required as part of hospitals and CAHs’ daily reporting. Additionally, the IFC adds new influenza-specific data elements that will be made optional for reporting beginning on October 19th, which CMS indicated in its FAQs will likely be transitioned to required reporting elements in the coming weeks. CMS further indicated in its FAQs that it will no longer send out one-time requests for data to aid in the distribution of remdesivir or any other treatments or supplies (remdesivir can now be purchased by hospitals from the manufacturer; HHS is no longer allocating supply).
As a companion to the Tracking Medicaid Enrollment Growth During COVID-19 Databook, this overview summarizes key findings from the analysis.
The Tracking Medicaid Enrollment Growth During COVID-19 Databook, which includes Medicaid enrollment data from over 40 states, provides a comprehensive, detailed look at 2020 Medicaid enrollment trends to-date, with certain limitations. The Databook provides enrollment detail by state across four eligibility categories: expansion adults, children (including those enrolled in CHIP), non-expansion adults, and aged, blind, and disabled individuals. It also compares enrollment trends across expansion and non-expansion states. While variations in states reporting mean that the enrollment numbers in this report are not necessarily comparable across states (and should not be summed across states), the data reported do allow states and others to track enrollment trends.
As a companion to the Databook, Manatt Health authored an Overview that summarizes key findings from an analysis of the Databook.
As a follow-up to its August 14 and September 19 guidance outlining the reporting requirements for Provider Relief Fund (PRF) recipients that received one or more General Distribution or Targeted Distribution payments exceeding $10,000 in the aggregate,* HHS released a one-page summary of the reporting deadlines, reporting requirements, and permissible uses of Provider Relief Fund payments. HHS also updated its PRF “Reporting Requirements and Auditing” landing page to include the first FAQ regarding the reporting requirements. The single FAQ currently available on the page does not provide new substantive information about reporting requirements, but providers will want to monitor this page as HHS is expected continue to post FAQs related to the reporting requirements on this page.* Does not apply to the ~$2.5 billion Nursing Home Infection Control distribution.
HRSA published updated data regarding providers that received reimbursement from the HRSA COVID-19 Uninsured Program and agreed to HHS’s terms and conditions. As of September 24, $445.3 million has been paid for testing claims and $824.8 million for treatment claims.
HHS published updated data regarding providers that have received Provider Relief Fund General Distribution (Phase 1 or Phase 2) and/or Targeted Distribution payments (which includes allocations for high impact areas, safety net hospitals, rural providers, tribal facilities, clinics and urban health centers, and skilled nursing facilities); attested to receiving payment; and agreed to HHS’s terms and conditions as of September 14. As of this cut-off date, 340,062 providers have attested to receiving $86.2 billion in Provider Relief Fund payments.
MS released the independent Coronavirus Commission for Safety and Quality in Nursing Homes (Commission) report. The Commission was convened to solicit lessons learned from early experience during the pandemic and develop recommendations for future actions to improve infection prevention and control measures, safety procedures, and quality of life for residents of nursing homes. Alongside the report, CMS issued a response to the report, which compares the Commission’s recommendations to a list of actions the agency has taken to date; the response does not describe which, if any, of the recommendations issued by the Commission it plans to build upon. CMS also prepared and issued a compilation of guidance and updates for nursing homes during COVID-19.
