Password-protected access to slides presented at the Medicaid Buy-in and Public Options Small Group Convening held on September 5 – 6 in Seattle, WA.
On August 12, 2019 the Department of Homeland Security (DHS) issued a final version of its public charge rule which was to go into effect on October 15. The public charge rule will change how DHS determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). The webinar reviewed the final rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers.
How States Can Use Measurement as a Foundation for Tackling Health Disparities in Medicaid Managed Care
Many people in America face segregation, social exclusion, encounters with prejudice, and unequal access and treatment by the health care system, all of which can impact health. Medicaid programs serve a disproportionate share of populations that are negatively impacted by health disparities. This new State Health and Value Strategies (SHVS) issue brief provides examples from a handful of states that have begun the work of identifying, evaluating, and reducing health disparities within their Medicaid managed care programs. Additionally, it offers an approach for other states interested in measuring disparities in health care quality in Medicaid managed care as a step towards achieving health equity, such that all Medicaid managed care enrollees have a fair and just opportunity to be as healthy as possible.
On Tuesday, June 18 at 1:00 p.m. ET, State Health and Value Strategies, in partnership with Manatt Health, hosted a webinar for states that provides an overview of the opportunities available to connect justice-involved populations to Medicaid coverage and care. States are exploring opportunities to engage justice-involved populations–including juveniles and adults–in Medicaid coverage, case management and health care both immediately prior to and following their release from prison or jail. States’ interests are motivated by the high needs and high related health costs of these individuals–who are often eligible for Medicaid upon release, especially in states that have expanded Medicaid. Despite the current prohibition on drawing down federal Medicaid financing to fund health care for people while they are incarcerated, there are a number of strategies states can deploy to meaningfully connect justice-involved populations to critical coverage as well as medication and physical and behavioral health care services when re-entering the community. The webinar provided an overview of Medicaid enrollment and suspension processes to make sure an individual has active Medicaid coverage and “in-reach” planning pre-release that helps with engagement and care management post-release.
On Thursday, April 25, State Health and Value Strategies, with Manatt Health, hosted a webinar for states on six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program. Lawmakers across the country are considering “Medicaid buy-in” or public option programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. The concept of Medicaid buy-in/public option is evolving, encompassing the original Medicaid-based proposals and extending to other programs through which states can leverage government bargaining power to offer a more affordable coverage option, like state employee health plans or a Basic Health Plan. During the webinar, speakers from Manatt Health discussed considerations related to (1) goal setting, (2) sources of cost-savings, (3) potential impacts on existing insurance markets, (4) federal 1332 waiver considerations, (5) implementation capacity, and (6) key steps for implementation. Additionally, representatives from Colorado, Connecticut, and Washington shared the status of efforts in their respective states.
Addressing Social Factors That Affect Health: Emerging Trends and Leading Edge Practices in Medicaid
Medicaid programs are increasingly considering how best to address social factors, such as housing, healthy food, and economic security, that can affect health and medical expenditures. Often referred to as social determinants of health (SDOH), these factors are significant drivers of population health outcomes. While states historically have had some experience tackling such issues for specialized, high-need populations, they are now confronting whether, and how, Medicaid should address SDOH for a broader population of Medicaid enrollees in order to achieve better health outcomes. This issue brief explores the “next generation” practices that states are deploying to address social factors using Medicaid 1115 waivers and managed care contracts, as well as the specific steps states can take to implement these practices.
On January 23, State Health and Value Strategies hosted a webinar examining the complexities of state Medicaid oversight of the pharmacy benefit in the managed care environment. State Medicaid programs commonly rely on contracted Managed Care Organizations (MCOs) and their subcontracted Pharmacy Benefit Managers (PBMs) to manage the prescription drug benefit offered to Medicaid enrollees. The webinar offered states real world tips on how to best monitor and evaluate operational and financial performance of their MCOs and their subcontracted PBMs.
On December 17, 2018 State Health and Value Strategies hosted a webinar on Medicaid buy-in proposals. Over the past year, state policy makers and advocates have expressed interest in proposals that would permit people above Medicaid eligibility levels to “buy in” to Medicaid (i.e., leverage the state’s bargaining power in some way) in order to offer more affordable and accessible coverage. During this webinar, Manatt Health discussed state considerations for developing a Medicaid buy-in proposal, evolving models of state proposals, and the administrative considerations and authorities needed for each model.
On November 16, State Health and Value Strategies hosted a webinar, with technical experts from Manatt Health, on H.R. 6, The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the “SUPPORT Act”) which was signed into law on October 25. Most stakeholders agree that the bill is a significant step forward in addressing the opioid epidemic, reflecting a range of important policy changes such as initiatives to increase access to medication-assisted treatment (MAT), new grant, pilot and demonstration projects, and a series of changes to Medicaid and Medicare. During the webinar, experts from Manatt Health reviewed major health provisions of the new law and implications for states.
On October 1, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar, facilitated by experts at Manatt Health on the long-anticipated proposed rule released by the Department of Homeland Security (DHS) on September 22. The proposed rule seeks to change how DHS determines whether immigrants—when seeking admission to the United States, an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). Consequentially, being determined a “public charge” may put immigration status at risk. The webinar reviewed the proposed rule and its potential impacts on consumers, states and providers. Specifically, we highlighted the key ways the proposed rule departs from current guidance, with a particular focus on the implications for Medicaid and other health-related public benefits, and how the proposed rule may impact consumers’ access to certain benefits. Click here for the webinar slides.