April 22 Update

In This Week’s Update:

  • Final 2020 Payment Notice
  • State Updates: AZ, CA, CO, MD, NY, OR, WA, & WV
  • State Medicaid Buy-Ins: Key Questions to Consider
  • Upcoming Webinar on Children’s Coverage
  • Impact of State-Level Policy,Operational Choices ACA Marketplace Performance
  • Organizing Complex Care for Rural Populations: A Case Study of Three Montana Communities

Final 2020 Payment Notice

Last week, the Centers for Medicare and Medicaid Services (CMS) released the final annual Notice of Benefit and Payment Parameters for the 2020 benefit year, also known as the 2020 Payment Notice. Overall, CMS made very few major changes from its proposed rule released earlier this year. The rule includes changes to many elements of marketplace functionality and will have impacts on premiums paid in the market next year. This Health Affairs blog post provides an overview of the final rule and dives deeper into the insurer and exchange provisions. Updates follow.

State Updates: AZ, CA, CO, MD, NY, OR, WA, & WV

  • Arizona – Governor Doug Ducey signed into a law a bill directing the Arizona Department of Health Services (DHS) to submit an annual report improving the tracking of veteran suicides in the state. The report will begin in January 2020 and will track a variety of data points that will provide historical and regional trends and compare Arizona’s resident veteran suicide rate to the national rate and other regions across the country.
  • California – Governor Gavin Newsom joined Los Angeles County leaders to announce that the county, among the largest public purchasers of prescription drugs in California, will partner with the state to use their combined market power to lower the cost of prescription drugs in the state. This announcement follows an executive order the governor signed shortly after being sworn in earlier this year directing California agencies to consolidate pharmacy purchasing authorities.
  • Colorado – The Colorado Department of Regulatory Agencies posted 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 our map, where we are tracking state action on 1332 waivers.
  • Maryland – The Maryland Health Benefit Exchange is holding a public forum on May 2 regarding the state’s reinsurance program. The forum will be an opportunity to provide feedback on the progress of the state’s program after its first year.
  • New York – NY State of Health, the state’s official state-based marketplace, will be hosting informational and enrollment events at more than 20 colleges across the state throughout the week of April 22, 2019. Certified in-person assistors will be available in high traffic areas on campuses to speak with soon-to-be graduates about how to get health coverage through the Marketplace.
  • Oregon – Governor Kate Brown issued an executive order establishing the Child Welfare Oversight Board to advise her direction to the Department of Human Services (DHS) so it can more effectively address Oregon’s child welfare crisis.
  • Washington – Governor Jay Inslee signed into a law a bill that will reinforce at the state level a significant number of consumer protections in the Affordable Care Act, including ensuring individuals with pre-existing conditions will not be denied coverage.
  • West Virginia – The West Virginia Department of Health and Human Resources, Bureau for Behavioral Health will host the West Virginia Peer Recovery Support Services Conference on April 16-17, 2019. The event is designed for peer workers who have been successful in the substance use disorder recovery process, and who help others experiencing similar situations.


Upcoming Webinars – 

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


Trends and Disparities in Children’s Health Insurance: New Data and the Implications for State Policy

Thursday, May 2, 2019 from 12:00 to 1:00 p.m. ET

The State Health Access Data Assistance Center (SHADAC) and State Health and Value Strategies (SHVS) will host an online discussion to share new data showing a recent uptick in the rate of uninsured children and highlight promising state-level policies that could help. The interactive webinar will feature experts from both SHADAC and SHVS and offer state-based policymakers a forum to learn from and share insight with each other. With key findings from an upcoming SHADAC report – including state-specific data broken down by race, income, and coverage type – the conversation will cover implications for policymakers, novel approaches states have put in place to ensure more children have access to care, and more.

Registration (required) at the following link: https://cc.readytalk.com/registration/#/?meeting=ga9wr29obvl1&campaign=59nbkh9vr5u0


Impact of State-Level Policy and Operational Choices on Performance in ACA Marketplaces

Sabrina Corlette and Rachel Schwab at Georgetown University wrote a blog post published by the Commonwealth Fund examining the factors that contributed to higher plan selection in state-based marketplaces during the 2019 open enrollment period. Factors included better advertising and outreach efforts, a longer sign-up period, and more flexible online platforms. The blog post also compares plan selections in state-based marketplaces with the federal HealthCare.gov platform over the last two open enrollment periods.


Organizing Complex Care for Rural Populations: A Case Study of Three Montana Communities

A report by the Center for Health Care Strategies highlights the experiences of three rural Montana communities on their methods for addressing the needs of extremely medically complex and socially vulnerable individuals using “ReSource Teams.” The ReSource teams consist of community health workers and volunteers who visit patients in their homes, and consult remotely (either by phone or iPad) with registered nurses, pharmacists, and behavioral health providers. The report provides examples of how to develop complex care programs in rural environments.