Standardizing Health Plan Benefit Design in the Individual Market: Opportunities and Implications
Eight states require or will require insurers to offer health plans with standardized benefit plans in the individual market, and several more are considering requiring such standardization in the future. On Wednesday, November 6, 2019 at 1:00 p.m. ET, SHVS hosted a webinar on the opportunities for states to implement standardized benefit designs, either through their health insurance marketplace or as part of a public option plan, issues to consider in developing standardized options, communicating with stakeholders, and leveraging standardized designs to improve affordability for enrollees and encourage maintenance of coverage. The webinar reviewed the development of standardized designs through state-based marketplaces, their role in Washington and other states’ public option proposals, operational requirements to improve the end-user experience, and data collection and analysis needs.
SHVS Health Equity Through Managed Care Webinar Series
On Tuesday, October 22 State Health and Value Strategies convened the fifth, and last, webinar in our series SHVS Health Equity Through Managed Care. For many states, eliminating disparities in Medicaid managed care programs means working with their MCO contractors, and implementing contractual requirements that advance health equity. Previous webinars in this series identified measures and MCO performance requirements that help reduce health disparities and improve health equity for a state’s Medicaid population. This webinar, The Medicaid MCO Experience in Addressing Health Equity, profiled the work of one MCO, HealthPartners, in addressing equity issues within its Medicaid line of business. We heard from Brian Lloyd, who manages Health Partners’ organization-wide equity initiative, which includes collecting data to eliminate disparities in care, supporting language access, partnering with communities, and building an organizational understanding of equity, diversity, inclusion, and bias.
Final Public Charge Rule: Analysis and Potential Implications
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.
HRA Regulations: State Implications and Responses
On Friday, June 21 at 1:00 p.m. ET State Health and Value Strategies hosted a webinar for state officials with technical experts to discuss the implications of the health reimbursement arrangements (HRA) rule and possible state responses. The webinar featured Jason Levitis, who led ACA implementation at the U.S. Treasury Department, as well as experts from Georgetown University’s Center on Health Insurance Reforms and from Manatt Health. The U.S. Departments of Health and Human Services, Labor, and Treasury released final regulations easing the rules governing HRA and other account-based, tax-preferred health care on June 13. The final rule represents the third of the three policy changes initiated by the October 12, 2017 Executive Order, which also called for easing the rules on short-term limited-duration coverage and association health plans. Like those changes, the HRA rule could have profound implications for health insurance markets, consumers, and Marketplaces. The rule is effective in 2020, which raises important considerations about Marketplace readiness and potential tax consequences for individuals.
Emerging Strategies for Connecting Justice-Involved Populations to Medicaid Coverage and Care
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.
State Medicaid Buy-Ins: Key Questions to Consider
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.
Leveraging Multi-Payer Claims Databases for Value
On Wednesday, March 27, 2019, State Health and Value Strategies, in partnership with the Peterson Center on Healthcare, hosted a webinar on the ways in which several states and one community organization are using their multi-payer claims databases. More states are leveraging multi-payer claims databases to better understand how their health care systems are operating and implementing data-driven decision-making. States may not be aware, however, of the strategies other states and organizations are adopting to leverage claims databases to support health care transformation goals. During the webinar, presenters from the state of Vermont and Rhode Island, as well as the Washington Health Alliance, discussed how they are employing claims databases to enhance the value of care and will share lessons learned for those seeking to optimize their own databases.
Overview of the HHS Proposed Notice of Benefit and Payment Parameters for 2020
The Centers for Medicare & Medicaid Services (CMS) recently released the proposed annual Notice of Benefit and Payment Parameters for plan year 2020. The Notice proposes regulatory and financial parameters for qualified health plans on the Exchanges, plans in the individual, small group, and large group markets, and self-funded group health plans. State Health and Value Strategies hosted a webinar for states Friday, January 25 at 1:00 p.m. E.T. During this webinar, experts walked through key components of the notice and discuss potential state considerations and options for commenting on the proposed rule.
Managing Managed Care: Best Practices for Medicaid Pharmacy
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.
Medicaid Buy-In: Emerging Models and Considerations
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.