On August 12, the Department of Homeland Security (DHS) issued a final version of its public charge rule, which will be published in the Federal Register later this week and will go into effect on October 15. On September 3, the Robert Wood Johnson Foundation’s State Health and Value Strategies program will host a webinar on the final rule, facilitated by experts at Manatt Health. 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 will review the final rule, highlight changes from the proposed rule, and explore the rule’s potential impacts on consumers, states and providers. Speakers will highlight the key ways the proposed rule departs from current guidance, with a particular focus on the implications for Medicaid and other health-related public benefits.
On Tuesday, August 27 at 2:30 p.m. ET State Health and Value Strategies will host the third webinar in a series on health equity and Medicaid managed. The five-part series will assist states interested in addressing disparities in health outcomes among Medicaid managed care beneficiaries as a step towards achieving health equity. The third webinar, Evidence-Based Strategies for Reducing Health Disparities, will identify evidence-based interventions that states can use to address disparities in their Medicaid managed care programs. During the webinar, Dr. Marshall Chin, Co-Director of Advancing Health Equity: Leading Care, Payment and Systems Transformation at the University of Chicago, will provide an overview of approaches for reducing disparities, drawing from a review of over 400 disparity intervention studies and from his program’s experience providing technical assistance to health care organizations. The webinar will also provide a roadmap to guide the work of Medicaid managed care programs to reduce disparities in care and elucidate the role of consumers in those interventions.
State Health and Value Strategies is hosting a workgroup for Medicaid agencies addressing social determinants of health (SDOH) in their managed care programs. The materials for the workgroup are available through password protected page.
On Friday, June 21 at 1:00 p.m. ET State Health and Value Strategies hosted a webinar for state officials with technical experts to discuss the implications of the health reimbursement arrangements (HRA) rule and possible state responses. The webinar featured Jason Levitis, who led ACA implementation at the U.S. Treasury Department, as well as experts from Georgetown University’s Center on Health Insurance Reforms and from Manatt Health. The U.S. Departments of Health and Human Services, Labor, and Treasury released final regulations easing the rules governing HRA and other account-based, tax-preferred health care on June 13. The final rule represents the third of the three policy changes initiated by the October 12, 2017 Executive Order, which also called for easing the rules on short-term limited-duration coverage and association health plans. Like those changes, the HRA rule could have profound implications for health insurance markets, consumers, and Marketplaces. The rule is effective in 2020, which raises important considerations about Marketplace readiness and potential tax consequences for individuals.
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.
On Tuesday, June 18 at 1:00 p.m. ET, State Health and Value Strategies, in partnership with Manatt Health, hosted a webinar for states that provides an overview of the opportunities available to connect justice-involved populations to Medicaid coverage and care. States are exploring opportunities to engage justice-involved populations–including juveniles and adults–in Medicaid coverage, case management and health care both immediately prior to and following their release from prison or jail. States’ interests are motivated by the high needs and high related health costs of these individuals–who are often eligible for Medicaid upon release, especially in states that have expanded Medicaid. Despite the current prohibition on drawing down federal Medicaid financing to fund health care for people while they are incarcerated, there are a number of strategies states can deploy to meaningfully connect justice-involved populations to critical coverage as well as medication and physical and behavioral health care services when re-entering the community. The webinar provided an overview of Medicaid enrollment and suspension processes to make sure an individual has active Medicaid coverage and “in-reach” planning pre-release that helps with engagement and care management post-release.
On Thursday, April 25, State Health and Value Strategies, with Manatt Health, hosted a webinar for states on six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program. Lawmakers across the country are considering “Medicaid buy-in” or public option programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. The concept of Medicaid buy-in/public option is evolving, encompassing the original Medicaid-based proposals and extending to other programs through which states can leverage government bargaining power to offer a more affordable coverage option, like state employee health plans or a Basic Health Plan. During the webinar, speakers from Manatt Health discussed considerations related to (1) goal setting, (2) sources of cost-savings, (3) potential impacts on existing insurance markets, (4) federal 1332 waiver considerations, (5) implementation capacity, and (6) key steps for implementation. Additionally, representatives from Colorado, Connecticut, and Washington shared the status of efforts in their respective states.
Lawmakers across the country are considering Medicaid buy-in programs to stabilize the Affordable Care Act insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. The concept of Medicaid buy-in is evolving, encompassing the original Medicaid-based proposals and extending to other programs through which the state can leverage its government bargaining power to offer a more affordable coverage option, like state employee health plans or a Basic Health Plans. Some refer to this evolving model as Medicaid buy-in, while others label it a “public option,” particularly for state-sponsored plans in the marketplace.
So far in the 2019 legislative session, more than 10 states have introduced legislation to study or implement a buy-in. The purpose of this issue brief is to identify the key questions that states pursuing these initiatives will want to consider as they seek to design and implement their proposals.
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.
On Wednesday, March 27, 2019, State Health and Value Strategies, in partnership with the Peterson Center on Healthcare, hosted a webinar on the ways in which several states and one community organization are using their multi-payer claims databases. More states are leveraging multi-payer claims databases to better understand how their health care systems are operating and implementing data-driven decision-making. States may not be aware, however, of the strategies other states and organizations are adopting to leverage claims databases to support health care transformation goals. During the webinar, presenters from the state of Vermont and Rhode Island, as well as the Washington Health Alliance, discussed how they are employing claims databases to enhance the value of care and will share lessons learned for those seeking to optimize their own databases.