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Health Equity Resources for States

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State Health and Value Strategies (SHVS), in partnership with Manatt Health, Health Equity Solutions, Georgetown’s Center on Health Insurance Reforms (CHIR), the State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB, developed this resource page to serve as an accessible “one-stop” source of health equity information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, regardless of where they live, how much money they make, or discrimination they face. SHVS will update this page frequently with new resources as they become available.

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SHVS Resources Health Equity

Finishing the Job of Medicaid Expansion

As the country struggles to respond to and recover from the devastating fallout of the COVID-19 pandemic, the case for Medicaid expansion has never been stronger. The public health crisis has focused a spotlight on both the benefits of stable health coverage and the gaps in the nation’s system of coverage and care. This expert perspective reviews what Medicaid expansion would mean in the 12 states that have not yet expanded.

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Date Created: Jan 26, 2021
SHVS Resources Health Equity

Ensuring Equity: State Strategies for Monitoring COVID-19 Vaccination Rates by Race and Other Priority Populations

The rollout of vaccines designed to end the coronavirus (COVID-19) crisis has begun in earnest across the United States. Currently, each state is responsible for determining how to allocate, distribute, track, and report its vaccine allotment from the federal government, although the federal government is expected to take on a larger role under a new Biden administration. Since the beginning of the pandemic, Black, Indigenous, and other people of color have been disproportionately impacted by both higher risks of infection and poorer health outcomes, and many are concerned that an inequitable or inefficient distribution of the COVID-19 vaccine may further widen health inequities among these populations. One way to help ensure the equitable administration of COVID-19 vaccine is to track vaccine administration disaggregated for key subpopulations, such as gender, race and ethnicity, and geography (e.g., urban vs. rural). This expert perspective reviews the data states are currently publically reporting related to vaccine administration and provides an interactive map that explores the extent to which all 50 states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography. The expert perspective also discusses what current data sources states are using to provide this information and provides an overview of options states can consider to collect information about the administration of COVID-19 vaccine in populations via survey data.

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Date Created: Jan 22, 2021
SHVS Resources Health Equity

Advancing Health Equity in Oregon: Building a Foundation

As health inequities continue to be exacerbated by the COVID-19 pandemic, there is concerted energy to address this topic across states. Oregon has had a longstanding focus on health equity and employed two foundational strategies that can serve as examples for other states seeking to further their health equity efforts. Oregon first developed a common language and defined what “health equity” meant in the state. The state also engaged community partners to ensure that the community voice was apparent in policy decisions on the state level. When combined, these strategies have helped Oregon develop a foundation to build and implement subsequent health equity efforts in the state.

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Date Created: Jan 6, 2021
SHVS Resources Health Equity

State Strategies for Overcoming Barriers to Advance Health Equity

The COVID-19 pandemic has highlighted longstanding health inequities which have resulted in an increased risk of sickness and death for people of color. The crisis has also propelled a nationwide focus on understanding and addressing health inequities. While COVID-19 and the reckoning on racial justice have mobilized some state officials working in Medicaid, public health, insurance departments, and Marketplaces, alike, states are at different places on their journeys to confront systemic racism and inequities in health care, and each faces unique and challenging barriers. This issue brief explores impediments and accelerants to advancing health equity as states are increasingly being called upon to drive change.

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Date Created: Nov 20, 2020
SHVS Resources Health Equity

Medicaid Managed Care Contract Language: Health Disparities and Health Equity

This document provides excerpts of health disparities and health equity contract language from Medicaid Managed Care (MMC) contracts from five states—Michigan, Minnesota, North Carolina, Ohio, Oregon—and Washington, D.C. as well as the contract for California’s Health Exchange, Covered California. The criteria for inclusion in this compendium were contracts that explicitly addressed health disparities and/or health equity. Website links to the full contracts are included where available. Excerpts from the MMC contract language are organized into specific categories and measures identified by the state as equity or disparities measures. This document will be updated as we identify other contracts to include.

