February 21 Update

In This Week’s Update:

  • Executive Order Promotes Community Engagement
  • Strategies to Connect Children of Undocumented Status to Coverage
  • Q&A: Actuarial Analysis of a Medicaid Palliative Care Benefit
  • Catalog of Value-Based Initiatives for Rural Providers
  • State updates: AK, CA, CO, FL, GA, IA, IL, MI, MT, NC, NY, RI, SC, TN, UT, VT & WA

Executive Order Promotes Community Engagement

Last week, President Biden signed an Executive Order to strengthen the federal government’s ability to address the barriers that under-resourced communities face. It includes an array of strategies designed to increase the federal government’s capacity to advance equity and builds on Executive Order 13985, which instructed federal agencies to conduct equity assessments, by requiring agencies to produce an annual public Equity Action Plan. The Order also directs agencies to increase engagement with under-resourced communities through culturally and linguistically appropriate listening sessions, outreach events or requests for information, during the development and implementation of the agencies’ Equity Action Plans, annual budget submissions, and grants and funding opportunities.

Community engagement is a critical component of advancing health equity as it enables trust and respect, improves barriers to health and allows for efficacy by ensuring programs utilize experiences from the communities they impact. State Health & Value Strategies recently published a new issue brief that examines effective strategies states can employ to use meaningful community engagement as a vehicle to advance health equity. 


Strategies to Connect Children of Undocumented Status to Coverage

A blog post from the Center for Health Care Strategies describes when children of undocumented status have access to affordable, high-quality healthcare and their parents receive adequate support navigating the healthcare system, the children are more likely to receive preventive services, as well as care to address chronic conditions and developmental disabilities. Covering all children, regardless of immigration status, increases health equity and leads to improved outcomes across the lifespan, from fewer emergency department visits for children to decreased incidence of chronic conditions in adults. Yet, as many as 32% of children of undocumented status are uninsured, compared to only 4% of citizen children with citizen parents. Recognizing this disparity, policymakers in a growing number of states—including California, Connecticut, Illinois, New Jersey, New York, Oregon, and Washington—have passed legislation to use state funds to extend healthcare coverage that mirrors Medicaid and CHIP coverage to income-eligible children of undocumented status. This blog post highlights outreach, enrollment, and retention strategies that states offering coverage to children of undocumented status are implementing to help gain the trust of immigrant communities and increase healthcare coverage for their children. As a reminder, SHVS published a state spotlight highlighting California’s approach to expanding health coverage to all lower-income residents, regardless of immigration status, in an effort to help the state’s 3.2 million remaining uninsured, of which 65% are undocumented people.


Q&A: Actuarial Analysis of a Medicaid Palliative Care Benefit

When state policymakers are considering a new benefit to their state’s Medicaid program, they often ask “how much does it cost?” An actuarial analysis from CBIZ Optumas and the National Academy for State Health Policy (NASHP) answers this question for offering a palliative care benefit to Medicaid enrollees, and found that—along with improved quality of life for people with serious illness—Medicaid palliative care benefits can also yield cost savings. This Q&A from NASHP summarizes the key takeaways from the actuarial analysis for state policymakers. A comprehensive palliative care Medicaid benefit is expected to be, at minimum, overall cost neutral to the state. However, effective administration of a Medicaid palliative care benefit for the highest service utilizers could produce cost avoidance savings ranging between $231 and $1,165 per member per month. As Medicaid members with serious illness use increasingly high levels of costly inpatient and emergency department services as they approach end-of-life, palliative care can serve to both reduce these costs and improve quality of life for those with serious illness and their families.


Catalog of Value-Based Initiatives for Rural Providers

Rural Health Value recently released its annual update of the Catalog of Value Based Initiatives for Rural Providers. This catalog summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. It is designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation and contains descriptions of each program, including: eligibility and rural-relevant requirements; timeline and key dates; payment model/funding; and current rural participation and impact. The catalog also provides direct links to the corresponding agency web page for each program.


