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.
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.
Providing a retroactive coverage option in the Marketplace is one innovative strategy for eliminating coverage gaps between Medicaid and Marketplace coverage for people eligible to make that transition at the end of the public health emergency. Pennsylvania’s state-based Marketplace, Pennie, is considering an optional retroactive coverage policy. This expert perspective describes the retroactive coverage policy innovation and its benefits, and offers strategies for states to consider in their implementation that will maximize coverage continuity, minimize adverse selection, and address potential operational challenges.
