Issue Briefs | Jun 3, 2019

How States Can Use Measurement as a Foundation for Tackling Health Disparities in Medicaid Managed Care

Kate Reinhalter Bazinsky and Michael Bailit, Bailit Health

Many people in America face segregation, social exclusion, encounters with prejudice, and unequal access and treatment by the health care system, all of which can impact health. Medicaid programs serve a disproportionate share of populations that are negatively impacted by health disparities. This new State Health and Value Strategies (SHVS) issue brief provides examples from a handful of states that have begun the work of identifying, evaluating, and reducing health disparities within their Medicaid managed care programs. Additionally, it offers an approach for other states interested in measuring disparities in health care quality in Medicaid managed care as a step towards achieving health equity, such that all Medicaid managed care enrollees have a fair and just opportunity to be as healthy as possible.

The companion State Health Policy Highlight, A Roadmap for Using Measurement to Address Health Disparities in Medicaid Managed Care, provides an overview of the step-by-step approach for states interested in measuring disparities in health care quality within Medicaid managed care.

As a reminder, SHVS is convening a series of webinars on advancing health equity through Medicaid managed care organizations. This five-part series will assist states interested in addressing disparities in health outcomes among Medicaid managed care beneficiaries as a step towards achieving health equity. On Thursday, June 20 at 2:00 p.m. ET SHVS (register here, required) will host the first webinar in the series, Advancing Health Equity in Medicaid Managed Care: An Introduction for States. This webinar will review the foundational principles of health equity, barriers to its realization, and the impact of health disparities.


Expert Perspectives

The No Surprises Act: Implications for States

In the waning days of 2020, Congress enacted a $900 billion COVID-19 relief package and government funding bill (H.R. 133). Included in the measure is the “No Surprises Act”, which contains new protections for consumers from surprise medical bills from out-of-network providers. The new law establishes, for the first time, comprehensive protections in the states without their own balance billing laws and for the nearly 135 million people in self-insured plans beyond the reach of state regulators. This expert perspective summarizes provisions that have particular implications for state regulators.

January 7, 2021

The State of Play: Public Option at the Federal and State Level and What to Expect in 2021

Faced with significant premium fluctuation and the risk of “bare counties”, many policy stakeholders have turned to the public option as a potential tool to promote stability and affordability in the individual insurance market. Since 2017, nearly a dozen states have considered or passed legislation to study or implement a state-based public option program. Additionally, the 2020 election and transition to a new federal administration marks a pivotal point for state policymakers with interest in fostering new coverage options. An incoming Biden Administration’s support for state innovation will create new state-based coverage opportunities, even as major federal legislation is unlikely under a divided Congress. This expert perspective provides a brief overview of selected states efforts to implement a public option and highlights what to expect in a federal policy environment.