The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
Social Risk Factor Screening in Medicaid Managed Care
Rachel Isaacson and Michael Bailit, Bailit Health
The past two years have seen a sharp increase in state Medicaid program interest in how social determinants of health (SDOH) influence Medicaid enrollee health status and spending. This brief provides an introduction to the first step most states are taking in response through their Medicaid managed care programs—screening members for social risk factors (SRFs). It explains why Medicaid managed care members should be screened for SRFs, identifies screening design decisions, identifies common SRFs, and reviews options for screening tool selection.
As a companion to this issue brief, State Health and Value Strategies hosted a webinar series that profiled the findings from this issue brief, and a second issue brief Developing a Social Risk Factor Screening Measure.