State updates: AK, CA, CO, FL, GA, IA, IL, MI, MT, NC, NY, RI, SC, TN, UT, VT & WA 

  • Alaska – The Alaska Department of health shared in a recent presentation that the state will begin Medicaid eligibility redeterminations beginning April 1.
  • California – The California Department of Health Care Services (DHCS) launched a statewide public information, education, and outreach campaign to raise awareness about the upcoming return of the Medi-Cal (Medicaid) eligibility renewal process. The statewide campaign will run from February 2023 through June 2024 and will reach across traditional and digital media channels. DHCS also launched a landing page, KeepMediCalCoverage.org, where Medi-Cal members can find out about the renewal process and how to update their contact information. Local county offices will begin mailing letters to members in April to let them know if their Medi-Cal coverage was renewed automatically or if they need more information to process the renewal.
  • Colorado
    • The Colorado Department of Health Care Policy & Financing released the Take Action on Your Renewal toolkit to help community partners, stakeholders, and advocates spread the word about the continuous coverage requirement ending. The materials in this toolkit are designed to encourage members to look for their renewal packet in the mail and online portal and take action when they receive it and includes messaging outreach partners can share in their websites, newsletters, social media as well as direct-to-member email and text messaging communications.
    • Connect for Health Colorado, the state’s official health insurance Marketplace, announced that Coloradans who missed the open enrollment deadline still have an opportunity to sign up for coverage as a result of the Tax Time Enrollment Program. The program provides Coloradans the opportunity to check a box on their state tax return to share their information with the Marketplace and the state Department of Health Care Policy & Financing for the purpose of obtaining health coverage.
  • Florida – The Florida Department of Children and Families shared the state’s Medicaid redetermination plan, which states that Florida Medicaid will begin sending notices of case expirations March 15, with the earliest Medicaid closures occurring April 30.
  • Georgia – The Georgia Department of Human Services announced that the state will begin redetermining Medicaid eligibility April 1, 2023.
  • Iowa – The Iowa Department of Health and Human Services announced that the state will begin sending Medicaid renewal packets April 1, 2023.
  • Illinois – The Illinois Department of Healthcare and Family Services announced that the first Medicaid renewals will be sent April 27, 2023, with possible loss of coverage beginning July 1, 2023.
  • Michigan – The Michigan Department of Health and Human Services announced that renewals for traditional Medicaid and the Healthy Michigan Plan will take place monthly starting June 2023 and run through May 2024. Monthly renewal notices will be sent three months prior to an enrollee’s renewal date starting with June renewal dates.
  • Montana – Governor Greg Gianforte announced a $2.1 million investment to increase access to universal screening for mental health and substance use issues among young Montanans. The Rural Behavioral Health Institute will expand the delivery a school-based suicide prevention intervention to reach up to 40% of all middle and high school students across the state. Thirty-seven schools have committed to implementing the program this spring.
  • New York – Governor Kathy Hochul announced more than $658 million in state funding to support 127 projects that will help to improve patient care by supporting high-quality facilities serving the inpatient, primary care, mental health, substance use disorder and long-term care needs of communities throughout the state.
  • North Carolina – Governor Roy Cooper announced $7.7 million in new funding to support North Carolina’s postsecondary institutions in providing additional mental health services to students, which include suicide prevention training for faculty and staff to better support students in crisis, funding to continue to provide students access to an after-hours mental health hotline and to develop a new resiliency training program for faculty, staff, and students.
  • Rhode Island – The Office of the Health Insurance Commissioner introduced changes to the Affordability Standards regulations designed to strengthen investment in behavioral healthcare and improve transparency of healthcare spending. A virtual hearing is scheduled for February 27, and public comments on the proposed amendments will be accepted through March 7.
  • South Carolina – The South Carolina Department of Health and Human Services (SCDHHS) announced that SCDHHS will begin sending continuation of benefits notices and annual Medicaid review forms April 1, 2023.
  • Tennessee – The Division of TennCare announced that Medicaid renewals will begin April 1, 2023.
  • Utah – The Utah Department of Health and Human Services announced that the Department of Workforce Services will begin priority review of Medicaid cases March 1, 2023 with the first transfers to the federal Marketplace and first cases beginning to close April 30, 2023.
  • Vermont – The Vermont Agency of Human Services and Department of Vermont Health Access announced that enrollees will be mailed Medicaid renewal forms in April 2023. Closures will begin to occur May 31, 2023.
  • Washington – The Washington State Health Care Authority (HCA) issued a call for volunteers from communities across the state to share messaging and ensure Apple Health (Medicaid) recipients have the information and resources they need to maintain coverage as the continuous coverage requirement ends. HCA invites volunteers to become an Apple Health Ambassador and help raise awareness.