Compendium of Medicaid Managed Care Contracting Strategies to Promote Health Equity
The Compendium identifies approaches states are taking within their Medicaid managed care programs to promote health equity and highlights examples from states to further illustrate how they are implementing specific approaches and includes excerpts from state contract and procurement documents. The Compendium synthesizes information across select states and categorizes their approaches to support cross-state learning. State policymakers and Medicaid officials can use the Compendium to develop managed care procurements or update and operationalize key managed care contract provisions.
Health Equity Policy Tool
The Health Equity Policy Tool is a framework for reviewing and assessing the impact on equity of current and/or proposed policies. The tool is designed for state agencies and provides a template for asking key questions to assess the likelihood that a policy will promote equity or exacerbate inequities.
Addressing Health-Related Social Needs Through Medicaid Managed Care
States are increasingly leveraging their Medicaid programs to transform healthcare delivery and improve individual and population health with a focus on addressing health-related social needs (HRSN). This toolkit identifies examples of approaches states are taking through their Medicaid managed care programs to address HRSN. States interested in implementing specific strategies to identify and address HRSN can use this toolkit to develop managed care procurements or update and operationalize key contract provisions.
Issue Spotting Common Policy and Operational Barriers to Ex Parte Renewals: State Assessment Tool
Many states are actively working to make changes to their systems to enable ex parte renewals at the individual level and implement mitigation strategies to ensure eligible Medicaid and CHIP enrollees retain coverage until those system changes are complete. This tool is intended to: (1) help states identify common policies and/or operational processes that, if adjusted, could improve ex parte rates and renewal functionality, and (2) facilitate internal, cross-divisional Medicaid agency discussions across policy, operational, and information technology systems.
Sample Social Media Messages for Open Enrollment
The open enrollment period (OEP) for health insurance Marketplaces will run from November 2023 to January 2024. This OEP will take place while most states are also conducting Medicaid renewals during the unwinding of the Medicaid continuous coverage requirement. State Health and Value Strategies has created sample messages and accompanying social media graphics to support states during the simultaneous Medicaid unwinding and open enrollment period.
Conducting Eligibility Redeterminations at the Individual Level: State Diagnostic Assessment Tool
Early unwinding-related renewal data shows that many states have low ex parte renewal rates and high procedural termination rates. One contributing factor that the Centers for Medicare & Medicaid Services and states have identified is that some states are conducting ex parte renewal processes at the household level, rather than at the individual level, as required by federal regulations. This diagnostic assessment tool is designed to assist states in assessing whether they are conducting ex parte and other renewal processes at the individual level in accordance with federal regulatory requirements.
Call Center Strategies to Support Unwinding: State Toolkit
Medicaid, CHIP, Marketplace and integrated human services call centers are experiencing a surge in the number of callers seeking information about their health coverage with the end of the Medicaid continuous coverage requirement. In some states, high call volume is translating into long wait times and high rates of call abandonment, adversely affecting Medicaid and CHIP enrollees who rely on the call center as a critical source of assistance and support. Recognizing the crucial role of call centers in supporting enrollees throughout the eligibility and enrollment process, states can use this toolkit to identify opportunities and explore strategies to improve call center functionality.
State Health Equity Measure Set
The State Health Equity Measure Set provides a standard set of health equity measures that states can use to assess their performance against other states, and inform interventions that strive to improve equity in healthcare access and outcomes within their state. The State Health Equity Measure Set includes 10 population-level measures, which gauge health status, and 19 healthcare measures, which evaluate receipt of, and outcomes associated with, evidence-based health services. All measures have been tested and are in use by national measurement bodies. The Measure Set provides states with the resources to inform policies and program interventions that are focused on reducing disparities in healthcare access, care delivery, and health outcomes for people of color.
1115 Demonstration Facilitation Tool: Crosswalk of Requested Reentry Demonstration Features to Federal Requirements and California’s Approved Demonstration
On January 26, 2023, the Centers for Medicare & Medicaid Services (CMS) approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. On April 17, 2023, CMS released a State Medicaid Director Letter (SMDL), “Opportunities to Test Transition-Related Strategies to Support Community Reentry and Improve Care Transitions for Individuals Who Are Incarcerated.” The following tool can be used as part of a state’s discussions with CMS regarding a requested demonstration’s proposed features as compared with the reentry requirements outlined in the SMDL and California’s section 1115 demonstration approval.
Buying Value
The Buying Value website, which is supported and maintained by State Health and Value Strategies in partnership with Bailit Health, hosts a suite of resources to support states interested in designing a measure set that will align with other priority national measure sets, as well as those that may already be in use in a state or region. The Buying Value Measure Selection Tool assists states in aligning measure sets. The Buying Value Benchmark Repository, is a database of non-HEDIS and modified HEDIS measures in use by state purchasers and regional health improvement collaboratives and associated performance levels.