December 20 Update

In This Week’s Update:

  • Notable Sate Health & Value Strategies pieces from 2021
  • Advancing Health Equity through APMs
  • Addressing hunger through cross-sector partnerships
  • State updates: CA, LA, MA, MD, MN, NC, NE, NJ, OK & PA

To support states as they plan for unwinding from the continuous coverage requirement, State Health and Value Strategies published a new resource, Leveraging Managed Care Plans to Support Medicaid Continuous Coverage Unwinding Toolkit. Close collaboration between states and managed care plans will be essential to ensuring eligible individuals retain coverage in Medicaid/CHIP and easing transitions to the Marketplace. The toolkit highlights opportunities for states to work with managed care plans to support unwinding the Medicaid continuous coverage requirement and builds on guidance recently released by CMS. As a reminder, SHVS has created an accessible one-stop source of information for states in “unwinding” when the Medicaid continuous coverage requirement ends.

Additionally, a new SHVS expert perspective highlights notable products published by SHVS in 2021. 

Advancing Health Equity Through APMs: Guidance for Equity-Centered Design and Implementation

Alternative payment models (APMs) present a significant opportunity to incentivize changes in delivery to help make care more accessible, drive better patient outcomes, and reduce inequities in both care and outcomes. The Health Care Payment Learning & Action Network (HCP LAN) convened the Health Equity Advisory Team to advise the HCP LAN on using APMs to advance equity, resulting in a new guidance document. Multi-stakeholder collaboration is necessary to seize this opportunity and align the design and implementation of APMs that advance health equity. The document provides stakeholders with actionable guidance on how they can leverage APMs to advance health equity in ways that are both aligned and tailored to meet their communities’ needs.

Fighting Hunger by Connecting Cross-Sector Partners and Centering Lived Expertise

To improve the health of individuals it serves, state Medicaid agencies are increasingly focusing on prevention, which includes strategies to enhance access to safe, nutritious, and affordable food, particularly in the wake of the COVID-19 pandemic and in the growing evidence that participation in programs like SNAP is associated with meaningfully lower health care use and cost. A new report, part of the Exploring Cross-Agency Partnerships to Address Food Insecurity initiative led by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation, offers four recommendations for policymakers to integrate individuals with lived expertise as partners in program and policy design, implementation, and evaluation to more effectively address food insecurity. The report highlights several recommendations drawn from conversations with individuals with lived expertise, interviews with state policymakers representing Medicaid and SNAP, and an environmental scan.

Reflections From Medicaid Directors on Their Why

The National Association of Medicaid Directors compiled reflections from a selection of Medicaid Directors on what motivates them in their role. As the video highlights, some are responding to a calling, while for others the motivation is improving the lives of others in tangible and immediate ways. Some of the Medicaid Directors profiled prioritize investing in invaluable partnerships, while others talk about being an engine for good. All of them reflect on how Medicaid supports millions of people in living their best lives.

State Updates:

  • California – 
    • The California Department of Public Health (CDPH) is partnering with celebrated cartoonist Lalo Alcaraz to develop artwork for social media encouraging Latinos to get vaccinated against COVID-19 this holiday season. CDPH’s partnership with Alcaraz is part of a comprehensive effort to reach California communities that are experiencing a disproportionate impact of COVID-19 cases with resources and messaging to achieve higher COVID-19 vaccination rates.
    • As part of its statewide “Coverage Matters” virtual tour, Covered California joined African American health experts to promote open enrollment while urging Black Californians to answer the call to get COVID-19 vaccinations and boosters, and sign up for comprehensive health insurance coverage through Covered California or Medi-Cal.
  • Louisiana – CMS granted approval for Louisiana Medicaid to implement Act 421 Children’s Medicaid Option, or TEFRA, which lets certain children with disabilities receive Medicaid coverage, even if their parents earn too much money to qualify for Medicaid. To qualify, children must have a disability that is recognized under the definition utilized in the Supplemental Security Income program of the Social Security Administration and must meet basic Medicaid and institutional level-of-care requirements. 

