Webinars | May 17, 2014

Payment Reform 101: Why Payment Reform? What is it?

Mary Beth Dyer, Michael Bailit and Richard Slusky, Bailit Health Purchasing

The first webinar in a three-part series on payment reform, this presentation by Bailit Health Purchasing addresses how traditional fee-for-service payment impedes state efforts to purchase value and describes the relationship between payment and delivery system reform. The webinar also highlights the role and influence of public purchasers in health care, reviews types of payment reform models being used by state purchasers and providse an overview of where payment reform is happening across the U.S. A state official offers insights into why his state opted to pursue payment reform and how it selected the models to implement.



Expert Perspectives

February 3, 2023

New CMS Guidance on Unwinding Provisions in the CAA, 2023

On January 27, 2023, the Centers for Medicare & Medicaid Services released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” The SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.

February 1, 2023

CMS Approves First-in-Nation Justice-Involved Re-Entry Section 1115 Demonstration

On January 26, 2023, the Centers for Medicare & Medicaid Services approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. This expert perspective describes the amendment, a centerpiece of which is approval for California Medicaid to provide a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. By providing re-entry services to Medicaid-enrolled individuals who are incarcerated, California aims to build a bridge to community-based care for justice-involved enrollees, offering them services to stabilize their physical and behavioral health conditions and establishing, prior to release, a re-entry plan for their community-based care.

January 27, 2023

Federal Ruling Provides Text Messaging Flexibility to Support State’s Unwinding Efforts

On January 23, 2023, the Federal Communications Commission issued an important ruling that provides states with new flexibility to support enrollee outreach and communication efforts as part of their processes to unwind the Medicaid continuous coverage requirement. The ruling permits state agencies and their partners to send text messages and make phone calls to individuals about enrollment-related issues not only for Medicaid but for other state-run health insurance programs, including marketplace coverage. This expert perspective reviews the ruling and implications for states.