The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
Developing a Social Risk Factor Screening Measure
Justine Zayhowski, Kate Reinhalter Bazinsky, and Michael Bailit, Bailit Health
State Medicaid agency interest in the impact of social determinants of health on the health status of Medicaid enrollees has surged in recent years. States have begun to stipulate performance requirements of their contracted managed care organizations and accountable care organizations to identify and mitigate social risk factors affecting individual members. To aid the identification process, some states have begun to recommend—and sometimes require—their contractors perform social risk factor screens.
This issue brief is designed as a resource for states looking to adopt a measure to assess social risk factor screening rates. It is the result of a series of convenings that the authors facilitated with three states—Massachusetts, Oregon, and Rhode Island—which helped them consider, discuss, and share perspectives related to the development of their own social risk factor screening process measures. The issue brief looks at the progress these states and North Carolina have made in developing their own social risk factor screening measures and highlights considerations for other states either planning to adopt an existing or develop a new screening measure.
As a companion to this issue brief, State Health and Value Strategies hosted a webinar series that profiled the findings from this issue brief, and another issue brief Social Risk Factor Screening in Medicaid Managed Care.