Expert Perspectives

Mar 8, 2022 

CMS Solicits Input on Medicaid and CHIP Reforms Regarding Eligibility, Enrollment, and Access to Care

On February 17, the Centers for Medicare & Medicaid Services released a request for information (RFI) regarding the federal standards that govern access to care in Medicaid and the Children’s Health Insurance Program. The RFI casts a wide net, soliciting suggestions for reform regarding access to coverage–namely, the processes for enrollment and eligibility redeterminations–as well as the standards for defining and monitoring enrollee access to care under both fee-for-service and managed care delivery systems. This expert perspective summarizes the RFI to assist states as they draft their submissions. Comments on the RFI are due by April 18.

Jan 28, 2022 

Text Messaging: An Important Communication and Outreach Strategy as States Unwind the Federal Medicaid Continuous Coverage Requirement

As state Medicaid and Children’s Health Insurance Program (CHIP) agencies develop their strategies for unwinding the federal Medicaid continuous coverage requirement under the Families First Coronavirus Response Act, many are looking to text messaging as a mechanism for outreach to their Medicaid and CHIP enrollees and communicating important information. This expert perspective describes states’ authority to send text messages and requirements for obtaining consent. The expert perspective also contains sample consent language to include in the Medicaid/CHIP application as well as template text messages.

Jan 28, 2022 

Stratifying Data and Implementing Financial Incentives: How States Are Leveraging Medicaid Managed Care to Further Health Equity

To support state efforts, State Health and Value Strategies continues to update the resource Medicaid Managed Care Contract Language: Health Disparities and Health Equity. This compendium provides Medicaid agencies with examples of how different states are leveraging their managed care programs, inclusive of contracts, quality initiatives, and procurement processes, to promote health equity and address health disparities. This expert perspective highlights trends in state Medicaid managed care procurements and model contracts from Michigan, North Carolina, Ohio, Oregon, Virginia, and Washington, as well as new excerpts of relevant language from Pennsylvania and Rhode Island.

Jan 21, 2022 

Tracking the Data on Medicaid’s Continuous Coverage Unwinding

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.