Toolkit

10.2024 / By https://www.shvs.org/

This customizable slide deck template supports internal state agency communication about the Beneficiary Advisory Council (BAC) and Medicaid Advisory Committee (MAC) and a summary of the new advisory groups' functions, objectives, composition, and outcomes.

Commentary

This commentary reviews changes beginning in fiscal year (FY) 2025 requiring states to report a subset of Child and Adult Core Set measures by race and ethnicity, sex, and geography. By requiring data disaggregation for key populations of interest, policymakers, advocates and researchers will have a new tool to measure, monitor and inform policies and practices that focus on health equity.

Commentary

On April 2, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final Notice of Benefit and Payment Parameters (NBPP) for 2025. This annual rule governs core provisions of the Affordable Care Act (ACA), including operation of the health insurance Marketplaces, standards for health plans, insurance brokers (including web-brokers), and the risk adjustment program. This blog focuses on provisions of the final rule of interest to state officials.

Blog

03.2024 / By That's Medicaid

That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage to building a nationwide Culture of Health.

Brief

CMS recently added new questions on the topic of sexual orientation and gender identity (SOGI) to the application used by HealthCare.gov and released guidance for states that want to add the same questions to their Medicaid and Children’s Health Insurance Program applications. This brief summarizes the guidance and presents several considerations for states as they look to improve their collection of sexual orientation and gender identity data.

The Center for Children and Families (CCF) at Georgetown University scanned state Medicaid agency websites for information about the performance of individual managed care organizations (MCOs) for children, youth in foster care, and pregnant and postpartum women. This blog assesses CCF's findings and the financial transparency of state Medicaid agency websites

02.2024

That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage to building a nationwide Culture of Health.

Blog

02.2024 / By Benefits Data Trust

This blog shares a “Medicaid Churn Toolkit” to guide Medicaid agencies and their partners in the design and implementation of efforts to reduce churn.

Blog

On December 18, 2023, the Centers for Medicare & Medicaid Services (CMS) released a suite of Medicaid unwinding-related guidance and enrollment data that includes a focus on ensuring eligible children maintain Medicaid and Children’s Health Insurance Program (CHIP) coverage. In conjunction with CMS’ release, the United States Department of Health and Human Services (HHS) sent letters to the governors of nine states with the highest child disenrollment rates.

This blog from State Health & Value Strategies reviews the HHS letters and discusses specific resources available to states as the unwinding continues. 

Blog

With support from the Robert Wood Johnson Foundation, the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota School of Public Health is leading a multi-phased project to assess whether identifying a set of key equity-related indicators and populating them into a centralized “Medicaid Equity Monitoring Tool” could be a helpful, feasible, and reliable way of tracking and advancing health equity in Medicaid.

Blog

As states prepare to unwind the COVID-19 pandemic-related Medicaid continuous coverage requirement and resume terminations of coverage as soon as April 1, this blog examines how they could streamline eligibility determinations for older adults and people with disabilities, who face unique challenges with the Medicaid enrollment and renewal process.

Commentary

This commentary discusses how Medicaid supported Ashley in taking control of her health and getting the help she needed after she unexpectedly lost her private health coverage. That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage to building a nationwide Culture of Health.

Blog

On January 4, the Centers for Medicare & Medicaid Services (CMS) issued a new State Medicaid Director Letter on how states can use “in lieu of” services (ILOS) authority, including to address social drivers of health. This blog reviews the letter and discusses why it is significant for state health policymakers. 

Commentary

This commentary shares how Medicaid supported Milly throughout her pregnancy. That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage to building a nationwide Culture of Health.

Blog

The ACA’s guarantee of free access to preventive services is at risk. If it is ultimately struck down as unconstitutional as the result of a court case that is winding its way through the federal judicial system, Congress will be the only entity that can act to codify and fully restore its benefits. However, there are some actions states can take. This brief explores what state-level health officials can do to mitigate the fallout of the preventive services provision being struck down.

Commentary

This commentary tells the story of Danielle, whose small business struggled in the opening months of the COVID-19 pandemic. In addition to trying to keep her business afloat, Danielle also had to care for her son and home school him. Medicaid provided Daneille with the mental health support needed to keep moving forward during an incredibly challenging period. 

That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage to building a nationwide Culture of Health.

Commentary

This commentary tells the story of Adrian, who works with the Medicaid-funded Mississippi Youth Programs Around the Clock program. Adrian's work provides youth and their families with needed "wraparound" services to cultivate healthier communities.

That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage to building a nationwide Culture of Health.

