Dec 18 Update

In This Week’s Update:

  • New CMS Maternal Health Model
  • Strategies for States to Support Worker Registries
  • Lessons from America’s Former Top Doctor
  • National Healthcare Spending in 2022
  • Expanding Health Coverage Through Facilitated Enrollment
  • State updates: AR, CA, CO, MA, MI, MO, MS, NE, NJ, NM, NY, OR & SC


New CMS Maternal Health Model

This week, CMS announced the new Transforming Maternal Health (TMaH) Model. TMaH will focus on improving maternal healthcare by supporting participating state Medicaid agencies in the development of a whole-person approach to pregnancy, childbirth, and postpartum care. As a reminder, State Health & Value Strategies (SHVS) published several resources related to improving maternal health outcomes, including a compendium of strategies that synthesizes research about the national state-of-play, including state examples, across four domains: maternal health models, quality improvement, workforce and benefits, and eligibility and enrollment/coverage expansion. SHVS also published an issue brief focused specifically on actions Medicaid agencies can pursue, through their managed care programs or directly with provider organizations, to promote health equity and improve birth-related health outcomes.


Also this week, CMS released an informational bulletin advising states about best practices and opportunities for enhanced federal funding to support worker “registries” in connection with Medicaid home and community-based services. In the guidance, CMS emphasizes that no federal approval is needed for states to implement the registry functions, and advises states about the availability of enhanced federal funding to support the development and maintenance of qualifying registry functions.


Lessons from America’s Former Top Doctor

In the latest episode of Heather Howard’s podcast, the Princeton Pulse, Heather is joined by former U.S. Surgeon General, Dr. Jerome Adams. Serving as the “nation’s doctor” during the height of the pandemic, and as a member of the President’s Coronavirus Task Force, Dr. Adams was an integral part of the U.S. response to COVID-19. The podcast discusses the importance of depoliticizing public health, improving science and health literacy, preventing misinformation, and preparing for the next public health crisis. It also delves into Dr. Adams’ experiences as Indiana’s Health Commissioner, including during the state’s response to the opioid crisis.


National Healthcare Spending in 2022

According to a new article from Health Affairs, healthcare spending in the U.S. grew 4.1% to reach $4.5 trillion in 2022, a faster rate of growth than the increase of 3.2% in 2021, but much slower than the rate of 10.6% seen in 2020. In 2022, strong Medicaid and private health insurance spending growth, including a turnaround in the net cost of insurance, was somewhat offset by continued declines in federal spending associated with the COVID-19 pandemic. The insured share of the population reached a historic high of 92% in 2022, as enrollment in private health insurance increased at a faster rate relative to 2021 and Medicaid enrollment continued to experience strong growth. The share of the economy accounted for by the health sector was 17.3% in 2022, down from a peak of 19.5% in 2020 but more consistent with the average share of 17.5% from 2016 through 2019.

Expanding Health Coverage Through Facilitated Enrollment Programs

Many states have implemented policies that take advantage of existing consumer-state interactions to help individuals enroll in health coverage more easily. Predominant models include tax return–based easy enrollment and leveraging administrative data from other state programs. To assist states in their efforts, SHVS published a new resource page of state facilitated enrollment resources which includes enacted legislation, tax forms, outreach letters, and consumer-facing materials. A new report from the Urban Institute summarizes existing facilitated enrollment programs, discusses considerations for states exploring them, and notes key design issues.


