On January 27, 2023, the Centers for Medicare & Medicaid Services released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” The SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.
Addressing Health-Related Social Needs Through Medicaid Managed Care
Erin Campbell, Mary Beth Dyer, and Erin Taylor, Bailit Health
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 social determinants of health (SDOH) can use this toolkit to develop managed care procurements or update and operationalize key contract provisions. The toolkit does not include all state MMC procurement questions or contract language related to addressing enrollees’ SDOH needs, but instead represents a curated list of specific examples from 16 profiled states. This toolkit was co-funded by the Health Foundation of South Florida.