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.
State Health and Value Strategies, a program of the Robert Wood Johnson Foundation, is pleased to publish the second in our series of webinars for state officials on achieving population health goals.
Medicaid’s unique and critical role in responding to events such as the opioid and HIV/AIDS epidemics, the 2001 World Trade Center attacks, the Flint, Michigan lead contamination crisis, and Hurricane Katrina are discussed in this brief.
Driven to improve care coordination and contain costs by moving away from a volume-based payment model, an increasing number of states are implementing risk-based managed care programs to deliver long-term services and supports (LTSS). As the primary payer for LTSS, state Medicaid programs have a significant interest in ensuring that entities with which they contract deliver high quality and cost-effective care to members. This issue brief identifies ways states can learn from value-based payment models being applied elsewhere to create more accountability for the quality and cost of LTSS.
Health Savings Accounts have been a frequent topic of conversation for policy options in the ACA markets. HSAs have gained attention in recent years as they are featured in both “Repeal & Replace” and Medicaid proposals. This webinar reviewed the basics of HSAs, how they have been considered under various repeal and replace proposals, and how alternative Medicaid expansions have used HSA-like programs for enrollees.
Continued uncertainty surrounding federal legislative action affecting the Affordable Care Act (ACA) have led many states to reconsider the option of Section 1332 State Innovation Waivers. These waivers allow states broad flexibility to redesign the coverage provisions of the ACA according to certain statutory guidelines. Given the renewed interest in 1332 waivers, the State Network hosted a webinar for state officials featuring the experts at Manatt Health.
As states seek to understand the impacts of proposed changes to Medicaid financing, comparative data on where states stand can be very valuable. The memos included here use state-specific data to analyze the impact of proposals to limit federal Medicaid funding on all 50 states and the District of Columbia.
Shared Accountability Across Health and Non-Health Sectors: Opportunities to Improve Population Health
On Wednesday April 5, 2017 the State Health and Value Strategies program hosted the first in a series of three webinars aimed at helping state officials achieve population health goals. This webinar outlined opportunities for state agencies to work collaboratively to improve outcomes and reduce inefficiencies across programs serving overlapping populations.