On January 27, 2023, the Centers for Medicare & Medicaid Services released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” The SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.
Measure Selection, Alignment and Performance Benchmarking: A New Resource for States
On October 12, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar, facilitated by experts at Bailit Health, on a new suite of publicly available resources that support states in their measure selection, alignment and performance benchmarking efforts. The Buying Value Benchmark Repository builds upon the Buying Value Measure Selection Tool and is a downloadable database of non-HEDIS and modified HEDIS measures that states and regional health improvement collaboratives are using for reporting, payment or other purposes. State purchasers can use the database for measure selection and benchmarking purposes as non-HEDIS and modified HEDIS measures rarely have national benchmarks which states can employ to assess and perhaps reward provider, ACO or MCO performance in value-based payment arrangements.
During the webinar technical experts from Bailit Health provided an overview of the repository and discussed how states can both utilize the tool and contribute measures to it. The webinar also reviewed the resources available through Buying Value to support measurement selection. These resources are publicly available to download and use, and the Measure Selection Tool can be customized to support measure alignment and selection processes.