State updates: AR, CA, CO, MA, MI, MO, MS, NE, NJ, NM, NY, OR & SC 

  • Arkansas – A Department of Human Services program that transforms primary care delivery, the Patient-Centered Medical Home (PCMH) program, has received the Center for Evidence-Based Policy’s inaugural Evidence-Based Innovation Award. The PCMH program aims to support primary care in Arkansas by enhancing the patient experience, promoting preventive and long-term disease management, and reducing cost to the program.
  • California – The California Department of Public Health launched a new, comprehensive opioid website that gives Californians a single source of prevention, data, treatment, and support information. Coinciding with the launch of the new website,, the state is awarding nearly $8 million in grants to local organizations to implement evidence-based and community-driven public health interventions for preventing overdose from fentanyl and other opioids.
  • Colorado – CMS approved a state plan amendment (SPA) for mobile crisis services in Colorado. This is the 14th mobile crisis SPA approved by CMS. As a reminder, SHVS published an expert perspective on the enhanced payment available through the American Rescue Plan Act for community-based mobile crisis services.
  • Massachusetts – MassHealth announced a new benefit allowing coverage of doula services for pregnant, birthing, and postpartum members beginning in spring 2024. Doulas provide non-medical emotional, informational, and physical support to individuals and families during pregnancy, birth, and the postpartum period.
  • Michigan – The Michigan Department of Health and Human Services has expanded Medicaid coverage to include community health worker (CHW) services, beginning January 1, 2024. CHWs are trusted members of the community and serve as links between residents and the health and social resources needed to improve wellbeing. The expanded Medicaid coverage includes health system navigation and resource coordination, health promotion and education, and screening and assessment.
  • Mississippi – CMS approved a SPA to extend postpartum coverage to a full year for individuals enrolled in Medicaid and CHIP in Mississippi. As a reminder, SHVS published an issue brief on the American Rescue Plan option to extend postpartum coverage.
  • Missouri – CMS approved Missouri’s Substance Use Disorder (SUD) and Serious Mental Illness (SMI) section 1115 demonstration request. This approval authorizes the state to receive federal financial participation for providing otherwise covered services for treatment of SUD and/or SMI to individuals with Medicaid ages 21 to 64 who are short-term residents in settings in which such services would not otherwise be covered because the settings qualify as institutions for mental diseases.
  • Nebraska – CMS recently approved a SPA to extend postpartum coverage to a full year for individuals enrolled in Medicaid in Nebraska. Nebraska’s approval marks 42 states, D.C., and the U.S. Virgin Islands that have extended postpartum Medicaid coverage for an entire year.
  • New Jersey – Governor Phil Murphy appointed six public members to serve on the Board of the New Jersey Maternal and Infant Health Innovation Authority. The Authority is tasked with overseeing the New Jersey Maternal and Infant Health Innovation Center and will be the government entity that continues the work of Nurture NJ, the statewide program to reduce maternal and infant mortality and ensure equitable care among women and children in New Jersey.
  • New Mexico – Governor Michelle Lujan Grisham announced the final recipients of funding through the $80 million Rural Health Care Delivery Fund. The announcement of 45 additional awardees comes on the heels of the initial distribution of $18 million to 11 rural healthcare organizations. The list of awardees includes a diverse range of healthcare services across New Mexico’s rural areas.
  • New York – Governor Kathy Hochul signed legislation to protect New Yorkers from ongoing financial consequences related to medical debt and unaffordable prescription drugs. Senate Bill S4907A prohibits hospitals, healthcare professionals and ambulances from reporting an individual’s medical debt to credit agencies. Senate Bill S608C prohibits the sale of medicine for an unconscionably excessive price throughout a drug shortage. As a reminder, I co-authored an op-ed on medical debt that highlights an innovative New Jersey pilot program to cancel an estimated $1 billion worth of debt for tens of thousands of residents.
  • Oregon – The Oregon Health Authority announced that Health Resources in Action (HRiA), a non-profit organization based in Boston, was selected as the new contractor for the helpline that connects individuals to treatment, housing, and overdose prevention providers within the statewide behavioral health resource networks. HRiA is planning to undertake extensive statewide outreach and add new functionalities to the hotline such as texting.
  • South Carolina – Effective January 1, 2024, the South Carolina Department of Health and Human Services (SCDHHS) will add coverage for hospital-based crisis stabilization services rendered to Medicaid members. These services will be available for reimbursement to hospitals that have constructed, or are constructing, behavioral health emergency units for crisis stabilization separate from the hospital’s general emergency department. This initiative originated through an SCDHHS grant that awarded $45.5 million in infrastructure funds in June 2023 to build these specialized units.