  • Maryland – The Maryland Department of Health’s Medicaid program announced support for a vaccine incentive program sponsored by the HealthChoice managed care organizations (MCOs). Unvaccinated HealthChoice participants ages 12 and older who complete a full two-dose Pfizer or Moderna COVID-19 vaccine series or who receive a single Johnson & Johnson vaccine can claim a $100 COVID-19 gift card from their MCO. The HealthChoice COVID-19 Gift Card Program lasts until the end of March 2022.

  • Massachusetts – 
    • Governor Charlie Baker signed into law an American Rescue Plan (ARP) Act spending package that includes $5 million in funding for a MassHealth redetermination and vaccination outreach campaign targeted to communities disproportionately impacted by the COVID-19 pandemic.
    • The Baker-Polito Administration announced plans to increase access to at-home COVID-19 test kits for residents across the commonwealth. The administration has secured 2.1 million iHealth Labs over the counter at-home rapid antigen tests that will be delivered to 102 towns with the highest percentage of families below the poverty level.

  • Minnesota –  
    • A joint partnership between the state’s Department of Health, Department of Human Services, and eight of the state’s managed care organizations published a report on the first phase of their vaccine equity partnership. The purpose of the partnership is for health plans to drive equitable outcomes among their members by prioritizing outreach efforts to those who live in high social vulnerability index areas and those enrolled in Minnesota health care programs.
    • The Minnesota Department of Human Services (DHS) was authorized to spend $50,000,000 from the State Fiscal Relief Fund, funded through ARP, to administer emergency grants for nursing facilities’ staffing shortages. Preliminary DHS estimates of how the emergency grant monies will be distributed state that nursing facilities will use at least 90 percent of the new funding received as bonuses to hire or retain existing employees.
  • Nebraska –  
    • The Department of Health and Human Services (DHHS) and the Nebraska Council on Developmental Disabilities are workingtogether on a person-centered planning initiative to reinvigorate person-centered supports for all Nebraska’s home and community-based services waivers. The planning initiative will provide introductory training for participants, families, and providers throughout January 2022.
    • DHHS’ Division of Behavioral Health is seeking applicants for the State Advisory Committee on Mental Health. The committee is currently seeking two consumers of mental health services or their family members, and one provider of mental health services.
  • New Jersey  – 
    • In partnership with Vault Medical Services, the state is offering COVID-19 saliva testing, at no cost, to any person who feels they need a test. Those seeking tests can order one from Vault and a test kit will be mailed home via expedited shipping. Results can be available 24 to 48 hours after a sample arrives at the lab.
    • First Lady Tammy Murphy and the New Jersey Department of Health released the Maternal Mortality Data Brief, which examines pregnancy-associated deaths in New Jersey between 2014 and 2016 and makes recommendations for improvements. Among the findings, the report demonstrates the wide racial disparities among maternal deaths with non-Hispanic Black women dying from pregnancy-related causes at 7.6 times the rate of non-Hispanic white women and Hispanic women die at a rate 2.7 times that of white women.
  • North Carolina – 
    • In order to better reach those with substance use disorders, the North Carolina Department of Health and Human Services (NCDHHS) is awarding $4.4 million in funding to 15 mobile units to provide screening, assessment, treatment, primary care and recovery support services.
    • NCDHHS released the 2020-2021 North Carolina Safer Syringe Initiative Annual Report highlighting the work that syringe services programs (SSPs) are doing across the state. The SSPs have responded to the ongoing COVID-19 pandemic, increases in overdoses and other challenges.

  • Oklahoma – The Oklahoma Health Care Authority proposed a rule permanently making Medicaid expansion adults eligible to receive services through SoonerCare, the state’s patient centered medical home (PCMH) program. The PCMH program assigns each enrollee a primary care provider to serve as their “medical home.” Public comments are open through January 18.

  • Pennsylvania – Governor Tom Wolf announced $2.5 million in state funding will help grassroots organizations across the commonwealth encourage hesitant Pennsylvanians to get the COVID-19 vaccine. A total of 65 grants were awarded through the COVID-19 Vaccine Outreach Grant Program.