Expert Perspectives

May 29, 2020 

Is COVID-19 the End of Fee-for-Service Payment?

The coronavirus pandemic of 2020 has created a seemingly paradoxical scenario for the finances of health care providers. While states were rushing to build field hospitals to prepare for a surge of COVID-19 patients, traditional revenue streams for providers completely dried up: elective procedures were suspended and social distancing protocols limited the number of patients in office settings. A public health crisis became a health care crisis, as COVID-19 revealed the faults in the way necessary and critical health care services are paid for in America.

May 28, 2020 

States’ Reporting of COVID-19 Health Equity Data

This expert perspective looks in more depth at which states are regularly reporting data that helps shed light on the health equity issues of this crisis. Specifically, the post includes interactive maps that explore the extent to which all 50 states and the District of Columbia are reporting (as of May 28) data breakdowns by age, gender, race, ethnicity, and health care workers for both cases of and deaths from COVID-19.

May 19, 2020 

Responding to COVID-19: State-Based Marketplaces Take Action

As the COVID-19 crisis began to take hold, state-based marketplaces (SBMs) were quick to respond to the first nationwide public health emergency since the Affordable Care Act created new coverage options in states. Informed by conversations with seven SBMs that established an SEP—Colorado, Maryland, Massachusetts, Nevada, New York, Rhode Island and Washington—this expert perspective highlights strategies that successfully drove enrollment, including: leveraging their SBM status to quickly and efficiently operationalize customer service in a new remote environment, directly engaging with existing customers as well as reaching out broadly to new ones, and adapting outreach tactics based on new insights regarding audience needs and behaviors to reach them most effectively.

May 19, 2020 

Impact of COVID-19 on Medicaid Managed Care Performance Incentives: Policy Options for States

The COVID-19 pandemic continues to evolve and bring about significant–and rapidly occurring–changes in care delivery. As a result, states are examining their Medicaid managed care incentive arrangements to evaluate the impact of COVID-19 on their health care quality and cost performance requirements. This expert perspective identifies actions federal and state policymakers have taken to address the impact of COVID-19 on their managed care performance incentive programs, and 2020 quality and total cost of care performance. The examples detailed in the expert perspective can be used to inform state decisions on whether and how to modify Medicaid managed care reporting and performance incentives as a result of COVID-19.

May 14, 2020 

Medicaid/CHIP and Marketplace Interactions in COVID-19

Chiquita Brooks-LaSure, Manatt Health

This expert perspectives provides an overview of strategies that states can consider to help address gaps in coverage to ensure as many people as possible get access to comprehensive care as the country continues to respond and recover from the COVID-19 health and economic crisis. Policymakers may want to consider continuing and expanding these solutions to increase coverage once the nation recovers from the current health care crisis so that the health care system is better prepared to weather the next one.

May 12, 2020 

The Final 2021 Notice of Benefit and Payment Parameters: Implications for States

Sabrina Corlette, Georgetown University Center on Health Insurance Reforms

On May 7, 2020, the U.S. Department of Health & Human Services (HHS) published its final annual rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for individual and small-group market health plans, and premium stabilization programs. This expert perspective focuses on several policies that have implications for state insurance regulation and the operation of the state-based marketplaces (SBMs).