In response to the COVID-19 pandemic, the federal government is moving rapidly to help states and health care providers respond to mounting needs for new sources of funding and flexibility. Congress has passed three COVID-19 stimulus bills, and the U.S. Department of Health and Human Services has issued guidance outlining new flexibilities available to states and providers, and is working to approve additional requests from states, to award funds appropriated by Congress, and to issue more guidance about such funding. This Q&A provides a moment-in-time update in response to questions SHVS has received about the federal government’s response.
On Tuesday, April 21, State Health and Value Strategies hosted a state-only webinar, Impact of COVID-19 on Medicaid Managed Care Performance Incentives. As the COVID-19 pandemic continues to evolve and significantly alter care delivery, states, managed care organizations (MCOs), and providers are considering the impact on health care quality and spending. States are examining their value-based payment programs and evaluating modifications to their performance year 2019 quality measurement and performance year 2020 quality and cost performance policies, particularly those arrangements that hold entities financially accountable for performance. During the webinar, experts from Bailit Health identified quality and cost performance issues related to Medicaid managed care performance incentives and discuss policy options for state consideration.
On Thursday, April 9 at 2:00 p.m. ET, State Health and Value Strategies hosted a webinar during which experts from Manatt Health walked through tools states can use to increase payments to providers through both fee-for-service and Medicaid managed care, despite COVID-19 driven changes to utilization. As the COVID-19 pandemic continues to progress, providers across the continuum of care are experiencing significant changes in utilization resulting in declining revenue and jeopardizing access to care. The federal government has acknowledged the financial challenges facing providers through supplemental funding included in the three federal stimulus bills enacted to date and several states have submitted Section 1115 waivers requesting CMS approval to establish “disaster relief funds,” paid for with Medicaid dollars, to further assist providers. States are increasingly seeking innovative strategies to leverage Medicaid authorities to support the essential and vulnerable providers on the frontlines of the pandemic.
The COVID-19 pandemic is causing dramatic changes in utilization that threaten the financial stability of providers and may jeopardize access to care during and after the national emergency. With elective cases generally cancelled, hospitals have sharply lower utilization and revenue. Some hospitals in hotspots are seeing a surge in COVID-19 related usage, which may offset some or all of the revenue decline and in some cases increase their costs. In addition, many other providers that rely on face-to-face visits—including primary care, behavioral health, and providers of long-term services and supports—are seeing large utilization declines due to social distancing requirements. Federal and state governments have acknowledged and responded to the financial challenges facing providers in several different ways. While it will take some time for waiver requests to be reviewed and for the new federal funds to be released, this toolkit identifies more immediately available tools that can help ensure payments continue flowing to providers despite substantial utilization changes.
On Wednesday, March 18 State Health and Value Strategies hosted a webinar, Responding to COVID-19: State Strategies for Medicaid and Commercial Health Insurance Oversight. As states navigate increased spread of COVID-19 (Coronavirus), and in light of the President’s declaration of a national emergency, states are evaluating the tools available to them to respond to this new public health crisis. The webinar explored both the strategies available to Medicaid programs and the opportunities for state regulators to reduce gaps in coverage and lower barriers to accessing care. Technical assistance experts from Manatt Health and Georgetown’s Center on Health Insurance Reforms discussed the steps states have taken so far, as well as strategies and opportunities for states to consider as they ramp up their response to COVID-19. The webinar included a question and answer session during which states posed their questions to the experts on the line.
TO BE RESCHEDULED. State Health and Value Strategies was planning to host a webinar on March 19, The Fiscal Impact of the Healthy Adult Opportunity Medicaid Demonstration Initiative that will discuss findings from a new publication by our friends at the Commonwealth Fund and Manatt Health. The Centers for Medicare & Medicaid Services (CMS) recently released guidance inviting states to apply for the Healthy Adult Opportunity Medicaid demonstration initiative, which allows states to opt into a block grant funding model. The issue brief finds that the initiative would result in substantially less federal funding for state Medicaid programs, as well as greater financial risks for states that elect to pursue the demonstration. During the webinar, experts from Manatt Health will share their findings from the new publication, with an opportunity for states to ask questions of the report authors.
State Health and Value Strategies will host a webinar on state public option and Medicaid buy-in proposals on Wednesday, April 1 at 3:00 p.m. ET. The webinar will be facilitated by Manatt Health and will provide updates on state public option/Medicaid buy-in implementation and legislative developments. This update will include an overview of the state approach and key features in Washington’s Cascade Care program and Colorado’s proposed Health Insurance Option. The webinar will also outline lessons-learned and evolving considerations for the next generation of states interested in implementing a public option or Medicaid buy-in.
On March 11, State Health & Value Strategies (SHVS) hosted a webinar in which experts from Manatt Health explored Medicaid strategies to improve maternal health outcomes and address disparities in five key domains: coverage, enrollment, benefits, models of care, and quality improvement. This webinar shared findings from a published Manatt Health issue brief for SHVS on Medicaid’s role in combating the maternal mortality crisis.
This issue brief describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities in five areas: coverage, enrollment, benefits, models of care, and quality improvement. In some cases, the Medicaid agency will be responsible for implementing these policies; in other cases, the Medicaid agency can lead collaboration with other state agencies such as the public health department or the state marketplace.
State Health and Value Strategies is hosting a workgroup for Medicaid agencies addressing social determinants of health (SDOH) in their managed care programs. Access to the materials are restricted to members of the workgroup and are available through password protected page.