Webinar: Using Social Determinants of Health Data in Medicaid Managed Care – A Webinar for States
Amy Lischko, Bailit Health Purchasing; Ellen Breslin, Health Management Associates; Arlene Ash, UMass Medical School
State Health and Value Strategies, a program of the Robert Wood Johnson Foundation, is pleased to announce the third in our series of webinars for state officials on achieving population health goals.
Using Social Determinants of Health Data in Medicaid Managed Care – A Webinar for States
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. Bailit Health’s Amy Lischko, kicked off the webinar with an overview of the methods for gathering SDOH data, and then the range of possible uses of the data by state policy makers.
The webinar delved into innovative efforts by state health policy leaders working to factor SDOHs in payment reform and quality measurement activities. First, Health Management Associates’ Ellen Breslin explored how states could factor SDOH into improved payment models and quality measurement activities drawing on a forthcoming issue brief from SHVS, Medicaid and Social Determinants of Health: Adjusting Payment and Measuring Health Outcomes. Next, University of Massachusetts Medical School’s Arlene Ash, described a new payment model that Massachusetts Medicaid is using to adjust managed care payments for certain social risk factors among enrolled populations. The webinar closed with the three panelists responding to questions from participants.
This event was the last in a three-part series of technical assistance webinars hosted by State Health and Value Strategies and funded by the Robert Wood Johnson Foundation. The series explores timely issues facing state health care leaders and features actionable information on what states can do. To access a recording and materials related to the first two webinars in the series, see immediately below.
“Shared Accountability Across Health and Non-Health Sectors: Opportunities to Improve Population Health,” click here.
“Medicaid Value-Based Payment for LTSS,” click here.
When the Families First Coronavirus Response Act Medicaid “continuous coverage” requirement is discontinued states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. A lack of publicly available data on Medicaid enrollment, renewal, and disenrollment makes it difficult to understand exactly who is losing Medicaid coverage and for what reasons. Publishing timely data in an easy-to-digest, visually appealing way would help improve the transparency, accountability, and equity of the Medicaid program. This expert perspective lays out a set of priority measures that states can incorporate over time into a data dashboard to track Medicaid enrollment following the end of the continuous coverage requirement. For a detailed discussion of the current status of Medicaid enrollment and retention data collection and best practices when developing a data dashboard to display this type of information, SHVS has published a companion issue brief.
On January 15, 2022, health insurers will be subject to new federal requirements to cover and waive cost-sharing for over-the-counter diagnostic tests for COVID-19 for the duration of the federal public health emergency. Past federal guidance required insurers to fully cover COVID-19 tests, but allowed them to require enrollees to first obtain a health professional’s determination that a test is medically necessary. The new requirements, published January 10, enable consumers to obtain the tests directly from pharmacies or online retailers without being seen by a health professional. With case rates surging and the costs of over-the-counter COVID-19 tests ranging from $14 to $34, this new benefit should provide significant financial relief to privately insured individuals. This expert perspective focuses on key provisions of the new coverage requirements as well as health equity considerations and implications for state insurance regulators.
On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official letter providing guidance on the scope of and enhanced payments for qualifying community-based mobile crisis intervention services for Medicaid enrollees experiencing a mental health or substance use disorder crisis. The CMS guidance comes as the United States is grappling with staggering need for mental health and SUD services that has grown as a result of the COVID-19 pandemic. This expert perspective provides an overview of the new guidance and reviews the requirements for community mobile crisis services.
