Ensuring Access to LTSS During COVID-19: Exploring a State Resource Guide Produced by Manatt Health and The SCAN Foundation
On Friday, July 10, State Health and Value Strategies hosted a webinar during which experts from Manatt Health presented key findings from a new COVID-19 state resource guide, funded by The SCAN Foundation. People who use long-term services and supports (LTSS), including individuals dually-eligible for Medicare and Medicaid, are particularly vulnerable to contracting COVID-19 and experiencing severe symptoms. We have seen COVID-19 have a devastating impact on people with complex care needs receiving care in nursing homes and other congregate care settings, in particular. To date, over 50,000 nursing home residents have died from COVID-19, representing up to 40 percent of U.S. COVID-19 deaths. Although there is less transparency on the impact of COVID-19 on people receiving LTSS in the community, we know that care has been disrupted due to caregivers being subject to stay-at-home orders, having no access to child care, lacking access to PPE to provide care safely, or quarantining after being sick or exposed to COVID-19.
In the resource guide, Manatt Health identifies federal and state Medicaid flexibilities available to state officials and other stakeholders and how those flexibilities are being deployed during COVID-19 to help ensure access to LTSS. The resource guide highlights examples of how states are ensuring continued access to LTSS by expanding the types of settings in which services can be delivered, bolstering pay and other supports for LTSS providers, and addressing barriers to care created by the COVID-19 pandemic. Several states are turning their attention to considering which flexibilities they want to “unwind,” which they want to retain to respond to future COVID-19 outbreaks or other public health emergencies, and which they want to make permanent to strengthen and improve LTSS care delivery. The webinar provided examples of how states are approaching answering these questions.
The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states have initiated plans to publish a data dashboard to monitor progress. To date, the District of Columbia and 15 states have published unwinding data in a visual dashboard format (this does not include states with pre-existing enrollment dashboards that don’t specifically identify unwinding cohorts). This expert perspective now includes an interactive map with the links to all the dashboards and states publishing CMS unwinding reports. SHVS will continue to update the EP and map as more states publish their unwinding data.
The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act. This presents State-Based Marketplaces with an opportunity to target outreach efforts to those audiences who have recently lost Medicaid or CHIP to help eligible individuals retain access to affordable healthcare through the Marketplace. This expert perspective focuses on best practices for timing and strategy in consumer outreach to consumers that are no longer eligible for Medicaid to help states develop a consumer “chase campaign.”