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.
Toward Hospital Global Budgeting: State Considerations
Robert Murray, Global Health Payment
As state policymakers seek to identify strategies to deliver higher-quality care at lower costs, payment reform efforts have largely centered on moving from a fee-for-service health care system based on paying for volume, to one based on paying for value. More recently, payment models including prospective episode-based payment, hospital global budgets and per member per month global capitation arrangements have gained attention. This issue brief provides an overview of hospital global budgeting, which represents a middle-ground approach between the narrow bundling of services and global capitation that transfers higher levels of financial risk to a hospital.
The State Health Policy Highlight Implementing Global Budgets: Opportunities and Challenges provides a brief overview of hospital global budgets for state health officials interested in whether global budgets may be an option for their state.