Communicating About Surprise Billing: A Toolkit for States Implementing the No Surprises Act
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.
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.
State Health Insurance Policy Implications of the American Rescue Plan Act and Build Back Better
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.
Promising Approaches to Reducing Disparities in Birth-Related Health Outcomes in Medicaid
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.
IT Systems and Data Strategies to Prepare for Medicaid Continuous Coverage Unwinding
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.
Enforcement of the No Surprises Act: Considerations for States
To explore enforcement considerations across potentially multiple state agencies, State Health and Value Strategies hosted a webinar on Thursday, November 4 at 1:00pm ET, during which experts from the Georgetown University Center on Health Insurance Reforms and GMMB provided an overview of federal regulators’ proposed approach to enforcement of the NSA as well as shared strategies to consider in planning provider and consumer education efforts. The webinar also included presentations from three states on their enforcement approaches to the NSA: Maryland, Pennsylvania and Texas, followed by a question and answer session.
Borrowing Proven Policy Strategies to Vaccinate Kids Against COVID-19: Lessons from Past Successes can Provide a Roadmap for Ensuring Equity in Immunization Efforts
With authorization of the first COVID-19 vaccine for children ages five and older, most kids in the United States are now eligible to be immunized. Recent experience with other vaccines shows the country is capable of vaccinating kids widely and equitably, but the challenges in vaccinating adults against COVID-19 and experiences with other immunizations in children, like the vaccine against the human papillomavirus (HPV), also demonstrate that success is not inevitable. To meet their COVID-19 vaccination goals to vaccinate kids against COVID-19, states can borrow strategies that have historically proved effective in immunizing kids against diseases such as measles and resulted in dramatic reductions in certain vaccination rate disparities. This issue brief highlights state strategies that have led to high childhood vaccination rates—and dramatic strides toward health equity—and identifies how those strategies could be applied in the context of the current COVID-19 crisis.
Resources for States on Unwinding the Medicaid Continuous Coverage Requirement
Landing page of resources related to unwinding of the PHE.