April 15 Update

In This Week’s Update:

  • SDOH and Medicaid’s Next Generation State Practices
  • State Updates: HI, ID, KS, KY, MI, NJ, NM & ND
  • Do Consumers Understand Short-Term Plans?
  • Improving the Health and Well-Being of the Nation’s Aging Population
  • Improving Care for Children with Health Complexity

Medicaid’s Emerging Trends and Leading Edge Practices

State Health and Value Strategies has published its next issue brief, Addressing Social Factors That Affect Health: Emerging Trends and Leading Edge Practices in Medicaid, that explores the “next generation” practices states are deploying to address social factors to achieve better health outcomes. Medicaid programs are increasingly considering how best to address social factors, such as housing, healthy food and economic security, that can affect health and health care expenditures and drive as much as 80 percent of population health outcomes. The new issue brief, authored by Manatt Health, explores how states are using Medicaid 1115 waivers and managed care contracts to implement next generation practices and provides specific steps states can take to implement these practices. For a summary of the leading edge strategies being implemented by states, check out the companion State Health Policy Highlight.

State Updates: HI, ID, KS, KY, MI, NJ, NM & ND

  • Hawaii – The Department of Human Services, Med-QUEST Division, is requesting proposals from qualified organizations to provide services that include performing outreach and application assistance for uninsured or underinsured Hawaii residents who may be eligible for health insurance coverage options available through the Medicaid program or the federal health insurance marketplace.
  • Idaho – Governor Brad Little signed into law a bill to expand Medicaid. The legislation requires the state to apply for a waiver to establish work/community engagement requirements as a condition of eligibility for the expansion population. The bill also directs the state to apply for a 1332 waiver such that individuals between 100 and 138 percent of poverty would default into coverage through the state marketplace rather than Medicaid.
  • Kansas – The Kansas Department of Health and Environment released its first annual report from the Kansas Pregnancy Risk Assessment Monitoring System (PRAMS). The 2017 PRAMS Summary provides information from women who were interviewed about their experiences before, during and shortly after pregnancy and identifies issues that affect the well-being of mothers and infants in Kansas.
  • Kentucky – The state hosted the 2019 Kentucky Harm Reduction Summit, which brought together health care professionals, law enforcement, state and local community and government leaders, community mental health centers, first responders and numerous service organizations from across the state. The informational summit focused on current harm reduction strategies being implemented and opportunities for additional harm reduction work.
  • Michigan – The Michigan Department of Health and Human Services issued a request for proposals for public and private non-profit organizations to implement and evaluate sexual violence primary prevention strategies. The Department expects to award approximately $525,000 annually through a competitive process to five agencies, with funding of $105,000 per year to implement and evaluate comprehensive sexual violence prevention programming.
  • New Jersey – Governor Phil Murphy signed legislation to enhance enforcement of mental health parity laws. The law requires health insurers to provide coverage for mental health conditions and substance use disorders under the same terms and conditions as provided for any other sickness and to meet the requirements of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act.
  • New Mexico – Governor Michelle Grisham signed House Bill 480, which passed both the House and Senate The legislation expands physician residency slots in the state by establishing a new grant funding program for graduate medical education.
  • North Dakota – The North Dakota Insurance Department released a draft application for a Section 1332 waiver to implement a reinsurance program. As a reminder, links to all draft state applications and pending legislation are available via the SHVS map, which tracks state action on 1332 waivers.


Upcoming Webinar – State Medicaid Buy-Ins: Key Questions to Consider

Thursday, April 25, 2019 from 2:00 to 3:00 p.m. ET

Lawmakers across the country are considering “Medicaid buy-in” or public option programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. State Health and Value Strategies, in partnership with Manatt Health, will host a webinar for states on the evolving concept of Medicaid buy-in/public option. During the webinar, speakers from Manatt Health will discuss six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program. These considerations include (1) goal setting, (2) sources of cost-savings, (3) potential impacts on existing insurance markets, (4) federal 1332 waiver considerations, (5) implementation capacity, and (6) key steps for implementation.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e4552a7919c29545260ce042391c9b49e


Study Finds Few Consumers Understand What Short-Term Plans Really Offer

A new study, commissioned by the consumer representatives to the National Association of Insurance Commissioners (NAIC), finds that most consumers struggle to understand the coverage benefits and limitations of short-term plans. The study, conducted by Kleinmann Communication Group, tested consumer understanding of a marketing brochure for a popular, short-term health insurance plan with the goal of assessing whether consumers could understand the benefits offered by the plan, the limits on benefits, and the out-of-pocket costs. The report is accompanied by a letter from the consumer representatives that outlines recommendations for state policymakers and the NAIC.


Improving the Health and Well-Being of the Nation’s Aging Population

The National Governor’s Association (NGA) released a report providing considerations for governors and state leaders in the design and implementation of strategies to meet the needs of the growing population of older adults and individuals with disabilities. As the primary payer for long-term services and supports (LTSS), state Medicaid programs provide care for millions of older Americans and individuals with disabilities, which is currently unavailable or unaffordable in Medicare and the private health insurance market. This unique position within the health system presents challenges for states in controlling LTSS costs while ensuring that the most vulnerable receive good care and have the highest quality of life as they age. The report summarizes the key takeaways and considerations that emerged from an expert roundtable hosted by NGA’s Center for Best Practices Health Division.


Lessons Learned from Oregon: Maximizing System-Level Data to Address Health and Social Complexity in Children

The Lucile Packard Foundation for Children’s Health recently hosted a webinar showcasing an innovative methodology being employed in Oregon that uses system-level data to identify children with health complexity. During the webinar, speakers discussed the new standardized approach, developed by the Oregon Pediatric Improvement Partnership and Oregon Health Authority, and how it has helped inform priority areas, potential policy improvements, investments and partnerships in support of children with health complexity. Speakers provided an overview of the statewide population-level health complexity findings and shared how the data has been utilized by Oregon’s coordinated care organizations.