In This Week’s Update:
- New CMS Models for Dual Eligibles
- State Updates: AZ, CO, ME, MA, NJ, OR, RI & SD
- Upcoming Webinar on Trends and Disparities in Children’s Health Insurance
- Building the Business Case for Investment in Childhood Obesity Prevention
- How Consumers Shape Health Care Reform
- Health Impacts of Early Childhood Interventions
CMS Announces New Models fro Dual Eligibles
Last week, the Centers for Medicare and Medicaid Services (CMS) announced new opportunities to test innovative integrated care models for dually eligible individuals. CMS sent a letter to state Medicaid directors inviting states to partner with the agency to explore new approaches to serve dually eligible individuals. The letter discusses approaches including capitated financial alignment model, a managed fee-for-service model, and state specific models.
State Updates: AZ, CO, ME, MA, NJ, OR, RI, & SD
- Arizona – Beginning in 2020, the Arizona Health Care Cost Containment System (AHCCCS) will require Medicaid providers of personal care and home health services to use Electronic Visit Verification (EVV), an electronic based system that verifies when caregiver visits occur and documents the precise time services begin and end. AHCCCS has selected Sandata Technologies LLC to deliver the statewide EVV system that will be made available to all service providers required to use EVV.
- Colorado – Governor Jared Polis named Elisabeth Arenales to the board of directors of Connect for Health Colorado, the state’s official health insurance marketplace, as an ex-officio member representing the governor’s office. Ms. Arenales serves as Senior Policy Advisor for Health in the Governor’s Office.
- Maine – The Department of Health and Human Services released an update on Medicaid expansion enrollment. With over three months of enrollment data now accumulated, the current snapshot of enrollment allows improved tracking of trends in enrollment over time. To date, 18,887 people are currently enrolled through the MaineCare expansion, including 15,469 adults without children and 3,418 parents and caretaker relatives. Cumulatively, between July 2 and April 26, 20,721 gained coverage through the expansion.
- Massachusetts – The Board of Directors of Massachusetts Health Connector, the state’s official health insurance marketplace, approved a five-year contract with Softheon, which will deliver new payment options for members. Starting in June 2020, members will be able to pay their monthly premiums by using a debit card, credit card or automated phone system fulfilling a long-time request from members for a wider variety of payment options.
- New Jersey – The New Jersey Department of Labor and Workforce Development awarded $3.9 million in funding to six organizations to fund job training and support services in counties most severely impacted by the opioid epidemic. The Opioid Recovery Employment Program, also known as Pathways to Recovery, is part of Governor Phil Murphy’s multi-agency strategy to address the state’s opioid crisis.
- Oregon – The Oregon Health Authority is sponsoring a disaster exercise to train staff and partners on responding to an intentional release of plague. Operation OX (“Oregon Exercise”) is coordinated by the Health Security, Preparedness and Response Section at the OHA Public Health Division and will simulate a response to the release of plague, and how medications and medical supplies are requested, received, distributed and dispensed from the Strategic National Stockpile. The Oregon Health Authority announced it received nineteen applications from organizations seeking contracts to serve as coordinated care organizations (CCOs) for the Oregon Health Plan’s nearly one-million members. Awards for the CCO contracts are expected to be announced in July 2019 and will start January 1, 2020, and go through December 31, 2024.
- Rhode Island – The state released a draft of its Section 1332 State Relief and Empowerment Waiver Application and is seeking public comments on the draft. The application seeks to waive certain requirements of the ACA with the goal of expanding the state’s flexibility to implement a reinsurance program in the individual health insurance market.
- South Dakota – The state is requesting a new five-year Section 1115 demonstration to develop an alternative service delivery model to target access to primary care services for American Indians. The state is proposing to use Federally Qualified Health Centers and Urban Indian Health Clinics to provide services to dual Medicaid and Indian Health Service eligible beneficiaries. The federal comment period on South Dakota’s application is open through May 23, 2019.
Upcoming Webinar – 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
Building the Business Case for Investment in Childhood Obesity Prevention
With support from the Robert Wood Johnson Foundation, Nemours Children’s Health System recently developed a Prevention Business Case Simulation Tool (and related user guide) to simulate the financial costs and benefits of investing in obesity prevention efforts through Medicaid. This beta tool allows states to prospectively simulate the cost savings and returns to Medicaid generated by different types of obesity prevention interventions and will help state Medicaid directors and managed care organizations make the financial argument for investing in interventions focused on preventing childhood obesity. As children who are overweight or obese are more likely to be overweight or obese in adulthood, the tool also supports efforts to explore reimbursement for upstream obesity prevention initiatives. For an overview of the tool, see this Culture of Health blog post.
How Consumers Have Shaped Health System Delivery Reform
A new report by the Center for Consumer Engagement in Health Innovation (the Center) at Community Catalyst highlights examples of how consumers with complex health and social needs, organized and supported by the Center’s state and local advocacy partners, have shaped policy and practice in delivery reform initiatives. The report features efforts in six states as examples of consumers having a positive impact on the health system. These organizations have built structures for meaningful consumer engagement and then organized and built the skill and knowledge base of consumer leaders who now participate in those structures and effect consumer-driven change.
Health Impacts of Early Childhood Interventions
Two new policy briefs from Health Affairs with support from the Robert Wood Johnson Foundation focus on the health impacts of early childhood interventions. One brief, Early Childhood Home Visiting Programs and Health, provides a landscape on home visiting services and explores research, strategies, and related policy implications to improve maternal and child health. Another brief, The Effects of Early Care and Education on Children’s Health, highlights the short- and long-term improvements in health related-outcomes related to early care and education programs. Together with two previously published briefs, these new releases round out a four-brief cluster as part of Health Affairs’ ongoing series on the social determinants of health.