The 186-page final Commission report submitted by the Commission to CMS includes 27 recommendations and accompanying action items organized into 10 themes with recommendations and associated action steps. These themes and some of the key recommendations include:
– Testing and screening: Develop and execute a national strategy with federal partners and SLTT authorities for testing and delivering rapid turnaround of results
– Equipment and PPE: Assume responsibility for a collaborative process with federal and SLTT partners regarding PPE procurement and availability; issuing specific guidance on the use, decontamination, and reuse of PPE; and issuing guidance on training on proper use of PPE and equipment, as needed
– Cohorting: Update cohorting guidance to balance resident and staff wellbeing with infection prevention and control; update cohorting guidance and reimbursement policies to reflect differences in nursing home resources
– Visitation: Emphasize visitation as a vital resident right and update and release consolidated, evidence-based guidance on safely increasing controlled, in-person visitation prior to Phase 3 re-opening; issue guidance on effectively planning for and implementing virtual visitation tools and techniques; provide resources to help facility staff assess the pychological wellbeing of residents; and streamline these and other resources into a single visitation source document
– Communication: increase specificity and expand breadth of guidance on communications between nursing home staff, residents, and families
– Workforce – stopgaps for resident safety: Mobilize resources to support a fatigued nursing home workforce, provide equity-oriented guidance that allows nursing home workforce to safely continue working in multiple nursing homes; support 24/7 registered nurse staffing resources at nursing homes in the event of a positive COVID-19 test within that facility, and leverage certified infection preventionists
– Workforce – strategic reinforcement: Catalyze interest in the certified nurse assistant profession and create a national CNA registry; update regulations to allow more fully qualified infection preventionists to be available in nursing homes; catalyze an overhaul of the workforce ecosystem in partnership with federal, SLTT, and other partners and convene a Long-Term Care Workforce Commission
– Technical assistance and quality: Increase availability of collaborative, on-site, data-driven and outcomes-oriented support prior to, during, and after a public health emergency
– Facilities: Identify and share with nursing homes short-term facility design enhancements to address pandemic-related risks; establish a national forum to share best practices and recommendations; establish long-term priorities and seek appropriate funding streams for redesign/facility strengthening
– Data: Standardize nursing home data; create an easy-to-use interactive technical infrastructure for nursing homes that streamlines reporting, dissemination of guidance, etc; enhance HIT interoperability to facilitate better communication, quality measurement standards, and data sharing
CMS released preliminary Medicaid and CHIP data highlighting that rates of vaccinations, well visits, and dental services among children enrolled in Medicaid/CHIP have dropped substantially, and issued an “urgent call to action.” The data set examines vaccinations, primary, and preventive services among children in Medicaid and CHIP for March-May 2020 compared to March-May 2019 and shows:- 22 percent fewer (1.7 million) vaccinations received by beneficiaries up to age 2- 44 percent fewer (3.2 million) child screening services that assess physical and cognitive development and can provide early detection of autism and developmental delay, among other conditions, even after accounting for the increased use of telehealth- 69 percent fewer (7.6 million) dental servicesThe preliminary data shows that beneficiaries age 18 and under enrolled in Medicaid and CHIP had relatively low treatment rates due to COVID-19. Although more than 250,000 children enrolled in Medicaid and CHIP were tested for COVID-19 through June 2020, only about 32,000 received treatment for COVID-19 and fewer than 1,000 were hospitalized for COVID-19 through the end of May.
HHS’s Office of the Inspector General (OIG) released a list of its Active Work Plan Items reflective of OIG’s audits, evaluations, and inspections that are underway or planned in determination of providers’ compliance with temporary authorities during the COVID-19 public health emergency. The newly-announced or revised items include:- A Review of Medicare Data to Understand Hospital Utilization During COVID-19- Audit of the Distribution of Supplies from Indian Health Service’s National Supply Service Center in Response to COVID-19
HHS issued a press release detailing recent national trends in COVID-19 testing, indicating that more than 59 million COVID-19 tests have been conducted nationally to-date. In the prior week, over 810,000 tests have been completed per day on average with 56% of tests completed within three days, compared to 45% of lab tests that were completed within three days in July.
The Treasury issued its first report detailing each state and local government’s Coronavirus Relief Fund payment amount, total costs incurred, and percent spend during the period from March 1 through June 30, 2020. Costs were considered to have been incurred if performance or delivery occurred during the covered period even if payment of funds had not yet been made. The data is based on recipients’ reporting, and the Treasury clarified that it has not yet verified or audited the data.
On Thursday, June 4, State Health and Value Strategies (SHVS) hosted a webinar during which experts from Manatt Health discussed the fiscal implications for states and Medicaid programs of the COVID-19 pandemic, the emerging economic downturn, and recent legislation to address these twin crises, including the Families First Coronavirus Response Act (“Families First”) and the Health and Economic Recovery Omnibus Emergency Solutions (“HEROES”) Act. The Databook is a follow-on product to the webinar. As discussed in the Overview, each table in the Databook displays projected changes in federal and state Medicaid and CHIP expenditures during calendar years 2020 and 2021 across all fifty states and the District of Columbia for a given scenario and policy response. Taken together, the Databook provides estimates that span across a range of plausible scenarios reflecting increased enrollment and per enrollee spending growth and changes to the duration of the federal Public Health Emergency.
CDC released a new study examining the disproportionate impacts of COVID-19 on American Indians and Alaska Natives (AI/AN) in 23 states between January 31 and July 3. The report found: • The cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN was 3.5 times that of non-Hispanic whites• Compared to whites, a higher percentage of cases among AI/AN individuals were in people under 18 years of age (12.9 percent AI/AN; 4.3 percent white) • A smaller percentage of cases were among AI/AN individuals who are 65 years or older (12.6 percent AI/AN; 28.6 percent white)
The Urban Institute simulates the potential changes in health insurance coverage due to skyrocketing unemployment rates. The analysis estimate that 10.1 million people will lose employer coverage tied to a lost job. Of those individuals, Urban estimates that 28 percent will enroll in Medicaid and 3.5 million people will become uninsured.
