On Tuesday, February 15, State Health and Value Strategies hosted a webinar, Centering Health Equity in Medicaid Section 1115 Demonstrations. Many states are looking to Medicaid as a critical lever for advancing health equity, and states have multiple tools and authorities in Medicaid to advance health equity through coverage and benefit policy, delivery system and payment reform, and innovations that impact social drivers of health. During the webinar experts from Manatt Health provided an overview of Medicaid’s role in promoting health equity and ways states can advance health equity and address structural racism throughout the Section 1115 demonstration lifecycle, from planning to implementation to monitoring, and evaluation.
A recognition by leaders and policymakers in many states that longstanding structural racism has caused disproportionate health risks and poorer health outcomes for communities of color is prompting action to prioritize and advance health equity. One key strategy states are using to test new or innovative ideas related to health equity in their Medicaid programs is Section 1115 demonstrations. A new series from State Health and Value Strategies shares strategies for states to consider as they work to advance health equity and address structural racism through Medicaid Section 1115 demonstrations.
As of January 1, 2022, a new federal law, the No Surprises Act, is in effect to protect consumers from surprise medical bills for out-of-network care. Some states have laws that already protect some consumers from surprise medical bills, depending on the type of health insurance they have. The federal law applies to all states, extends protections, and offers protections to many more people, including those with employer-sponsored health insurance. This toolkit includes suggested template resources to use in communicating with consumers about the No Surprises Act.
This document provides excerpts of health disparities and health equity language from Medicaid managed care (MMC) contracts and requests for proposals (RFPs) from 17 states and the District of Columbia. The criteria for inclusion in this compendium were contracts and RFPs that explicitly addressed health disparities and/or health equity. Website links to the full contracts are included where available.
Tracking Medicaid Coverage Post the Continuous Coverage Requirement: Using Data Dashboards to Monitor Trends
The Families First Coronavirus Response Act Medicaid “continuous coverage” requirement has allowed people to retain Medicaid coverage and get needed care during the COVID-19 pandemic. When continuous enrollment is discontinued, states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. The current lack of publicly available and timely Medicaid enrollment, renewal, and disenrollment data will make it difficult to understand exactly who is losing coverage and for what reasons. One effective way to monitor this type of information is through the use of Medicaid enrollment and retention dashboards. This issue brief examines the current status of data collection to assess Medicaid enrollment and retention, summarizes potential forthcoming reporting requirements, and describes some of the best practices states should consider when developing a data dashboard to display this type of information.
Supporting Health Equity and Affordable Health Coverage for Immigrant Populations: CHIP Coverage Option for Pregnant Immigrants and their Children
Under federal regulations, states may provide pregnancy-related care through the Children’s Health Insurance Program (CHIP) state plan to targeted low-income children from conception to birth (the so called “unborn child” option). This option–referred to in this brief as the CHIP coverage option for pregnant immigrants and their children–enables states to provide prenatal, labor and delivery, and postpartum services to pregnant individuals, regardless of immigration status. This issue brief–the second in a series, “Supporting Health Equity and Affordable Health Coverage for Immigrant Populations”–offers considerations for policymakers around the CHIP coverage option for pregnant immigrants and their children, regardless of immigration status.
This slide deck presents policy considerations for states in light of provisions from American Rescue Plan Act of 2021 and if passed, potential implications from the Build Back Better legislation.
Conceptualizing Performance Measurement for Social Care Interventions: An Issue Brief for State Medicaid Agencies
Growing recognition that socioeconomic adversity impacts health outcomes has led the healthcare sector to support initiatives that address social determinants of health (SDOH). There is an opportunity to leverage performance measures to further incentivize these interventions and track adoption. This issue brief explores opportunities for state Medicaid agencies to implement performance measures with contracted entities that could strengthen their growing interest in social care and highlights several barriers to those applications.
An extensive body of research reports on poor birth-related outcomes and disparities in maternal mortality and morbidity in the United States, particularly for individuals enrolled in Medicaid. Importantly, Medicaid provides healthcare coverage to individuals who may otherwise not be eligible for coverage until pregnancy, until which time they may have been uninsured or under-insured and have untreated health conditions or lack access to routine care. As states start to tackle institutionalized racism in the healthcare system, they are considering approaches to center health equity by addressing disparities in birth outcomes. This issue brief describes the drivers of birth-related health disparities and identifies purchasing and payment strategies to support state efforts to reduce disparities in birth outcomes. The brief focuses specifically on actions Medicaid agencies can pursue through their managed care programs or directly with provider organizations to promote health equity and improve birth outcomes.
On Wednesday, November 10 State Health and Value Strategies hosted a webinar that provided an overview of strategies for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the Medicaid continuous coverage requirement ends. States will be resuming eligibility and enrollment activities for all enrollees in Medicaid and the Children’s Health Insurance Program (CHIP), and as part of their planning, states have an opportunity to retain coverage gains experienced over the pandemic period by taking steps to ensure that eligible enrollees are able to keep Medicaid/CHIP coverage, and those who are eligible for subsidized Marketplace coverage are transitioned and enrolled. Experts from Manatt Health and McKinsey & Company discussed how states can prepare now by deploying strategies to update enrollee contact information, and make other eligibility and enrollment technology changes to better serve their residents.