State Health and Value Strategies hosted a two-part webinar series on screening Medicaid members for social risk factors. State Medicaid agencies are increasingly recognizing the impact that non-medical factors, such as social risk factors, have on health. Social risk factors are adverse social conditions which create barriers to health for individuals, such as food insecurity and homelessness. The first webinar reviewed key terms, screening tools, and design decisions for states interested in screening Medicaid managed care members for social risk factors. The second webinar, explored adopting a measure to assess social risk factor screening rates.
On Friday, October 30, State Health & Value Strategies hosted a webinar during which experts from Manatt Health and GMMB reviewed the trajectory of 2020 Medicaid enrollment growth to date and provide effective strategies related to communication with members and coordination across state Medicaid agencies and Marketplaces to support coverage access and retention in this dynamic environment.
This issue brief is designed as a resource for states looking to adopt a measure to assess social risk factor screening rates. It is the result of a series of convenings that the authors facilitated with three states—Massachusetts, Oregon, and Rhode Island—which helped them consider, discuss, and share perspectives related to the development of their own social risk factor screening process measures. The issue brief looks at the progress these states and North Carolina have made in developing their own social risk factor screening measures and highlights considerations for other states either planning to adopt an existing or develop a new screening measure.
The past two years have seen a sharp increase in state Medicaid program interest in how social determinants of health (SDOH) influence Medicaid enrollee health status and spending. This brief provides an introduction to the first step most states are taking in response through their Medicaid managed care programs—screening members for social risk factors (SRFs). It explains why Medicaid managed care members should be screened for SRFs, identifies screening design decisions, identifies common SRFs, and reviews options for screening tool selection.
Coronavirus (COVID-19) Unwinding Federal Medicaid Flexibilities: Issues and Considerations for States
States quickly mobilized to implement emergency federal authorities (e.g., Section 1135 waivers, 1915(c) Waiver Appendix K, emergency Section 1115 waivers) and state-level regulatory flexibilities to respond to the COVID-19 pandemic; now they must determine which flexibilities to scale back or sustain, taking into account fiscal implications. The interaction of the stimulus package dates, the Public Health Emergency, and the President’s National Emergency Declaration, among other factors, are complex, and states are actively grappling with decision making regarding which flexibilities they need and want to keep, and how. This Excel workbook is intended to serve as a tool for states as they strategize and plan for the next phase of the COVID-19 pandemic. Specifically, states can utilize this template to conduct both a primary analysis as they determine which flexibilities to unwind or maintain and a secondary analysis to plan for operational and implementation implications. The workbook has been updated to reflect the renewal of the Public Health Emergency as of October 2, 2020.
On Thursday, September 17, State Health and Value Strategies hosted a webinar that will discuss the federal government’s response to the financial challenges facing providers. The COVID-19 pandemic has caused dramatic changes in utilization that threaten the financial stability of providers. Most of the Provider Relief Fund has been distributed, yet providers are still experiencing lost revenue and increased costs related to COVID-19. Medicaid payment strategies—especially for providers serving high numbers of Medicaid patients—remain a critical tool for states to support providers as new COVID-19 hotspots emerge and utilization patterns change. During the webinar, experts from Manatt Health reviewed examples of specific strategies states implemented between April and August 2020 to increase payments to providers in financial distress as a result of decreased health care utilization.
The COVID-19 pandemic has caused dramatic changes in utilization that threaten the financial stability of providers and may jeopardize access to care during and after the national emergency. With elective cases generally cancelled, hospitals have sharply lower utilization and revenue. Between March and August 2020, a combination of lost revenue related to fewer elective procedures and emergency department/outpatient encounters, and higher costs related to COVID-19 has put many hospitals in a precarious financial position. In addition, many other providers that rely on face-to-face visits have seen large utilization declines due to social distancing requirements: as of July 2020, outpatient visits remain 10 percent below the pre-COVID-19 baseline, even after accounting for the increased use of telemedicine. Most of the Provider Relief Fund dollars have been distributed, yet providers are still experiencing lost revenue and increased costs related to COVID-19. Under any scenario, Medicaid payment strategies—especially for providers serving high numbers of Medicaid patients—remain a critical tool for states to support providers as new COVID-19 hotspots emerge and utilization patterns change.
As the COVID-19 pandemic accelerated in April, State Health and Value Strategies hosted a webinar to discuss tools in both fee-for-service and Medicaid managed care that states can use to increase payments to providers in financial distress as a result of decreased health care utilization. Since that time, the federal government has responded to the financial challenges facing providers due to the pandemic in several different ways. The slide deck from the webinar has been updated as of August 26, 2020 to reflect more recent federal guidance and examples of specific strategies states implemented between April and August 2020.
Ensuring Access to LTSS During COVID-19: Exploring a State Resource Guide Produced by Manatt Health and The SCAN Foundation
On Friday, July 10, State Health and Value Strategies hosted a webinar during which experts from Manatt Health presented key findings from a new COVID-19 state resource guide, funded by The SCAN Foundation. People who use long-term services and supports (LTSS), including individuals dually-eligible for Medicare and Medicaid, are particularly vulnerable to contracting COVID-19. COVID-19 has had a devastating impact on people with complex care needs receiving care in nursing homes and other congregate care settings, in particular. In the resource guide, Manatt Health identifies federal and state Medicaid flexibilities available to state officials and other stakeholders and how those flexibilities are being deployed during COVID-19 to help ensure access to LTSS. The webinar provided examples of how states are ensuring continued access to LTSS by expanding the types of settings in which services can be delivered, bolstering pay and other supports for LTSS providers, and addressing barriers to care created by the COVID-19 pandemic.
Analyzing the Fiscal Impact of COVID-19, the Economic Downturn, and Recent Policy Changes: 50-State Databook
As states and Medicaid programs face significant fiscal uncertainty as a result of the COVID-19 public health crisis, the Databook provides projected changes in federal and state Medicaid and CHIP expenditures during calendar years 2020 and 2021 across all fifty states and the District of Columbia for a given scenario and policy response. Taken together, the Databook provides estimates that span across a range of plausible scenarios reflecting increased enrollment and per enrollee spending growth and changes to the duration of the federal Public Health Emergency.