February 11 Update

In This Week’s Update:

  • State of the Union and Health Care
  • State Updates: ME, NJ, NY, NC, OR, RI & VA
  • Screening for ACEs and Trauma
  • Health Workforce Development Recommendations



State of the Union

During his State of the Union address last week, President Trump highlighted several health care priorities for his Administration, including eliminating HIV/AIDS, funding for childhood cancer, and addressing rising prescription drug costs. For a health care focused analysis of his speech and other recent health policy initiatives proposed by the Administration, listen to this Kaiser Health News’ What the Health? podcast (start at 1:22). Updates follow.


  • Maine – Governor Janet Mills signed an executive order directing her Administration to take immediate steps to combat the opioid crisis. The Order outlines the initial actions that will be taken to prevent overdose deaths, increase treatment and recovery efforts, and bolster prevention efforts – all of which will be done in a manner to reduce the stigma associated with substance use disorders.
  • New Jersey – The New Jersey Department of Human Services on Wednesday announced it has launched a new Office of Medicaid Innovation to improve the quality, delivery and cost of care within the state’s Medicaid program. The Office will lead New Jersey Medicaid’s work on value-based payment and purchasing strategies. The Office will be led by Gregory Woods, who most recently served as the Director of the Policy and Programs Group at the federal Center for Medicare and Medicaid Innovation in Baltimore.
  • New York – NY State of Health, the state’s official health plan Marketplace, announced that more than 4.7 million New Yorkers enrolled in comprehensive health coverage through the Marketplace, an increase of more than 435,000 people from 2018. Marketplace enrollment is at its highest point ever, including more than 1 million people enrolled in Qualified Health Plans and the Essential Plan; 86 percent of enrollees were returning from last year and 14 percent were new in 2019.
  • North Carolina – The North Carolina Department of Health and Human Services announced the selection of Prepaid Health Plans (PHP) that will participate in Medicaid managed care when the program launches in November 2019. Statewide PHP contracts were awarded to AmeriHealth Caritas North Carolina, Inc.; Blue Cross and Blue Shield of North Carolina; UnitedHealthcare of North Carolina, Inc.; and WellCare of North Carolina, Inc. A regional contract for Regions 3 and 5 was awarded to Carolina Complete Health, Inc.
  • Oregon – A joint report from the Oregon Health Authority and Department of Consumer and Business Services shows that in 2017 Oregon’s public and private health insurance plans’ spending on primary care averaged from 10.6 to 16.5 percent of their medical expenditures. The report found that coordinated care organizations (CCOs) spent the highest percentage of their medical spending on primary care.
  • Rhode Island – Governor Gina M. Raimondo signed an executive order establishing an official target for health care spending growth in Rhode Island: 3.2% annual growth through 2022. The 3.2% growth target came out of work that Brown University’s School of Public Health began last summer after receiving a $550,000 grant from the Peterson Center on Healthcare.
  • Virginia – The Virginia Department of Medical Assistance Services (DMAS) announced it will conduct a top-to-bottom review of the agency’s forecasting and rate-setting processes over 60 days and has selected Milliman to lead the review and provide recommendations for improving the agency’s rate-setting and forecasting processes.


Screening for Adverse Childhood Experiences and Trauma

The Center for Health Care Strategies (CHCS) launched a new technical assistance tool that offers various approaches and considerations for screening adults and children for adverse childhood experiences (ACEs) and trauma. Drawing from the experiences of pilot sites that participated in Advancing Trauma-Informed Care, a multi-site demonstration by CHCS that sought to identify how trauma-informed approaches can be practically implemented within the health care sector, the tool offers key considerations for health systems and provider practices looking to integrate screening for ACEs and trauma into their clinical workflow, including when and how to screen, and the importance of identifying appropriate referral pathways.


Health Workforce Development Recommendations

The California Future Health Workforce Commission announced a report of recommendations focused on addressing the state’s projected shortfall of primary care and psychiatric health providers and bolster the pipeline of students and health workers to deliver care in underserved communities — all by the year 2030. The Commission’s final report includes a set of 27 detailed recommendations within three key strategies that will be necessary for: (1) increasing opportunities for all Californians to advance in the health professions, (2) aligning and expanding education and training, and (3) strengthening the capacity, retention, and effectiveness of health workers. When identifying the recommendations, the Commission focused on the need to increase the diversity of the state’s health workforce, enable the workforce to better address health disparities, and incorporate new and emerging technologies.