With the Patient Protection and Affordable Care Act’s (ACA’s) ninth open enrollment period (OEP) set to launch in less than a month, the ACA Marketplaces are seeing record enrollment numbers with more generous subsidies, new carrier competition, and a relatively stable rating environment. At the same time, there is uncertainty with the trajectory of the COVID-19 pandemic and medical costs trending upward as the economy recovers, albeit at an uneven pace. These trends have made for a challenging rate review process in the 47 states plus the District of Columbia (D.C.) that conduct their own ACA rate reviews of carrier-proposed rates using federal review standards. State announcements of 2022 rates have trickled out at a slower pace than in prior years, and it is likely that many states will not publish their approved rates until the beginning of open enrollment. As always, state rate results vary widely and, even within states, there often are substantial variations among carriers and across different regions in geographically diverse states. With these caveats, this expert perspective highlights some observations about the factors that are impacting rate changes this year and the kind of variations that exist among states.
Coverage Transitions and Value Based Purchasing
Small Group Convening hosted by the Center for Health Care Strategies
This joint meeting, hosted by the State Network and Medicaid Leadership Institute, was held in Boston, MA on April 23-24, 2012. The Center for Health Care Strategies (CHCS) led sessions that ranged from continuity of care during coverage transition to methods for integrated care and reimbursement. The attached slides include: 1) an overview by CHCS of ‘Coverage Transition Models’ highlighting keys to seamlessness and models for care linkages during coverage transitions; and 2) a presentation by Robin Callahan, Deputy Medicaid Director in Massachusetts, describing the Massachusetts Medicaid eligibility system and how the state is approaching continuity. This Small Group Convening expanded on an issue brief prepared by CHCS that analyzes how states have historically dealt with individuals that shift between public subsidy programs and how these experiences can prepare states for transitions between the Medicaid expansion and exchange qualified health plans in 2014.