In light of recent postal delays and housing displacements caused by the COVID-19 pandemic and related economic crisis, and a wave of natural disasters across the country, state Medicaid and Children’s Health Insurance Program (CHIP) agencies face new challenges communicating with their enrollees about their health coverage. Acting now to mitigate these challenges is essential as states are preparing for the end of the public health emergency (PHE) and “catching up” on coverage renewals for a large portion of their enrollees. This expert perspective reviews strategies that state Medicaid and CHIP agencies may consider to help mitigate coverage losses.
A Strategic Approach for Insurance Exchanges to Select and Manage Qualified Health Plans
Wakely Consulting Group – Jon Kingsdale, Susan Tuite, Patrick Holland, and James Woolman
Wakely Consulting Group has prepared this policy brief to aid state Exchanges in their contracting strategies with qualified health plans (QHPs). Section I of this brief describes many of the types of decisions that Exchanges should consider in preparing to launch a clean, effective QHP solicitation process. Section II describes the standards that Exchanges will use to certify QHPs. It summarizes the major federal requirements that all QHPs must meet and sets forth examples of additional requirements that some states are considering. Section III sets forth options for “negotiating” key elements of the issuers’ proposals. Unlike many start-up tasks, certifying, re-certifying, de-certifying and managing the relationship over time with health plans is an ongoing and evolving set of tasks. Therefore, Exchanges should take a strategic approach to these functions, each state can craft plan selection and ongoing partnerships to support the achievement of its goals for health care reform.
Wakely also hosted a webinar covering the topics of this brief.