States are using a variety of approaches to measure and incentivize Medicaid managed care (MMC) entities to address unmet social needs that can contribute to poor health outcomes, lower quality care, and higher medical expenditures. This toolkit identifies examples of approaches states are taking through their MMC programs to address health-related social needs. States interested in implementing specific strategies related to SDOH can use this toolkit to develop managed care procurements or update and operationalize key contract provisions. This toolkit was co-funded by the Health Foundation of South Florida.
Password protected resource page for members of the Facilitated and Automatic Enrollment Strategies affinity group.
Materials from virtual Maternal Health Roundtable hosted by SHVS on September 15, 2022.
When the federal Medicaid continuous coverage requirement expires, states will redetermine eligibility for nearly all Medicaid enrollees, including roughly 1.7 million people enrolled in a Medicaid or CHIP pregnancy eligibility group. This issue brief reviews proactive strategies that states can deploy to support postpartum individuals in maintaining health coverage and access to care when the Medicaid continuous coverage guarantee ends and beyond.
SHVS is tracking the latest federal guidance related to implementation and oversight of the No Surprises Act (NSA), the comprehensive federal law banning balance bills in emergency and certain non-emergency settings beginning January 1, 2022. This resource page highlights the latest SHVS resources for states on federal NSA guidance and summarizes its implications for state regulators.
Implementing a statewide, competitive procurement for Medicaid managed care is one of the more important things state purchasers do to improve value. This toolkit is designed to help states develop a procurement process focused on improving program performance in specific areas valued by the state. It guides Medicaid agencies through key action steps and considerations in the major phases of the procurement cycle: 1) strategic procurement planning, 2) solicitation development, 3) bid review and selection, 4) contract execution, readiness review and implementation, and 5) contract management.
This resource provides excerpts of health disparities and health equity language from Medicaid managed care (MMC) contracts and requests for proposals (RFPs) from 17 states and the District of Columbia. The criteria for inclusion in this compendium are contracts and RFPs that explicitly address health disparities and/or health equity. Website links to the full contracts are included where available.
On Wednesday, July 20, State Health and Value Strategies hosted a webinar facilitated by experts from Bailit Health. The webinar explored how the Buying Value suite of resources can help states, employers, consumer organizations and providers implement quality measures to incentivize high-quality, high-value healthcare. The webinar highlighted two free, Excel-based tools, the Buying Value Measure Selection Tool and the Buying Value Benchmark Repository.
Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates
To help states respond to the ongoing COVID-19 pandemic, the White House, the U.S. Department of Health and Human Services, and the Centers for Medicare and Medicaid Services have invoked their emergency powers to authorize temporary flexibilities in Medicaid and the Children’s Health Insurance Program. Congress’s legislative relief packages have provided additional federal support for state Medicaid programs, subject to certain conditions. The timeframes for these emergency measures are summarized in the chart, including the effective dates and expiration timelines dictated by law or agency guidance. This SHVS product has been updated to reflect HHS’s July 15 notice renewing the federal Public Health Emergency.
Defining the “Glide Path”: State Medicaid Agencies’ Efforts to Promote Action on Social Determinants
State Medicaid agencies are increasingly exploring opportunities to incorporate “social care” into strategies for improving health, decreasing healthcare costs, and achieving equity. While some target healthcare delivery organizations, most revolve around managed care organizations (MCOs). This slide deck highlights findings from a series of interviews with 13 states that explored the choices Medicaid leaders face around selecting which monitoring mechanisms to use to ensure that social programs are implemented as they envisioned.