On September 17, 2021, the U.S. Departments of Health and Human Services and Treasury finalized the 2022 Notice of Benefit and Payment Parameters (NBPP) rule and announced a significant expansion of their oversight of health plans’ provider networks. This expert perspective reviews provisions of the rule of particular import to the state-based marketplaces (SBMs) and state insurance regulators.
Strategies for Building Seamless Health Systems for Low-Income Populations
The George Washington University – Sara Rosenbaum; Center for Health Care Strategies – Stephen Somers and Shannon McMahon
The Affordable Care Act offers numerous opportunities to stabilize coverage and care for beneficiaries as their incomes fluctuate, and states can reduce the impact of churn between coverage programs with design and purchasing strategies that promote seamlessness. This brief explores the challenges for states in creating seamless health coverage for low-income populations, while providing states with a roadmap as they consider building seamless health systems. Key issues for states to consider include managing subsidy fluctuations through carefully designed eligibility and enrollment strategies and ensuring stable coverage and care by creating seamlessness across benefits, providers, and health plans.