While Medicaid typically does not pay for housing (room and board), it does pay for some clinical and non-clinical services that can help people obtain and maintain their housing. New federal authorities to cover housing-related services have motivated states to think more broadly about the Medicaid populations who could benefit from access to housing-related services and the types of services that can promote housing stability. State Investments in Supportive Housing provides an overview of the federal authorities under which states are able to cover nonclinical housing-related services for high-need Medicaid enrollees. The issue brief also details how states are using these authorities to invest in supportive housing for diverse high-need Medicaid populations.
On Tuesday, January 14, 2020 at 4:00 pm EST, State Health and Value Strategies hosted a webinar on a proposed rule released by the Centers for Medicare & Medicaid Services (CMS) that would make significant changes to Medicaid supplemental payments and financing mechanisms, including provider taxes and intergovernmental transfers (IGTs). The proposed fiscal accountability rule would, if finalized, sharply limit states’ abilities to use IGTs to fund their Medicaid programs and require many states to redesign aspects of their provider taxes, with resulting serious ramifications for many states’ Medicaid budgets. The webinar, facilitated by experts from Manatt Health, provided an overview of the proposed rule, highlighting the provisions with the most significant implications for states. During the webinar, experts also discussed how the rulemaking process may unfold over the next several months and what states can do to prepare.
Protected: Roundtable Materials: Maternal Morbidity and Mortality: Medicaid’s Role in Addressing the Crisis
The U.S. is experiencing a maternal health crisis. The overall rate of maternal morbidity in the U.S. has grown by more than 200 percent since 1993, and women in the U.S. die from pregnancy-related causes at a rate significantly higher than other developed countries. The data paints an even more disturbing picture for Black and American Indian/Alaska Native women, who are three times more likely to die from pregnancy-related causes than White women. Notably, the majority of pregnancy-related deaths are preventable—contributing factors include hindered access to care, missed or delayed diagnoses, and a failure to respond to warning signs of pregnancy complications.
Medicaid finances nearly half of U.S. births, and in some states, it finances nearly three quarters of births. In other words, Medicaid is covering and paying for care today for women and families impacted by the crisis and has a crucial role to play in developing solutions.
On December 10, 2019, delegates from six states and the District of Columbia gathered in Washington, D.C. at a roundtable discussion to talk about potential Medicaid interventions to mitigate the maternal mortality and morbidity crisis. During the roundtable, SHVS and Manatt Health — along with national experts in maternal health and health equity—facilitated a discussion about opportunities for Medicaid to implement coverage, payment and delivery system reforms to improve health outcomes for pregnant and post-partum women, with a particular focus on health equity.
As a follow-up to the November 20th SHVS office hour on the collection of REL data, this resource page provides links to a few resources that were mentioned on the call.
State Health and Value Strategies is hosting a workgroup for Medicaid agencies addressing social determinants of health (SDOH) in their managed care programs. Access to the materials are restricted to members of the workgroup and are available through password protected page.
As the opioid epidemic continues, Medicaid programs are applying for SUD Section 1115 Demonstration waivers (SUD waiver) to expand Medicaid-funded treatment options. Some states with approved SUD waivers have formally implemented the American Society for Addiction Medicine (ASAM) Criteria to promote consistency in client placement for SUD treatment. The ASAM Criteria is a clinically driven multidimensional client assessment model that emphasizes treatment outcomes, client-specific lengths of service, and a team-based approach to care. This issue brief draws from the experiences of states that were among the first to implement their SUD waivers to profile how the ASAM Criteria is used within the context of managed care and utilization review, and the challenges and best practices associated with its use.
Eight states require or will require insurers to offer health plans with standardized benefit plans in the individual market, and several more are considering requiring such standardization in the future. On Wednesday, November 6, 2019 at 1:00 p.m. ET, SHVS hosted a webinar on the opportunities for states to implement standardized benefit designs, either through their health insurance marketplace or as part of a public option plan, issues to consider in developing standardized options, communicating with stakeholders, and leveraging standardized designs to improve affordability for enrollees and encourage maintenance of coverage. The webinar reviewed the development of standardized designs through state-based marketplaces, their role in Washington and other states’ public option proposals, operational requirements to improve the end-user experience, and data collection and analysis needs.
The Department of Homeland Security (DHS) final rule, Inadmissibility on Public Charge Grounds, was published in the Federal Register on August 14, 2019. Public Charge Final Rule: Frequently Asked Questions provides answers to questions about whom the rule will impact, what benefits are implicated by the rule, and how the rule might be administered. The rule was to go into effect as of October 15, but multiple federal courts have issued nationwide preliminary injunctions temporarily blocking the Administration’s implementation of the rule.
On August 12, the Department of Homeland Security (DHS) issued a final version of its public charge rule which was to go into effect on October 15, but has since been delayed as a result of litigation. On September 3, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted 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 reviewed the final rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers. Speakers highlighted 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, as well as communications and messaging. In addition, New York provided one example of how a state has engaged its assistors to help communicate potential implications of the rule.
On Tuesday, October 22 State Health and Value Strategies convened the fifth, and last, webinar in our series SHVS Health Equity Through Managed Care. For many states, eliminating disparities in Medicaid managed care programs means working with their MCO contractors, and implementing contractual requirements that advance health equity. Previous webinars in this series identified measures and MCO performance requirements that help reduce health disparities and improve health equity for a state’s Medicaid population. This webinar, The Medicaid MCO Experience in Addressing Health Equity, 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.