Commentary

This commentary tells the story of Theresa. At an early age, she was diagnosed with Spastic Quadriplegia Cerebral Palsy, a disorder that affects a person’s ability to maintain balance and posture. Now in her 40s, Medicaid allows her to work and live independently. It also provides her with speech, physical and occupational therapies, a wheelchair and the help of personal care attendants who assist with basic needs such as meal preparation, cleaning, dressing, and laundry.

Brief

This update to the methodology documentation for the Urban Institute’s Health Insurance Policy Simulation Model explains how they estimated health coverage in 2023, taking into account major uncertain issues such as Medicaid enrollment after the HHS public health emergency and the potential expiration of enhanced premium tax credits for Marketplace coverage in 2023.

Resource Page

This page provides communications resources designed to support states as they prepare for the various stages of work needed to inform stakeholders and consumers about the upcoming end of the Medicaid continuous coverage requirement. The end of the Medicaid continuous coverage requirement presents states with tremendous opportunities to keep individuals enrolled in Medicaid or transition to another form of health coverage.

Map

This interactive map and chart summarize proposed and approved legislation since 2018, Medicaid waivers, financial estimates, and other initiatives designed to extend coverage during the postpartum period. (Under the Families First Coronavirus Response Act, Medicaid enrollees who typically lose coverage after 60 days postpartum cannot be disenrolled until the end of the month in which the public emergency period ends.)

Blog

At the end of the Pubic Health Emergency, more than 15 million people may become uninsured if they cannot secure alternate sources of health coverage. This blog provides actions states should carefully consider to ensure that stakeholders, including insurers, are facilitating these critical transitions.

Blog

This blog explores how states can work with The Program of All Inclusive Care for the Elderly (PACE) and its organizations to provide a comprehensive, fully integrated package of Medicare and Medicaid services to elderly individuals who require a nursing home level of care.

Blog

This blog discuss the important role that ACA marketplaces will play in mitigating coverage losses as they prepare for the end of the Public Health Emergency and identifies basic as well as more innovative strategies marketplaces can adopt to help consumers make a smooth transition to affordable, comprehensive coverage.

Blog

This blog explores strategies on how to invest in the development of Medicaid leaders to help states and territories improve the health and well-being of people served by publicly financed care.

Key tips include:

Always have a plan b, plan c, and plan d.
Build relationships and find a common thread.
Fill the void.
And more.

Report

This report examines existing data and research to comprehensively describe the scope and prevalence of obesity and available obesity treatments in the US covered by fee-for-service Medicaid, Medicaid managed care, state employee health plans, and state essential health benefits benchmark plans.


Blog

This blog examines some of the key factors and decision points states may want to consider as they build out mobile mental health crisis services and systems that qualify for enhanced federal medical assistance percentage funding; engaging a cross-agency team and a broad range of external stakeholders can help ensure full consideration of diverse state crisis needs.

Blog

This brief features key considerations for state policy makers for leveraging federal funds through the American Rescue Plan Act including: Maximizing and aligning Medicaid and other funding sources; Sustaining new crisis capacity; Providing crisis services in rural areas; Addressing endemic workforce challenges; Sharing data;  and investing strategically.

Brief

This brief explores how nearly 13 million adults delayed or did not get needed prescription drugs in the past year because of the cost, including 2.3 million elderly Medicare beneficiaries and 3.8 million nonelderly adults with private insurance, 1.1 million with Medicaid, and 4.1 million who were uninsured at any point during the year.

Map

This map features how states are using these one-time funds to support transitions from institutional settings into the community through housing navigation, employment placement, assistance with transition costs and other social determinant supports, as well as by investing in affordable and accessible housing for home-and community-based services populations to remain within the community.

Commentary

11.2021

This commentary tells the story of Adrian, who serves as an assistant director at the Hattiesburg, Miss., office of Youth Villages and oversees the Medicaid-funded Mississippi Youth Programs Around the Clock (MYPAC) effort, which currently has more than 500 people enrolled throughout the state.

Brief

This issue brief reviews state Medicaid/Children's Health Insurance Program agency data and information technology system “table stakes”—strategies that will have the highest impact for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the Public Health Emergency continuous coverage requirements end.

Report

10.2021 / By Urban Institute

This report finds that generous funding to support policies related to home- and community-based services (HCBS) eligibility, caregiver wages, and services could drastically improve the lives of people in need and the workers who serve them.

Commentary

09.2021 / By David Schaefer

This op-ed, authored by David Schaefer of the Georgia Budget Policy Institute, argues that closing the Medicaid coverage gap in Georgia will also increase access to health care and strengthen health infrastructure in rural communities.

