Protected: State-Based Marketplace (SBM) Strategies for Streamlining Coverage Transitions Post-Public Health Emergency (PHE)
On October 25, 2021, State Health and Value Strategies hosted a virtual roundtable focused on SBM-Medicaid coordination strategies, opportunities and challenges related to enrollment, and communication and outreach tactics for SBMs to consider in preparation for the end of the PHE.
The End of the COVID-19 Public Health Emergency: Data and IT “Table Stakes” for Retaining Coverage Gains
Following the expiration of the Public Health Emergency (PHE), states will resume normal eligibility and enrollment activities for all enrollees in Medicaid and the Children’s Health Insurance Program (CHIP). The volume of expected redetermination activity at the end of the PHE is unprecedented. This issue brief reviews state Medicaid/CHIP agency data and information technology (IT) system “table stakes”—strategies that will have the highest impact for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the PHE continuous coverage requirements end. If adopted, these strategies will also enable states to dramatically improve Medicaid/CHIP enrollment and coverage retention in the longer-term for people eligible for government subsidized health coverage.
Supporting Health Equity and Affordable Health Coverage for Immigrant Populations: State-Funded Affordable Coverage Programs for Immigrants
Access to affordable health coverage and healthcare for immigrant populations in the U.S. is critical to advancing health equity and reducing health disparities. This issue brief—the first in a series “Supporting Health Equity and Affordable Health Coverage for Immigrant Populations”—provides an overview of the national immigrant health coverage landscape and offers considerations for policymakers related to state-funded affordable coverage programs for low-income individuals who do not qualify for subsidized health insurance under the ACA or other public programs due to immigration status.
COVID-19, the resulting behavioral health crisis (including those related to mental health and substance use disorders), and calls for law enforcement reform related to behavioral health crisis response have heightened the urgency among federal, state, and local policymakers to expand access to behavioral health crisis services. Recently, the federal government has provided new funding opportunities to states to improve access to behavioral health crisis services, including mobile crisis services. As states review the opportunities available to begin, enhance, or expand mobile crisis intervention services under the American Rescue Plan Act of 2021, policymakers may further consider a hybrid funding model that provides mobile crisis providers with a consistent and steady stream of funding to ensure they are able to maintain 24/7 availability and respond in a timely manner to all individuals in crisis, regardless of insurance status. Such a new model for funding mobile crisis services could also be designed to hold payers accountable for covering mobile crisis services when their enrolled members use this essential resource. This issue brief presents a sustainable, hybrid coverage and funding approach for mobile crisis services.
Collection of Sexual Orientation and Gender Identity (SOGI) Data: Considerations for Medicaid and Spotlight on Oregon
Thirteen million people identify as part of a sexual or gender minority (SGM) in the United States, and an estimated 1.17 million of those SGM adults (age 18-64 old) have Medicaid as their primary source of health insurance. Although there has been increasing recognition over the last decade that sexual orientation and gender identity (SOGI) are important determinants of health, the recent coronavirus (COVID-19) crisis has amplified the stark health disparities that many vulnerable populations face. Despite gaps and inconsistencies in state and federal reporting on COVID-19, data continues to show that Black, Indigenous, and other people of color (BIPOC) have been disproportionately impacted by both higher risks of infection and poorer health outcomes. However, health-related data about SGM populations is particularly scarce. This brief documents how information describing SGM populations is currently collected at the federal level and in Medicaid. The brief also spotlights Oregon’s recent efforts to improve the collection of SOGI data, and present several issues that states should consider as they look to improve their collection of SOGI data in Medicaid.
Promoting Health Equity in Medicaid Managed Care: A Guide for States describes recommended process steps for states to integrate a focus on health equity in their Medicaid managed care programs. It offers a series of concrete steps to be more intentional about advancing health equity in Medicaid, and specifically through Medicaid managed care programs. The guide focuses on the internal agency commitments and changes that are necessary to address systemic barriers to accessing high quality health care and improving health outcomes, particularly among populations that experience persistent health inequities. It is organized into three primary sections, each containing specific actions for Medicaid agencies.
State Health and Value Strategies, in partnership with Health Equity Solutions, created the Health Equity Language Guide for State Officials which is comprised of three tools to help state officials with the language they use to discuss and write about race and health equity. The Guide includes definitions and explanations of words and phrases, how to think about their usage, and examples of how they might be applied.
Drawing on insights learned through discussions with state officials, informed by grassroots community organization input and a review of the literature, this issue brief outlines key barriers states face in their efforts to increase vaccination rates among BIPOC and highlights strategies states are pursuing in partnership with community-based organizations (CBOs) to address these challenges. This issue brief also considers future phases of the COVID-19 vaccine rollout and planning, including near-term efforts to vaccinate children and adolescents, as well as longer-term opportunities to build sustainable infrastructure and capacity to advance health equity related to the pandemic, emergency preparedness, and beyond within state and local public health and health care delivery systems.
On Thursday, August 12, State Health and Value Strategies hosted a webinar during which experts from Manatt Health and Health Equity Solutions provided an overview of the strategies states can pursue in partnership with community-based organizations to reduce disparities in COVID-19 vaccine uptake, and in the longer term, to build a more equitable and sustainable public health system. While more than 20 states and the District of Columbia reached the Biden administration’s goal of administering one or more COVID-19 vaccine doses to at least 70 percent of adults by early July, wide variation in vaccination rates persists across communities within these states and among the 30 states still working to reach this goal. This variation in vaccination rates at the community level translates to disparities across racial and ethnic groups, as most states continue to have disparities in vaccination rates between Black, Indigenous and people of color (BIPOC) and white populations. States and their community partners are implementing a broad range of distribution and outreach strategies to improve vaccine equity and are looking to build sustainable infrastructure and capacity to advance health equity within state and local public health and health care delivery systems.
On Tuesday, June 22, State Health and Value Strategies hosted a webinar on innovative measures that states have developed to address their program priorities. States are responsible for ensuring that their Medicaid programs are delivering high-quality, high-value care, but there are not always nationally-endorsed measures focused on states’ areas of interest. The webinar featured state officials from the Oregon Health Authority and Massachusetts Executive Office of Health and Human Services, who discussed their experiences developing and implementing homegrown measures in their state Medicaid programs.