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Date Created: Oct 8, 2020
SHVS Resources Health Equity

Adjusting Open Enrollment Outreach to Meet a New Moment

A new open enrollment landscape created by the continued health and economic impacts of the COVID-19 pandemic, a national movement calling for racial justice, and the concurrent timing of a presidential election year is raising new challenges for states as they plan outreach and enrollment campaigns. Marketplaces are reimagining their campaign strategies to meet this moment, with plans to operationalize virtual activities, communicate with new and existing audiences, and reflect changing consumer behaviors in their outreach tactics. This expert perspective highlights strategies from SHVS’ 2-part webinar series on preparing for OEP 2021 and features several strategies states can pursue to help ensure a successful open enrollment period this year.

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Date Created: Sep 1, 2020
SHVS Resources Health Equity

Maintaining Medicaid and CHIP Coverage Amid Postal Delays and Housing Displacements

In light of recent postal delays and housing displacements caused by the COVID-19 pandemic and related economic crisis, and a wave of natural disasters across the country, state Medicaid and Children’s Health Insurance Program (CHIP) agencies face new challenges communicating with their enrollees about their health coverage. Acting now to mitigate these challenges is essential as states are preparing for the end of the public health emergency (PHE) and “catching up” on coverage renewals for a large portion of their enrollees. This expert perspective reviews strategies that state Medicaid and CHIP agencies may consider to help mitigate coverage losses.

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Date Created: Sep 24, 2020
SHVS Resources Health Equity

Exploring Strategies to Fill Gaps in Medicaid Race, Ethnicity, and Language Data

As states seek to address the social determinants of health and advance health equity, they face longstanding and persistent challenges in collecting complete, accurate, and consistent race, ethnicity and language (REL) data. This expert perspective provides an overview of current REL data collection standards; ideas for increasing completeness in data by engaging the enrollee and enrollment assisters, and modifying enrollment and renewal interface; and provides suggestions for how states could leverage alternative sources of data in order to improve REL data completeness.

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Date Created: Oct 1, 2020
SHVS Resources Health Equity

Equitable Recovery Strategies

This expert perspective provides a survey of actions that state and local governments have taken to intentionally incorporate equity into their recovery and reopening policies.

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Date Created: Jun 2, 2020
SHVS Resources Health Equity

SHVS Two-Part Webinar Series on Preparing for OEP 2021

On Wednesday, July 22, State Health and Value Strategies hosted part II of the Preparing for OEP 2021 webinar series that provided a deep dive into effective strategies to consider as states design their outreach and education campaigns for OEP 2021 in a shifting health care environment. Presenters from GMMB explored how the impacts of COVID-19 should inform the marketplace’s tactical campaign approaches for virtual outreach and partnership engagement, digital and social platform usage, and paid advertising and earned media. Participants also heard insights from several state officials from state-based marketplaces along the way. Topics for discussion included coordinating with state agencies, engaging micro-influencers, leveraging social media live streams, hosting virtual enrollment events, developing advertising buys, and considering new earned media hooks. This webinar included a question and answer session during which webinar participants can pose their questions to the experts on the line.

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Date Created: Jul 28, 2020
SHVS Resources Health Equity

Addressing Equity through COVID-19 Response: Communications Approaches in States

This expert perspective highlights examples employed by DC Health Link, the Oregon Health Authority, and beWellnm and the community-centered outreach they are using to actively enroll and connect consumers to care. The expert perspective also includes best practices surfaced for marketplaces and agencies to adapt their COVID-19 communications and outreach—and beyond—to ensure those with inequitable access to health coverage are prioritized and supported.

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Date Created: Jun 23, 2020
SHVS Resources Health Equity

Advances in States’ Reporting of COVID-19 Health Equity Data

This expert perspective provides an update on states’ reporting of health equity data and a summary of CARES Act reporting requirements.

