On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
Approaches to the Integration of Services for Individuals with Intellectual and Other Developmental Disabilities
Brendan Hogan, Kate Bazinsky, and Beth Waldman, Bailit Health Purchasing
Today, there is a great deal of focus on integration of physical and behavioral health care services within the health care system overall, as well as within state Medicaid programs. Individuals with intellectual and other developmental disabilities (I/DD) often have multiple physical, behavioral, and long-term services and support (LTSS) needs. Many advocates of integration suggest that the consolidation of these services can provide an opportunity to improve care for individuals with I/DD. Based on interviews conducted with I/DD staff in six states (Arizona, Kansas, Michigan, New York, Tennessee, and Vermont), this paper highlights approaches to integrating services within the Medicaid program for individuals with I/DD, and lessons learned from states with integration activities underway.