December 9 Update

In This Week’s Update:

  • 2018 National Health Care Spending
  • Catalyst for Payment Reform Virtual Summit
  • State Updates: LA, ME, MI, MN, OR, PA, VT & VA
  • CMS Beneficiary Engagement Toolkit
  • Improving Care for Children in Foster Care


2018 National Health Care Spending

Last week, the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS) released findings from its study of national health care spending in 2018 and found that spending on health care grew 4.6 percent, an increase of 0.4 percent compared to 2017, to a total of $3.6 trillion, or $11,172 per person. While health care spending increased during 2018, it did not grow at the same pace as the overall economy, and as a result, the share of the Gross Domestic Product devoted to health spending decreased from 17.9 percent in 2017 to 17.7 percent in 2018. The Health Affairs Blog analyzed the drivers behind the growth.


Catalyst for Payment Reform Virtual Summit

Catalyst for Payment Reform will host an upcoming free virtual summit (register here) on Tuesday, December 10. The summit will feature Medicaid leaders from across the country who will share strategies they are pursuing and the lessons they are learning as they use their managed care organization contracts to hold providers accountable for better health care quality and lower costs. Speakers from several state Medicaid agencies and leading experts, including State Health and Value Strategies Deputy Director Dan Meuse, will describe and discuss current and future strategies.


State Updates: LA, ME, MI, MN, OR, PA, VT & VA

  • Louisiana – The Louisiana Department of Health and Walmart announced a collaboration and pilot screening program to advance the state’s goal of eliminating hepatitis C. The free hepatitis C screenings will be available at the pharmacies of 10 Walmart stores for people who are at risk of the disease.
  • Maine – MaineCare submitted a Section 1115 demonstration waiver application to CMS with the goal of improving the service delivery system to treat individuals with substance use disorders (SUDs). If approved, this waiver would allow for additional federal funding for residential or inpatient SUD treatment for MaineCare-enrolled adults and would provide state flexibility to pilot four services focused on MaineCare-enrolled parents with SUD who are involved with, or at risk of, involvement with Child Protective Services.
  • Michigan – In a letter, Governor Gretchen Whitmer urged the state legislature to suspend Michigan’s Medicaid work requirements while the legality of the requirements are being challenged in federal court. If not suspended, the work requirements are set to take effect January 1, 2020.  
  • Minnesota – MNSure, the state-based marketplace, reminded residents that all private health plans offered on the MNsure marketplace limit the out-of-pocket cost to enrollees for insulin prescriptions in 2020. Each of MNsure’s four insurers are offering either low-cost or free insulin benefits, and consumers purchasing plans through MNsure will pay no more than $25 per month for insulin.
  • Oregon – The Oregon Health Authority (OHA) honored World AIDS Day by partnering with a national HIV education campaign to promote a new initiative known as U=U, or “Undetectable equals Untransmittable.” The OHA endorsement of Prevention Access Campaign’s U=U effort is part of the End HIV Oregon initiative launched in December 2016 to end new HIV infections in Oregon and eliminate stigma for those living with the disease.
  • Pennsylvania – The Pennsylvania Health Insurance Exchange Authority announced its selection of GetInsured as its technology and customer service vendor to provide services for individuals and families purchasing health and dental insurance on the state’s newly created state-based marketplace beginning in the 2021 plan year. 
  • Vermont – Governor Phil Scott submitted a concept paper to the U.S. Department of Health and Human Services detailing the state’s proposal to import prescription drugs from Canada. Vermont plans to submit its formal application to allow the state to buy prescription drugs from Canada by next July.
  • Virginia – Medicaid Director Karen Kimsey formally asked CMS to delay finalizing the state’s pending Section 1115 waiver, which includes a work requirement and premiums for some enrollees.  


New CMS Beneficiary Engagement Toolkit

In a new toolkit, CMS highlights strategies used by accountable care organizations (ACOs) and end-stage renal disease seamless care organizations (ESCOs) to engage beneficiaries. Specifically, the toolkit explores how ACOs and ESCOs engage beneficiaries in ACO governance; elicit beneficiary and family feedback; support beneficiaries in self-care management; enhance beneficiary communication in the clinical setting; and communicate with beneficiaries about the ACO as a value-based care organization. The beneficiary engagement toolkit is part of a broader series of toolkits on the strategies ACOs use to provide value-based care while also providing actionable ideas to current and prospective ACOs to help them improve or begin operations.


Cross-Agency Collaborations to Better Serve Children in Foster Care

In the latest Medicaid Leadership Exchange podcast, West Virginia Medicaid director Cindy Beane and Kentucky Medicaid director Carol Steckel discuss their efforts to establish cross-agency collaboration between Medicaid and their respective child welfare departments to better serve the needs of children and their families. During the episode, the two state leaders discuss their pursuit of new care delivery models through the use of a single, specialized managed care organization to serve the needs of these children. To build relationships between their respective Medicaid and child welfare agencies, both states are developing a shared language, aligning line staff, and creating “cultures of safety.”