HHS issued a notice that it is developing new system of records, “COVID-19 Insights Collaboration Records,” for use by HHS for analysis, research, and public health activities related to the study of COVID-19. The new database will aggregate existing patient records from federal agencies, state agencies and private sector entities. Patient records will be selected for patients who have and, for control purposes, have not, tested positive for COVID-19. The notice was published on the Federal Register on July 16 and public comments will be accepted until August 15 (30 days thereafter).
The Committee on Ways and Means Majority at the US House of Representatives authored a report on the stark barriers that communities of color and rural communities face to accessing equitable health care.
HRSA published updated data regarding providers who have received reimbursement from the Claims Reimbursement for COVID-19 Care of the Uninsured Program and agreed to HHS’ terms and condition as of July 10. As of this cut-off date, HHS has disbursed $348.1 million to this cohort of 12,659 providers.
HHS published updated data regarding providers who have received the following Provider Relief Fund and related payments: – Lump Sum Provider Relief Fund Payments: As of July 1, 215,667 providers have accepted $60.0 billion in Provider Relief Fund payment that match this criteria.- Claims Reimbursements from the HRSA COVID-19 Uninsured Program: As of July 1, HRSA has disbursed $250.6 million to 7,895 providers.
CMS released a trends report indicating that 487,000 individuals signed up for coverage on Healthcare.gov through the existing “loss of Minimum Essential Coverage” special enrollment period (SEP) in April and May, representing an increase of 46% from the same time period last year. [moved this sentence to be the final sentence] The Administration did not establish a new SEP in response to the COVID-19 pandemic—a decision that the City of Chicago is challenging in court and a host of Democratic Attorneys General and the House of Representatives have supported. [do we need a link to source for this final statement? totally defer to your typical process]
On Thursday, June 4, State Health and Value Strategies hosted a webinar during which experts from Manatt Health presented key results from a financial model examining the Medicaid fiscal implications of the interaction between the COVID-19 pandemic, the emerging economic downturn, and recent policy changes. States and Medicaid programs are entering a time of substantial fiscal uncertainty as they continue to respond to the COVID-19 pandemic while also preparing for a potentially severe recession that is expected to lead to significant budget shortfalls and surges in Medicaid enrollment. During the webinar, Manatt discussed key considerations for states as they develop their own internal forecasts and plan for the challenging times ahead.
NIH announced it will launch a centralized analytics platform to store and study medical record data from people diagnosed with COVID-19 as part of its National COVID Cohort Collaborative (N3C) initiative intended to analyze health risk factors and identify potentially effective treatments.
A blog post from the Urban Institute analyzing how HHS has distributed Provider Relief Fund payments to date. As of June 10, 2020, 35 percent of the aid remains unallocated.
New COVID-19 data have revealed that Black families face a much higher risk of contracting and dying from the virus. Residents of majority-Black counties have three times the rate of infection and almost six times the rate of deaths as residents of majority-white counties.This paper examines policy pptions for eliminating structural racism in key aspects of Black families’ lives.
On Thursday, May 7, State Health and Value Strategies hosted a webinar that reported on how states are tracking the disproportionate impact of COVID-19 on vulnerable populations and provided a framework for states to examine their COVID-19 response efforts to yield better outcomes for such populations. As the COVID-19 crisis evolves, it has become increasingly clear that vulnerable populations are disproportionately impacted. Unsurprisingly, these disparately affected groups are the same ones that have long experienced stark health disparities, such as communities of color, low income populations, and those that reside in congregate living facilities (nursing homes, jails, shelters, etc.). During the webinar, technical experts from Health Equity Solutions and SHADAC shared findings from recent SHVS publications.
HHS published an updated database representative of providers who have received Provider Relief Fund payments for either the general allocation, the allocation for high impact areas, or the rural allocation; attested to receiving payment; and agreed to HHS’ terms and condition as of May 29. As of this cut-off date, HHS has paid nearly $45.9 billion to this cohort of providers
Recommendations developed by the Connecticut Health Foundation aimed at ensuring the state’s COVID-19 response reaches those who are most at risk.
HHS OIG issued its strategic plan to support the COVID-19 response and recovery.
FEMA announced that government officials can now access the “Community Mitigation Decision Support Tool,” which makes data for each metric in the President’s Guidelines for Opening Up America Again available in one tool.
HHS announced $500 million in Provider Relief Fund awards to Indian Health Service (IHS) and tribal hospitals, clinics, and urban health centers. As part of the announcement, HHS released the methodology for calculating award amounts for HIS and Tribal Hospitals, Clinics and Urban Programs.
