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Templates & Toolkits

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.

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Date Created: Aug 9, 2022


State Materials , Templates & Toolkits

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.

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Date Created: Jul 28, 2022


Webinars

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

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Date Created: Jul 20, 2022


Regulatory Analysis

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.

 

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Date Created: Jul 18, 2022


Reports

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.

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Date Created: Jul 8, 2022


Meetings & Presentations

Password protected resource page for members of the Affordable Health Coverage for Immigrant Populations affinity group.

Date Created: Jun 30, 2022


Meetings & Presentations

Password protected resource page for members of the Coordinating the Continuous Coverage Unwinding affinity group.

Date Created: Jun 24, 2022


Webinars

On Tuesday, June 14, State Health and Value Strategies hosted a webinar that featured state officials and Medicaid managed care entities from Rhode Island and Massachusetts who shared their experiences implementing social risk factor screening measurement. The webinar highlighted states who have implemented social risk factor screening measures for incentive use in managed care contracts. States use these social risk factor screening measures to hold plans and provider entities accountable for identifying Medicaid members affected by risk factors, such as homelessness and food insecurity.

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Date Created: Jun 14, 2022


Templates & Toolkits

Improving ex parte rates as part of the Medicaid renewal process is one of the most effective tools available to states to mitigate coverage loss for eligible individuals when the public health emergency (PHE) ends. There are tremendous benefits to enrollees and to states in maximizing eligibility redetermination through an ex parte process. As states develop their unwinding policies and operational plans in readiness for the end of the PHE, improving ex parte rates should be at the top of their priority list. This toolkit contains a table that can be used by a state to examine current ex parte processes and identify and deploy additional strategies that could increase their ex parte rates.

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Date Created: Jun 9, 2022


Meetings & Presentations

Slide decks that were shared at the Small Group Convening on Marketplace and Department of Insurance Innovations that was held on May 24, 2022 in Philadelphia, PA.

Date Created: May 27, 2022