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.
Promising Approaches to Reducing Disparities in Birth-Related Health Outcomes in Medicaid
Erin Taylor, Jennifer Sayles, and Michael Bailit, Bailit Health
Disparities in birth-related health outcomes are rooted in structural racism and the related policies and practices that result in inequitable distribution of social and economic resources. Research estimates that more than one half of cases of maternal mortality and severe maternal morbidity (SMM) are preventable, and birth-related mortality rates among Black, American Indian, and Alaska Native people are two to three times the rate of White people.
The brief focuses specifically on actions Medicaid agencies can pursue through their managed care programs or directly with provider organizations to promote health equity and improve outcomes. It highlights state interventions and collaborations that demonstrate promise in reducing disparities and begin to center equity in birth-related health policies, including: Virginia, which is integrating and enrolling doula providers and services into Medicaid managed care and streamlining the credentialing process for doulas; North Carolina, which has nearly 10 years’ experience with a pregnancy medical home model of care; and Colorado, which will require hospitals that provide labor and delivery services and participate in a Medicaid performance-based incentive program to begin reporting on their plans for reducing peripartum racial and ethnic disparities.