HHS announced that providers who have received Provider Relief Fund payments now have an additional 45 days (90 days total) to accept the Terms and Conditions and the payment or return the funds.
HHS issued a clarification for providers who are eligible for, but have not yet received, a second payment from the $20 billion tranche of the $50 billion Provider Relief Fund General Allocation. These providers must accept HHS’s Terms & Conditions and submit revenue information via tax forms or financial statements to HHS by June 3 in order to remain eligible for the additional payment. HHS also issued updated FAQs
An analysis by the Commonwealth Fund on the impact of COVID-19 on outpatient visits. Although visits to ambulatory care practices have rebounded since ealry April after a decline of nearly 60 percent, visits are still a third lower than they were before the pandemic.
HHS released provider-level data regarding the distribution of the $12 billion COVID-19 High-Impact Allocation from the Provider Relief Fund, of which $2 billion was based on hospitals’ Medicare disproportionate share and uncompensated care payments. These funds were distributed by HRSA to 395 hospitals that accounted for 71 percent of COVID-19 inpatient admissions reported to HHS from nearly 6,000 hospitals around the country.
This Health Affairs blog post highlights states’ policy responses to the COVID-19 pandemic, as well as their proactive approaches to addressing a wide range of health concerns.
This issue brief provides insights into the current picture of Medicaid spending and enrollment, as Congress considers providing additional fiscal relief through the federal Medicaid match rate. Nearly all states anticipate growing Medicaid enrollment and spending during fiscal years 2020 and 2021.
A recent analysis by the Urban Institute estimates eight different FMAP increase approaches and how they would affect the amount of fiscal relief states would receive.
Analysis of CARES Act Provider Relief Fund distribution to hospitals, including the implications of distributing funds based on net patient revenue. The analysis found that the formula used to allocate the $50 billion in funding favored hospitals with the highest share of private insurance revenue as a percent of total net patient revenue.
CMS announces temporary changes for Medicare Advantage and Part D plans.
CDC published in the Federal Register a proposed data collection, “Emerging Infections Program (EIP) Tracking of SARS-CoV-2 Infections among Healthcare Personnel.This program would determine the extent of COVID among health care workers, describe the characteristics of health care workers infected with COVID and compare exposures and other characteristics of workers who do not become infected. Public comments will be accepted on or before July 14.
CMS issued a memo regarding new COVID-19 infection control and reporting rules for nursing homes in the recent interim final rule. The memo indicates CMS will be publicly posting facility-level data from the CDC National Healthcare Safety Network.
Consistent with NCQA guidance regarding HEDIS 2020 hybrid measures, California’s Department of Health Care Services is modifying performance requirements for Medi-Cal managed care plans due to COVID-19.
The Florida Agency for Health Care Administration revised its Medicaid managed care plan performance reporting requirements in response to the impact of COVID-19. The Agency’s policy guidance includes information pertaining to reporting HEDIS hybrid rates, CAHPS surveys, and provider satisfaction surveys.
The Social Interventions Research and Evaluation Network (SIREN) at the University of California San Francisco, is a research organization focused on the intersection of medical and social services. In response to the COVID-19 crisis, SIREN has developed a resource center of sites aggregating data about health equity, policy, and social risk related to the coronavirus and related financial crisis.
The University of Minnesota COVID-19 Health Insurance Model (MN-HIM) estimates the number of people at who lost employer-sponsored health insurance (ESI) during the four-week period ending on April 11, 2020. In developing this model SHADAC aimed to create both national and state-level estimates as well as provide a further breakdown between policyholders (age 18-64) and their dependents (adults and children).
This expert perspective looks in more depth at which states are regularly reporting data that helps shed light on the health equity issues of this crisis. Specifically, the post includes interactive maps that explore the extent to which all 50 states and the District of Columbia are reporting (as of April 14) data breakdowns by age, gender, race, ethnicity, and health care workers for both cases of and deaths from COVID-19.
This expert perspective reviews the key indicators currently being tracked by states via their COVID-19 dashboards and also provides an overview of “best practices” states can consider when developing or modifying these same COVID-19 dashboards.
This guidance allows practitioners further flexibility in prescribing and dispensing buprenorphine to new and existing patients with opioid use disorder via telephone without examination in person or via telemedicine.
The Department of Health Services is publishing data on COVID-19 cases by county via a map and is providing information about the number of individuals tested and confirmed cases.
The Department of Health is tracking COVID-19 cases to date by county with details of age and sex of individual and whether a case is travel related.