Reducing Overuse and Misuse: State Strategies to Improve Quality and Cost of Health Care
This issue brief focuses specifically on the key purchasing strategies that state Medicaid agencies and state employee health benefit purchasers can implement in order to reduce the overuse and misuse of health care services, and improve the quality and reduce the cost of care. A webinar presentation on the subject is also available for download.
Realizing the Potential of All-Payer Claims Databases: Creating the Reporting Plan
This paper examines the critical components of states’ APCD reporting efforts to date and suggests essential steps to creating credible and robust analytics. Drawn from interviews with APCD leaders, state-specific documents, and the experience of the authors, this paper is intended to help states with functioning and developing APCDs identify the building blocks necessary to create and evolve a comprehensive analytic program. This information may also be useful to those charged with designing APCD outputs, such as datasets and reports.
The Basics of All-Payer Claims Databases: A Primer for States
The purpose of this paper is to assist states embarking on APCD initiatives by highlighting key considerations for building statewide APCDs and potential solutions based on experiences in early-adopting APCD states.
Report from the States: Early Observations about Five State Marketplaces
Implementation of the health insurance marketplaces has been an ongoing challenge across the country in the initial months of open enrollment. While state marketplaces are still evolving, and some are experiencing their own implementation challenges, they are largely working. This brief, prepared by the team at Manatt Health Solutions, looks at five state marketplaces to assess early lessons that might help to explain early enrollment trends.
How State-based Marketplaces Can Better Meet the Needs of the Unbanked and Underbanked
The Affordable Care Act (ACA) will make health insurance more accessible to millions of Americans. To effectuate coverage, flexible payment methods will help ensure insurance accessibility is not hampered by the absence of a traditional bank account, an all too common scenario for many uninsured households.
Operationalizing the New Fast Track Enrollment Options: A Roadmap for State Officials
Earlier this year, the Centers for Medicare & Medicaid Services (CMS) issued guidance alerting states to the availability of waivers to facilitate the enrollment of eligible individuals into Medicaid using data states already have “on hand” in their Supplemental Nutrition Assistance Program (SNAP) and Medicaid files.
Qualified Health Plan Selection: Considerations for Consumers Webinar
As part of their series on “Helping Consumers Understand the Marketplaces,” Manatt Health Solutions, with support from the State Health Reform Assistance Network, led a webinar reviewing factors states will want to call out for consumers seeking guidance on how to choose among plans, especially young adults who may be choosing between catastrophic coverage and other options.
Implementation of the Affordable Care Act’s Hospital Presumptive Eligibility Option: Considerations for States
The Affordable Care Act (ACA) gives qualified hospitals the opportunity to determine presumptive eligibility (PE) for all Medicaid-eligible populations which will enable hospitals to temporarily enroll individuals in Medicaid, ensuring compensation for hospital-based services, while providing patients access to medical care and a pathway to longer-term Medicaid coverage.
Reconciliation of Advanced Premium Tax Credits: A Primer for Assisters Webinar
As part of a series on “Helping Consumers Understand the Marketplaces,” Manatt Health Solutions led a webinar reviewing a primer on the reconciliation of advance premium tax credits (APTC), explaining how reconciliation will work when consumers file their taxes, and strategies consumers can use to minimize the risk of repayment.
Advance Premium Tax Credits and Cost-Sharing Reductions: A Primer for Assistors
dvance Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs) remain critical to the ability of marketplaces to offer affordable coverage. It is especially important that marketplace staff, eligibility workers, navigators, certified application counselors, and other assistors are well-informed regarding the role of APTCs and CSRs in the continuum of coverage created by the Affordable Care Act.