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.
Defining the “Glide Path”: State Medicaid Agencies’ Efforts to Promote Action on Social Determinants
Social Interventions Research and Evaluation Network (SIREN) at the University of California, San Francisco
State Medicaid agencies are increasingly exploring opportunities to incorporate “social care” into strategies for improving health, decreasing healthcare costs, and achieving equity. While some target healthcare delivery organizations, most revolve around managed care organizations (MCOs). This slide deck highlights findings from a series of interviews with 13 states that explored the choices Medicaid leaders face around selecting which monitoring mechanisms to use to ensure that social programs are implemented as they envisioned. The findings are derived from a two-part research project that explored ways to scale and sustain social care across the healthcare sector. The first component, Conceptualizing Performance Measurement for Social Care Interventions: An Issue Brief for State Medicaid Agencies, examines social care performance measurement.