1115 Demonstration Facilitation Tool: Crosswalk of Requested Reentry Demonstration Features to Federal Requirements and California’s Approved Demonstration
On January 26, 2023, the Centers for Medicare & Medicaid Services (CMS) approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. On April 17, 2023, CMS released a State Medicaid Director Letter (SMDL), “Opportunities to Test Transition-Related Strategies to Support Community Reentry and Improve Care Transitions for Individuals Who Are Incarcerated.” The following tool can be used as part of a state’s discussions with CMS regarding a requested demonstration’s proposed features as compared with the reentry requirements outlined in the SMDL and California’s section 1115 demonstration approval.
Buying Value
The Buying Value website, which is supported and maintained by State Health and Value Strategies in partnership with Bailit Health, hosts a suite of resources to support states interested in designing a measure set that will align with other priority national measure sets, as well as those that may already be in use in a state or region. The Buying Value Measure Selection Tool assists states in aligning measure sets. The Buying Value Benchmark Repository, is a database of non-HEDIS and modified HEDIS measures in use by state purchasers and regional health improvement collaboratives and associated performance levels.
Tracking Medicaid Enrollment Growth During the COVID-19 Pandemic Databook
The Tracking Medicaid Enrollment Growth During the COVID-19 Pandemic Databook provides a comprehensive, detailed look at Medicaid enrollment trends to-date. Using Medicaid enrollment data from over 40 states, the Databook provides a comprehensive, detailed look at Medicaid enrollment trends from the beginning of the COVID-19 pandemic through December 2022. The Databook provides enrollment detail by state across four eligibility categories: expansion adults, children (including those enrolled in CHIP), non-expansion adults, and aged, blind, and disabled individuals. It also compares enrollment trends across expansion and non-expansion states. The latest version of the Databook (as of March 2023) has been updated through December 2022.
Ensuring Compliance With Federal Renewal Requirements: State Diagnostic Assessment Tool
As states begin the herculean task of redetermining eligibility for 91 million enrollees in Medicaid and the Children’s Health Insurance Program, they are readying their systems, staff, and vendors that support Medicaid eligibility operations. Using this diagnostic assessment tool, states can take the critical step of evaluating their compliance with federal regulatory requirements for conducting redeterminations and renewals. The tool aims to help states qualify for the sustained enhanced Federal Medical Assistance Percentage, avoid corrective action imposed by CMS, promote continuity of coverage and care during unwinding, and make long-term improvements to eligibility and enrollment infrastructure.
Infographics on the Unwinding Provisions in the Consolidated Appropriations Act (CAA)
These infographics provide an overview of the key changes to the parameters for unwinding enacted by the Consolidated Appropriations Act (CAA) as well as an illustrative continuous coverage unwinding timeline under the CAA. The infographics are intended to help states communicate internally or with key stakeholders about the Medicaid continuous enrollment condition provisions in the CAA and can be downloaded to use in communications.
Reaching Non-Citizen Communities: Resources to Support State Outreach and Education to Drive Healthcare Enrollment
States are working in various ways to engage and enroll individuals in health coverage regardless of their immigration status. In some cases, states continue to conduct outreach to eligible but remaining uninsured individuals, such as citizen children in families with mixed immigration status. In other cases, states are in the process of expanding coverage options to make new options available for non-citizens. The resources in this toolkit were informed by research and developed for states to customize based on their unique needs, program eligibility criteria, and environments to support outreach and education efforts to drive enrollment in new or existing health coverage programs.
Open Enrollment Period 2022-23 Messaging
The open enrollment period for the plan year beginning 2023 will begin on November 1, 2022, and marketplaces will be encouraging consumers to sign up for health coverage. This open enrollment period will see a continuation of enhanced subsidies and for some states, implementation of a fix to the so-called “Family Glitch.” This document includes research-based messaging to support outreach and enrollment, addressing common barriers consumers have to getting and keeping health coverage.
Medicaid Managed Care Procurements: A Toolkit for State Medicaid Agencies
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.
Improving Ex Parte Renewal Rates: State Diagnostic Assessment Tool
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.
Consulate Outreach Template Flyers
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.