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Issue Brief

With health care providers increasingly being rewarded based on changes in cost of care, it is critical that sufficient statistical safeguards are in place to ensure that payment arrangements fairly reflect provider performance rather than random variation in medical utilization. The underlying changes in cost of care for populations served by patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) are difficult to accurately assess when there are a small number of attributed patients.

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Date Created: Apr 26, 2016


Webinar

The State Network 1332 Waivers Affinity Group continued with a presentation on potentially broader reforms that states may pursue through the Section 1332 State Innovation Waivers process. This discussion followed a prior presentation focused on narrower, more targeted reforms that several states are seeking to implement through the waiver process. This presentation, prepared by the State Network team at Manatt Health, included information on waiver considerations in California and Minnesota.

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Date Created: Apr 14, 2016


Report , Templates & Toolkits

Since the passage of the Affordable Care Act (ACA), thirty-one states plus the District of Columbia have expanded Medicaid, providing a substantial base of evidence for the impact of Medicaid expansion, from a variety of perspectives. Data available from these states and a growing research base provide key information about the benefits and the strategic value of expansion.

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Date Created: Apr 12, 2016


Issue Brief , Report

Changes in population-based payment models in health care delivery have spurred enhanced efforts toward closer integration between state purchasers of health care and state, county, and local public health officials. This issue brief, developed by Bailit Health Purchasing LLC and Dr. Karen Hacker, investigates approaches that state agencies might employ in order to better integrate public health and health care delivery as a means of improving health and the value of health care, and it is organized according to seven features of integration. The issue brief is accompanied by three case studies providing additional detail to some of the examples cited in the brief.

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Date Created: Mar 30, 2016


Issue Brief , Report

Recent guidance released by the Centers for Medicare and Medicaid Services (CMS) in February 2016 increases the range of Medicaid services and providers for which states may claim full federal funding. States with significant American Indian and/or Alaska Native (AI/AN) populations stand to benefit from this increased federal Medicaid funding. This issue brief, developed by Manatt Health, summarizes the new policy expanding federal funding for state Medicaid services provided to AI/AN populations, and explains the ways in which these additional funds reduce the cost of Medicaid expansion for states.

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Date Created: Mar 29, 2016


Issue Brief , Report

Provider assessments, fees, and taxes are tools available to states to generate funds to cover the non-federal share of Medicaid payments. This issue brief, developed by the State Network team at Manatt Health, examines two revenue sources that states may utilize to fund the non-federal share of Medicaid expansion: provider assessments and provider donations. Both of these are authorized by federal law and have been used by states in connection with Medicaid expansion. The issue brief summarizes the rules regarding their use and describes the ways in which they have been utilized in several states.

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Date Created: Mar 22, 2016


Issue Brief , Report , State Materials

In addition to the impact that state decisions to expand Medicaid have had on coverage rates across the country, there is an increasing body of evidence showing consistent economic benefits among these states. This report, prepared by Manatt Health, is an update to an April 2015 State Network report, and examines data regarding Medicaid expansion in eleven states, demonstrating that states continue to realize budget savings and revenue gains as a result of expanding Medicaid.

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Date Created: Mar 22, 2016


Regulatory Analysis , Webinar

The Department of Health and Human Services (HHS) recently published its final Notice of Benefit and Payment Parameters for 2017, as well as the final version of its 2017 letter to Qualified Health Plan (QHP) issuers participating in the federally-facilitated marketplace (FFM). The State Network team at Manatt Health led a webinar explaining this final rule and what it will mean for states.

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Date Created: Mar 11, 2016


Webinar

The State Network 1332 Waivers Affinity Group continued with a presentation from the team at Manatt Health Solutions. This webinar included an overview of the small group market requirements in the ACA, and the efforts of three states to preserve their innovative pre-ACA programs.

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Date Created: Feb 26, 2016


Issue Brief

With states increasingly moving to develop population-based payment arrangements with provider organizations, the critical role of safety-net providers has become a challenging consideration for states. While safety-net providers typically lack the capital, experience, and/or scale to operate as an Accountable Care Organization (ACO), their role in state Medicaid programs underscores their integral role in the implementation of a population-based payment strategy with ACOs.

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Date Created: Jan 26, 2016