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Date Created: Jun 23, 2020
SHVS Resources Health Equity

How States Can Use Measurement as a Foundation for Tackling Health Disparities in Medicaid Managed Care

Many people in America face segregation, social exclusion, encounters with prejudice, and unequal access and treatment by the health care system, all of which can impact health. Medicaid programs serve a disproportionate share of populations that are negatively impacted by health disparities. This new State Health and Value Strategies (SHVS) issue brief provides examples from a handful of states that have begun the work of identifying, evaluating, and reducing health disparities within their Medicaid managed care programs. Additionally, it offers an approach for other states interested in measuring disparities in health care quality in Medicaid managed care as a step towards achieving health equity, such that all Medicaid managed care enrollees have a fair and just opportunity to be as healthy as possible.

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Date Created: Jun 19, 2020
SHVS Resources Health Equity

Rethinking Telehealth Policy After the First COVID-19 Surge

On Friday, June 12 at 12:00 p.m. ET, State Health & Value Strategies hosted a webinar during which experts from Manatt Health and Georgetown reviewed the current telehealth policy landscape and considerations for states as they design their post-apex telehealth policies. This webinar included a question and answer session during which webinar participants posed their questions to the experts on the line.

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Date Created: Jun 15, 2020
SHVS Resources Health Equity

States’ Reporting of COVID-19 Health Equity Data

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 May 28) data breakdowns by age, gender, race, ethnicity, and health care workers for both cases of and deaths from COVID-19.

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Date Created: May 28, 2020
SHVS Resources Health Equity

Health Equity and COVID-19: Tracking and Taking Action to Address Disparities

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.

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Date Created: May 8, 2020
SHVS Resources Health Equity

Five Key Questions State Health Officials Can Ask Right Now to Advance Health Equity During COVID-19 Response Efforts

Early evidence suggests there are health disparities based on race, gender, and geography in both the contraction of COVID-19 and deaths related to the virus. People of color and those who live in urban centers are faring worse from this pandemic. These higher rates of illness and death are rooted in longstanding, structural inequities in our country. While these inequities cannot be fixed overnight, states can begin to foster a more equitable and just COVID-19 response, relief, and recovery effort by employing a few key guidelines. This expert perspective poses a series of questions states can use to inform immediate actions to strengthen their initial responses and lay the foundation for broader reforms to advance health equity.

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Date Created: May 6, 2020
SHVS Resources Health Equity

State COVID-19 Data Dashboards

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.

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Date Created: Apr 9, 2020
SHVS Resources Health Equity

Public Charge Final Rule: Frequently Asked Questions

On August 14, 2019, the Department of Homeland Security (DHS) published a final rule, Inadmissibility on Public Charge Grounds. The rule makes significant changes to the standards DHS will use to determine whether an immigrant is likely to become a “public charge”—a person dependent on the government for support—which will have consequences for certain immigrants’ legal status. This document provides answers to frequently asked questions about whom the rule will impact, what benefits are implicated by the rule, and how the rule might be administered.

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Date Created: Feb 26, 2020
SHVS Resources Health Equity

The Department of Homeland Security Begins Implementing Its Public Charge Rule on February 24, 2020

In this Expert Perspective, our colleagues at Manatt Health review the Supreme Court’s decisions granting the Administration’s requests to stay preliminary injunctions that had blocked the Department of Homeland Security public charge final rule from taking effect in October 2019.

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Date Created: Feb 24, 2020
SHVS Resources Health Equity

Leveraging American Community Survey (ACS) Data to Address Social Determinants of Health and Advance Health Equity

State Medicaid programs are increasingly seeking to understand and address social factors that contribute to poor health—such as food insecurity, unstable housing, and a lack of access to social supports—in order to lower costs, improve outcomes for their members, and advance health equity. To inform this work of addressing the social determinants of health (SDOH) and advancing health equity, states and Medicaid officials need data in order to identify priority areas of unmet social and economic needs, execute SDOH initiatives, and monitor and evaluate the impacts of these programs. Increasingly, states are leveraging a broad array of data sources to support efforts to address health equity. While those sources closest to the Medicaid program are the most widely used, each has advantages and disadvantages. This brief focuses on how Medicaid programs can use data from one federal survey, the American Community Survey (ACS), to inform and target interventions that seek to address social determinants of health and advance health equity. This brief also highlights relevant examples from states that use SDOH and health equity measures from the ACS, including which measures and what they are used for.

