State Health and Value Strategies (SHVS) and the National Academy for State Health Policy (NASHP) co-hosted an ancillary session at the 2017 annual NASHP meeting on October 23, 2017 in Portland, Oregon. The meeting was entitled “Managed Long-Term Services and Supports: Value-Based Purchasing Strategies, Challenges and Opportunities” and focused on supporting state learning, skill-building, and strategy development to foster sound Medicaid managed care (MMC) policies and value-based purchasing (VBP) strategies specific to long term services and supports (LTSS).
Value Based Purchasing for Managed Care Procurement: A Toolkit for State Medicaid Agencies is designed to assist states interested in implementing value-based purchasing (VBP) approaches with their Medicaid managed care organizations (MCOs). Using a VBP approach can mean significant and ongoing changes for a state Medicaid agency and its MCOs. The Toolkit is designed to guide Medicaid agencies through key action steps and considerations in four phases of the managed care procurement cycle – 1) strategic procurement planning, 2) solicitation development, 3) bidder selection, and 4) contract management.
In a final effort to pass a bill to repeal and replace the Affordable Care Act before reconciliation instructions expire on September 30th, Senators Graham and Cassidy are advancing a proposal that would retain many key provisions of the Better Care Reconciliation Act (BCRA) – including per capita caps for Medicaid non-expansion populations – and replace federal funding for tax credits, cost sharing reductions, Medicaid expansion, and the Basic Health Program with a capped allotment that would be distributed to states in the form of a block grant.
This brief provides an overview of the proposal developed by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) and filed on July 27th as a substitute for the American Health Care Act passed by the House to “repeal and replace” the Affordable Care Act (ACA). The proposal retains many features of the July 20th version of the Better Care Reconciliation Act (BCRA) released by Senate leadership (and rejected by the Senate on July 25th), including per capita caps on Medicaid spending and elimination of the individual and employer mandates.
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This issue brief digs into opportunities that states have to account for SDOH in Medicaid programs.
Webinar — Understanding the Senate’s Better Care Reconciliation Act of 2017 (BCRA): Key Implications for Medicaid
Following our June 5th webinar, “Per Capita Caps Under Medicaid: Emerging Issues for States,” State Network, in partnership with technical experts from Manatt Health, is hosting a series of conversations that will provide opportunities for state leadership to dive deeper into emerging issues. Given the recent release of the Senate repeal and replace proposal, we will review and discuss the Senate’s BCRA. State Network, in partnership with technical experts from Manatt Health, will host a webinar during which we will review the major Medicaid provisions of the BCRA, providing an opportunity for state leadership to understand how the Senate bill compares to the AHCA and its potential implications for states. This session will start with a short presentation, followed by time for Q&A and a discussion, focusing on the Medicaid provisions of the BCRA.
Understanding the Senate’s Better Care Reconciliation Act of 2017 (BCRA): Key Implications for Medicaid
Senate leadership has released a proposed substitute for the House-passed American Health Care Act (AHCA) known as the Better Care Reconciliation Act of 2017 (BCRA) that eliminates enhanced funding for Medicaid expansion after a three-year phase out, establishes a cap on federal Medicaid funding for nearly all beneficiaries and services, and makes a number of other changes to Medicaid. Using the Manatt Medicaid Financing Model, this analysis estimates the state-by-state impact of the cap on Medicaid and elimination of enhanced funding for expansion, taking into account that states may respond to the proposed law in a number of different ways.
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This webinar includes an overview of the methods for gathering SDOH data, and the range of possible uses of the data by state policy makers. It also explores how states could factor SDOH into improved payment models and quality measurement activities. Lastly it describes a new payment model that Massachusetts Medicaid is using to adjust managed care payments for certain social risk factors among enrolled populations.
The American Health Care Act (AHCA), as passed by the House of Representatives on May 4, 2016, would overhaul federal financing of state Medicaid programs, and for the first time, would cap federal Medicaid funding. As policymakers debate the potential implications of per capita caps, it has been suggested that per capita caps are really no different than Medicaid managed care—a concept with which states are fully familiar and well able to manage. This policy brief tests that hypothesis by examining the similarities and differences between the federal per capita cap and a state’s per capita “cap” in Medicaid managed care spending.
Following the House’s passage of the American Health Care Act (AHCA) and the Senate’s on-going repeal and replace negotiations, it is clear that significant changes to federal Medicaid financing remain in play. Building on past State Network webinars that have reviewed the AHCA Medicaid financing provisions and identified their implications for states, the State Network, in partnership with technical experts from Manatt Health, held a webinar that provided a deep-dive on critical issues that will influence the impact of capped funding on states, including choice of base year, trend rates, and treatment of supplemental payments. The discussion was informed by updated modeling based on the House-passed version of the AHCA.