February 18 Update

In This Week’s Update:

  • SHVS Expert Perspective on Proposed 2021 NBPP
  • ACS Data and Social Determinants of Health
  • State Updates: GA, MD, MI, NY, OH, PA & VA
  • CO and WA Governors Discuss Public Options
  • Measuring the Impact of Trauma-Informed Primary Care
  • Improving Social Needs Intervention Research


SHVS Expert Perspective on Proposed 2021 NBPP

Last week, State Health and Value Strategies (SHVS) published an expert perspective, authored by Sabrina Corlette at Georgetown University’s Center for Health Insurance Reform, that provides an overview of the annual HHS draft Notice of Benefit and Payment Parameters (NBPP) rule. The NBPP governs core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for individual and small-group market health plans, and premium stabilization programs. This expert perspective focuses on several policies that would have implications for state insurance regulation and the operation of the state-based marketplaces. Comments on the rule are due March 2, 2020.


ACS Data and Social Determinants of Health

Also last week, SHVS published a new issue brief entitled Leveraging American Community Survey (ACS) Data to Address Social Determinants of Health and Advance Health EquityDeveloped by the State Health Access Data Assistance Center (SHADAC), the brief focuses on how Medicaid programs can use data from one federal survey, the American Community Survey (ACS), to inform and target interventions that seek to address social determinants of health and advance health equity. This brief also highlights relevant examples from states that use SDOH and health equity measures from the ACS, including which measures and what they are used for.


State Updates: GA, MD, MI, NY, OH, PA & VA

  • Georgia – Governor Brian Kemp requested that CMS pause its preliminary review of Phase II of the state’s Section 1332 waiver request. In a letter notifying the state that its Phase I application had been deemed complete, CMS agreed to pause its preliminary review of Phase II.
  • Maryland
    • Maryland Health Connection, the state’s official health insurance marketplace, published a blog post on public charge and the recent Supreme Court ruling.
    • More than one million Maryland residents recently gained access to more integrated health services from the Maryland Primary Care Program (MDPCP) as CareFirst BlueCross BlueShield, Maryland’s largest private health insurer, joined the program. Under the MDPCP, Medicare and CareFirst members have access to advanced primary care. Practices provide onsite care managers and behavioral health specialists, medication management, and integrated community and social support.
  • Michigan – The Michigan Department of Health and Human Services issued a request for proposals for public and private nonprofit organizations to expand the child and adolescent health center (CAHC) program. The CAHC program provides school-based or school-linked health care sites or school wellness programs that serve children and youth between ages five and 21. The program is jointly funded by MDHHS and the Michigan Department of Education.
  • New York – The Medicaid Redesign Team II (MRT II), convened by Governor Andrew Cuomo to manage the state’s Medicaid budget shortfall, outlined its process and timeline at the first meeting of the panel on February 11. MRT II will provide recommendations to the governor for how to manage the estimated $4 billion shortfall in the coming fiscal year.
  • Ohio – The Ohio Department of Medicaid released a request for information (RFI) outlining its vision for a reimagined statewide managed care program which seeks to improve the design, delivery, and timeliness of care coordination. The RFI seeks input from providers, associations, advocacy groups, data and information technology vendors, and managed care organizations.
  • Pennsylvania – Governor Tom Wolf announced that the Insurance Department, in partnership with multiple state agencies, is surveying health care providers about barriers to mental health and substance use disorder treatment. Recent market conduct examinations of Pennsylvania insurers have indicated that there are noncompliant barriers that are limiting consumers’ ability to access treatment.
  • Virginia – The Virginia Department of Medical Assistance Services released a new report highlighting increases in access to addiction treatment for Medicaid members along with improved health outcomes, including a reduction in emergency department visits. The two-year report on the Addiction and Recovery Treatment Services benefit, launched in April 2017, is the first evaluation to include adults who gained health coverage when Virginia expanded its Medicaid program.


A Conversation with Washington Governor Inslee and Colorado Governor Polis on the Public Option in Their States

The Kaiser Family Foundation hosted a conversation with Colorado Governor Jared Polis and Washington Governor Jay Inslee about their states’ efforts to establish a public health insurance option and make other changes to address health costs and access. The two governors have made health reforms a key part of their agendas and are seeking to expand access to affordable coverage for their residents through a public option – an approach that some national leaders have proposed on a federal level. Both governors discussed the opportunities and challenges they have encountered as they seek to implement a public option for their residents, as well as other state initiatives aimed at tackling issues like health costs and long-term care.


Measuring the Impact of Trauma-Informed Primary Care

Many trauma-informed care (TIC) programs focus on upstream variables such as changing provider behavior and developing workforce wellness practices, yet the evaluation of health care interventions are traditionally oriented toward impact on patient outcomes instead of measuring program success. In a new brief published by the Center for Health Care Strategies (CHCS), authors from Montefiore Medical Group’s Trauma-Informed Care Program propose a measurement model for trauma-informed primary care and suggest variables that could be assessed for each major intervention component. This measurement model is based on the experiences of Montefiore Medical Group and other health care organizations that participated in Advancing Trauma-Informed Care, a national initiative led by CHCS with support from the Robert Wood Johnson Foundation.


Key Questions for Improving Social Needs Intervention Research

On February 25, the Social Interventions Research and Evaluation Network (SIREN) at the University of California, San Francisco is hosting a webinar on the key questions facing the field of health care-based social interventions research. The webinar will feature the authors of the American Journal of Preventive Medicine article “Improving social needs intervention research: Key questions for advancing the field.” During the webinar, speakers will discuss the most pressing knowledge gaps from federal agencies’ perspectives and how best to fill those gaps.