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Date Created: Feb 10, 2020
SHVS Resources Health Equity

Advancing Health Equity in Medicaid Managed Care: An Introduction for States

The first webinar in the SHVS Health Equity Through Managed Care Series series reviewed the foundational principles of health equity, barriers to its realization and the impact of health disparities.

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Date Created: Oct 22, 2019
SHVS Resources Health Equity

The Medicaid MCO Experience in Addressing Health Equity

The fifth webinar in the SHVS Health Equity Through Managed Care Webinar Series profiled the work of one MCO, HealthPartners, in addressing equity issues within its Medicaid line of business. We heard from Brian Lloyd, who manages Health Partners’ organization-wide equity initiative, which includes collecting data to eliminate disparities in care, supporting language access, partnering with communities, and building an organizational understanding of equity, diversity, inclusion, and bias.

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Date Created: Oct 22, 2019
SHVS Resources Health Equity

Using MCO Contract and Performance Requirements to Advance Health Equity

The fourth webinar in the SHVS Health Equity Through Managed Care Webinar Series reviewed approaches employed by states to incorporate contract requirements and performance incentives in Medicaid managed care contracts to reduce health disparities among covered populations.

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Date Created: Oct 22, 2019
SHVS Resources Health Equity

Evidence-Based Strategies for Reducing Health Disparities

The third webinar in the SHVS Health Equity Through Managed Care Webinar Series identified evidence-based interventions that states can use to address disparities in their Medicaid managed care programs.

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Date Created: Oct 22, 2019
SHVS Resources Health Equity

Health Equity and Medicaid Managed Care: Data Collection and Measurement

The second webinar in the SHVS Health Equity Through Managed Care Webinar Series explored how states can use data collection and measurement to support their efforts to advance health equity in Medicaid managed care.

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Date Created: Oct 22, 2019
SHVS Resources Health Equity

New Policy Regarding Uninsured Noncitizens

On October 4, the President issued a proclamation that requires immigrants to show that they have health insurance or can pay medical expenses out of pocket in order to receive a visa. The proclamation will impact individuals applying for a visa with the Department of State (DOS) through consular offices abroad. In this expert perspective, Manatt Health reviews this latest policy regarding uninsured noncitizens and provides their take on implications for states.

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Date Created: Oct 18, 2019
SHVS Resources Health Equity

Final Public Charge Rule: Analysis and Potential Implications

On August 12, 2019 the Department of Homeland Security (DHS) issued a final version of its public charge rule which was to go into effect on October 15. The public charge rule will change how DHS determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). The webinar reviewed the final rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers.

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Date Created: Sep 3, 2019
SHVS Resources Health Equity

Addressing Social Factors That Affect Health: Emerging Trends and Leading Edge Practices in Medicaid

Medicaid programs are increasingly considering how best to address social factors, such as housing, healthy food, and economic security, that can affect health and medical expenditures. Often referred to as social determinants of health (SDOH), these factors are significant drivers of population health outcomes. While states historically have had some experience tackling such issues for specialized, high-need populations, they are now confronting whether, and how, Medicaid should address SDOH for a broader population of Medicaid enrollees in order to achieve better health outcomes. This issue brief explores the “next generation” practices that states are deploying to address social factors using Medicaid 1115 waivers and managed care contracts, as well as the specific steps states can take to implement these practices.

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Date Created: Apr 12, 2019
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© 2019 State Health and Value Strategies is a program of the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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