December 16 Update

In This Week’s Update:

  • Impact of Health Insurance Coverage on Mortality
  • State Updates: CO, MI, NH, NY, PA, SC, VA & WA
  • Rise of Uninsurance in Young Kids
  • Medicaid MCOs as Agents of Payment Reform
  • Top State Network Resources in 2019


Impact of Health Insurance Coverage on Mortality

Last week, researchers at Stanford University and the U.S. Treasury Department released a study examining the link between outreach to the uninsured, subsequent enrollment in insurance coverage, and reduced mortality. The results illustrate that letters sent by the Internal Revenue Service to individuals who paid a tax penalty in 2017, which included information on where these individuals could obtain insurance, were effective in connecting the uninsured to coverage and ultimately reduced their mortality. Additionally, as State Health and Value Strategies partner and former Treasury official Jason Levitis pointed out on Twitter, states with their own individual mandates can leverage the information they collect to do similar outreach.


State Updates: CO, MI, NH, NY, PA, SC, VA & WA

  • Colorado – The Department of Health Care Policy & Financing (HCPF) released a comprehensive report outlining the primary drivers of prescription drug costs in Colorado. HCPF will be hosting stakeholder events to inform more effective prescription drug affordability policy and best practices to the benefit of all Coloradans.
  • Michigan
    • Robert Gordon, director of the Michigan Department of Health and Human Services (MDHHS), presented to a bipartisan panel of legislators the department’s vision for a strengthened behavioral health system, serving individuals with severe mental illness, substance use disorders, and developmental disabilities. The new system will integrate physical and behavioral health services.
    • MDHHS announced that more than 238,000 people enrolled in the Healthy Michigan Plan will begin receiving letters explaining how to comply with the program’s new work requirements.
  • New Hampshire – Governor Chris Sununu signed an executive order that will expedite the licensing of providers for the state’s Medicaid to Schools program, which uses Medicaid funds for health care services provided in schools.
  • New York – The state submitted to the Centers for Medicare and Medicaid Services (CMS) a request to amend its Medicaid Redesign Team demonstration for their Delivery System Reform Incentive Payment program. The proposal is structured in two phases: a one-year extension of the current waiver program expiring on March 31, 2020, and a subsequent three-year renewal. The federal public comment period is open through January 10, 2020.
  • Pennsylvania – Governor Tom Wolf signed into law legislation requiring patients who use opioids for chronic pain to sign a treatment agreement with their physician that outlines the risks involved with the use of the drugs. The legislation also requires that patients consent to be periodically drug tested.
  • South Carolina – CMS approved a part of the state’s Section 1115 demonstration request to require participation in community engagement as a condition of eligibility for the Medicaid state plan parent, caretaker, and relative group and individuals eligible through Transitional Medicaid Assistance.
  • Virginia – Governor Ralph Northam announced his proposed budget will include approximately $22 million to combat maternal and infant mortality and reduce the racial disparity in Virginia’s maternal mortality rate. Proposed funding will expand Medicaid coverage for new moms, increase home visiting, and explore Medicaid reimbursement for doula support services.
  • Washington – The Washington Health Benefit Exchange board approved the design for Cascade Care plans. Cascade Care plans are qualified health plans that have a standard health benefit design across health insurance carriers. The approval of the designs is a step in implementing Senate Bill 5526. The Exchange will be working on marketing materials and outreach for Cascade Care informed by focus groups and testing with a goal to develop tools and materials for consumers that will help them in selecting the best plan among their available options.


Nation’s Youngest Children Lose Health Coverage at an Alarming Rate

A new report by Georgetown University’s Center on Children and Families finds that the number and rate of uninsured children under age six grew between 2016 and 2018, reversing years of steady progress covering the nation’s infants, toddlers, and preschool-aged children. The report highlights the many factors that may have contributed to the rise of uninsurance in this population, including recent federal policies and states decisions to expand Medicaid, and implications these factors have on health outcomes of children under six and their adult caretakers. In particular, the lack of health care coverage makes it more difficult for young children to get recommended checkups and families may miss out on opportunities for support. The report also includes state-specific analysis and highlights that 13 states in particular showed statistically significant increases in the rate of the uninsurance in this population.


Medicaid MCOs as Agents of Payment Reform

On December 10, Catalyst for Payment Reform (CPR) released Medicaid MCOs as Agents of Payment Reform, a resource for employers and other health care purchasers, including Medicaid agencies, that assembles key contract provisions from across the 39 states with Medicaid managed care and the District of Columbia. The report catalogues the strategies Medicaid agencies are pursuing to accelerate growth and innovation in payment reform through mandates to their MCO contractors. Language directly excerpted from MCO model contracts instructing MCOs on the goals, targets, and mechanisms for executing payment reform include general provisions for payment models as well as programs specifically aimed at maternity care, behavioral health, pharmacy, provider enablement, and social determinants of health. This resource is designed to help Medicaid agencies, employers, and other health care purchasers learn from each other, spur continued innovation, and accelerate effective payment reform. There is also a free recording of the Virtual Summit CPR held during which three states and experts, including SHVS Deputy Director Dan Meuse, discussed the latest trends and innovations.


State Network Top Resources for 2019 provides state policymakers and others with timely, data-driven resources to better understand and shape local health policies. The top 10 most viewed resources of 2019 were:

  1. 50-State Analysis of Drug Overdose Trends: The Evolving Opioid Crisis Across the States
  2. What Medicaid Expansion Means in Your State  
  3. Priority Medicaid Issues for New State Officials
  4. Many Adults Targeted by Medicaid Work Requirements Face Barriers to Sustained Employment
  5. Medicaid: The Basics
  6. Wellness Check: Food Insecurity Among Families with Infants and Toddlers
  7. Championing Treatment for Substance Use Disorder in Primary Care: A Q&A with New Jersey Providers
  8. New York’s 2014 Law to Protect Consumers from Surprise Out-of-Network Bills Mostly Working as Intended: Results of a Case Study
  9. 2019 County Health Rankings
  10. What’s the Difference Between Medicaid and Medicare?