Commentary

This commentary explains how increased flexibility in the delivery and payment of telehealth across many coverage programs, but particularly in Medicaid and CHIP, throughout the COVID-19 pandemic has been a significant shift for some states. Many state officials are considering if and how to adapt rapidly implemented telehealth policies as the nation emerges from the public health emergency. 

Commentary

This commentary examines how recent approval of the Alzheimer’s drug Aduhelm under the U.S. Food & Drug Administration’s Accelerated Approval Program is controversial for a range of reasons, including its projected impact on state Medicaid budgets which will be required to cover the drug, priced at $56,000 a year, despite inconclusive evidence of its clinical effectiveness. 

Chart

This chart details the amounts and required oversight of COVID-19 federal funds allocated to hospitals, providers, and states by the Families First Coronavirus Response Act (Families First Act), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the Paycheck Protection Program and Health Care Enhancement Act (HR 266), the Consolidated Appropriations Act, 2021, and the American Rescue Plan Act of 2021.

Webinar & Presentations

This podcast features Lynnette Rhodes, executive director of medical assistance plans at the Georgia Department of Community Health, and Cindy Beane, commissioner at the West Virginia Bureau for Medical Services, discussing leadership challenges and successes they have faced in developing equitable vaccine distribution strategies and the status of their respective states’ vaccine rollout.

Report

This brief provides a high-level summary of the Center for Medicare and Medicaid Services guidance related to: (1) conducting redeterminations for Medicaid enrollees who were continuously enrolled; (2) terminating, or extending where appropriate, temporary flexibilities; and (3) developing a consumer and provider communication strategy.

Commentary , Report

06.2020 / By The RAND Corporation

This commentary gauges the potential effects on coverage and cost if public options become available in the country's health insurance exchanges, based on observations from a RAND COMPARE microsimulation model.

Report

This report documents access and affordability challenges facing uninsured new mothers using 2015–18 data from the National Health Interview Survey (NHIS). It also uses 2015–17 data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) to describe the health status of women who lost Medicaid coverage following their pregnancies.

Commentary

In this podcast episode, Ed O’Neil, PhD, MPA, a leadership development expert, speaks with Hilary Kennedy, program director for Medicaid leadership at the National Association of Medicaid Directors, about strategies Medicaid leaders can use to continue developing their staff at a distance.

Report , Webinar & Presentations

This report reviews the key features of the proposed capped funding demonstrations and highlights the considerations for states. On January 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) inviting states to apply for Section 1115 demonstration projects that would impose caps on federal Medicaid funding for the adult expansion and some other adult populations in exchange for new programmatic flexibility.

Report

This report gives an overview of the federal authorities under which states are able to cover nonclinical housing-related services for high-need Medicaid enrollees, and also details how states are using these authorities to invest in supportive housing for diverse high-need Medicaid populations.

Report

09.2019 / By Urban Institute

This report explores what child care challenges parents with Medicaid work requirements may face, and suggests parents may struggle to find care that is affordable, good quality, accessible, and available for nontraditional or unpredictable work schedules.

Brief

This brief outlines the basics of the Medicaid program, including financing and eligibility, for new state policymakers in order to lay the groundwork for considering the challenges and opportunities that lie ahead. 

Report

The Department of Homeland Security’s (DHS) proposed rule, Inadmissibility on Public Charge Grounds, proposes significant changes to how it will determine whether an immigrant is likely to become a “public charge” including, for the first time, the use of Medicaid benefits as a key factor in that analysis.This resource answers popular questions about the rule. 

Report

CMS approved state work/community engagement (CE) waivers in Arkansas, Indiana, Kentucky, and New Hampshire; and additional states have submitted or are poised to submit similar waivers. This series of charts outlines the legal, policy, financial and operational tasks and issues that states will face in adding a work/CE condition to their Medicaid program.

Report

08.2018 / By Urban Institute

This report investigates the work patterns of Medicaid beneficiaries in Kentucky who are are potentially subject to Medicaid work requirements. It finds that the structure of Kentucky’s Medicaid waiver does not seem to align with the reality of some working enrollees’ lives, and that working enrollees losing coverage may not have access to an employer plan.

Webinar & Presentations

This webinar reviews the Stewart v. Azar decision and potential implications for states with approved, pending or planned Medicaid waivers that include work/community engagement requirements. The court’s findings may shape what analysis will be necessary to demonstrate that future waivers advance the Medicaid statute's objectives.