Materials from virtual Maternal Health Roundtable hosted by SHVS on September 15, 2022.
When the federal Medicaid continuous coverage requirement expires, states will redetermine eligibility for nearly all Medicaid enrollees, including roughly 1.7 million people enrolled in a Medicaid or CHIP pregnancy eligibility group. This issue brief reviews proactive strategies that states can deploy to support postpartum individuals in maintaining health coverage and access to care when the Medicaid continuous coverage guarantee ends and beyond.
Implementing a statewide, competitive procurement for Medicaid managed care is one of the more important things state purchasers do to improve value. This toolkit is designed to help states develop a procurement process focused on improving program performance in specific areas valued by the state. It guides Medicaid agencies through key action steps and considerations in the major phases of the procurement cycle: 1) strategic procurement planning, 2) solicitation development, 3) bid review and selection, 4) contract execution, readiness review and implementation, and 5) contract management.
This resource provides excerpts of health disparities and health equity language from Medicaid managed care (MMC) contracts and requests for proposals (RFPs) from 17 states and the District of Columbia. The criteria for inclusion in this compendium are contracts and RFPs that explicitly address health disparities and/or health equity. Website links to the full contracts are included where available.
Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates
To help states respond to the ongoing COVID-19 pandemic, the White House, the U.S. Department of Health and Human Services, and the Centers for Medicare and Medicaid Services have invoked their emergency powers to authorize temporary flexibilities in Medicaid and the Children’s Health Insurance Program. Congress’s legislative relief packages have provided additional federal support for state Medicaid programs, subject to certain conditions. The timeframes for these emergency measures are summarized in the chart, including the effective dates and expiration timelines dictated by law or agency guidance. This SHVS product has been updated to reflect HHS’s July 15 notice renewing the federal Public Health Emergency.
Defining the “Glide Path”: State Medicaid Agencies’ Efforts to Promote Action on Social Determinants
State Medicaid agencies are increasingly exploring opportunities to incorporate “social care” into strategies for improving health, decreasing healthcare costs, and achieving equity. While some target healthcare delivery organizations, most revolve around managed care organizations (MCOs). This slide deck highlights findings from a series of interviews with 13 states that explored the choices Medicaid leaders face around selecting which monitoring mechanisms to use to ensure that social programs are implemented as they envisioned.
On Tuesday, June 14, State Health and Value Strategies hosted a webinar that featured state officials and Medicaid managed care entities from Rhode Island and Massachusetts who shared their experiences implementing social risk factor screening measurement. The webinar highlighted states who have implemented social risk factor screening measures for incentive use in managed care contracts. States use these social risk factor screening measures to hold plans and provider entities accountable for identifying Medicaid members affected by risk factors, such as homelessness and food insecurity.
Improving ex parte rates as part of the Medicaid renewal process is one of the most effective tools available to states to mitigate coverage loss for eligible individuals when the public health emergency (PHE) ends. There are tremendous benefits to enrollees and to states in maximizing eligibility redetermination through an ex parte process. As states develop their unwinding policies and operational plans in readiness for the end of the PHE, improving ex parte rates should be at the top of their priority list. This toolkit contains a table that can be used by a state to examine current ex parte processes and identify and deploy additional strategies that could increase their ex parte rates.
State Health and Value Strategies has created a flyer for states to customize and place in consulate offices, to serve as a resource to enroll eligible immigrants in health coverage in their state. The flyer is designed so that states can add their own contact information and logos for their outreach purposes and has been translated into Spanish.
Medicaid estate recovery has important health equity implications. While estate recovery is intended to recoup funds to support the Medicaid program and ensure that enrollees and their families who are able to pay for long-term services and supports do so, the burden falls disproportionately on families of color and exacerbates existing inequities in the distribution of wealth tied to the historical and contemporary realities of structural discrimination and racism. This toolkit is intended to assist state officials in evaluating their current estate recovery policies and understanding where they may have flexibility to make the policies less burdensome for affected low-income families.