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.
Value-Based Innovation by State Public Employee Health Benefits Programs
Michael Bailit, Megan Burns and Mary Beth Dyer, Bailit Health
In late March 2017, the Robert Wood Johnson Foundation’s State Health and Value Strategies (SHVS) program convened a meeting of public employee purchasers from multiple states to share strategies and learnings to promote value through their purchasing and benefit design work. The meeting participants described innovations in three areas: value-based payment; incentivizing selection of high-value providers; and incentivizing use of high-value services.
Value-Based Innovation by State Public Employee Health Benefits Programs provides an overview of three areas of value-based innovation and then affords a deeper examination into specific examples of state employee purchaser activity in California, Connecticut, Massachusetts, Minnesota, Tennessee, and Washington. Despite their differences in size and scope, these state health care purchasers found they could learn from their colleagues in other states as they strive to improve the value of care. For a summary of the examples from the six states, we have also published an Overview that highlights policy innovations and findings to date.