February 25 Update

In This Week’s Update:

  • CMS Launches New Podcast
  • Growth in Health Care Expenditures
  • State Updates: KY, MD, MN, NJ, NY, NC, PA & WA
  • Policies for Action Medicaid Research Hub
  • State Approaches to Surprise Billing
  • Antipsychotic Use Among Children in the Foster Care System

CMS Launches New Podcast

Last week, the Centers for Medicare & Medicaid Services (CMS) announced CMS: Beyond the Policy, a new podcast that will highlight updates and changes to CMS policies and programs in an easily accessible and conversational format. The podcast was created in direct response to stakeholders’ suggestions, who expressed that a podcast would be a more modern and user-friendly way to keep up-to-date on CMS. The inaugural episode focuses on evaluation and management coding and can be downloaded here.

Growth in Health Care Expenditures

Also last week, in case you missed it, the CMS Office of the Actuary released projections of national health care expenditures. Growth in health care expenditures is expected to average 5.5 percent annually between 2018 and 2027, reaching nearly $6.0 trillion by 2027.

State Updates: KY, MD, MN, NJ, NY, NC, PA & WA

  • Kentucky – The Cabinet for Health and Family Services Department for Medicaid Services and Office of Health Data and Analytics released a report on the state’s pharmacy benefit program. Medicaid Pharmacy Pricing: Opening the Black Box looks at the impact and role of Pharmacy Benefit Managers and provides recommendations to create transparency, control the pricing of medications for Medicaid beneficiaries, and improve the care provided by pharmacies within the Commonwealth.
  • Maryland – In a blog post, Maryland Health Connection, the state’s official health insurance marketplace, shared information with consumers about how to prepare for filing their taxes and the documentation that proves they met the federal requirement to have health insurance in 2018.
  • Minnesota – Governor Tim Walz released his budget this week and detailed his health care proposals in a fact sheet. One of his proposals calls for creating a health coverage option for Minnesotans statewide by having the Minnesota Department of Human Services offer a comprehensive platinum-level buy-in product in Minnesota’s individual market, called ONECare.
  • New Jersey – Governor Phil Murphy signed into law an expansion of the state’s paid family leave program. The expansion includes doubling the number of weeks of paid family leave and temporary disability insurance in addition to increasing the weekly benefit and expanding paid family leave to include caring for any individual shown to have the equivalent of a family relationship.
  • New York – New York state is hosting two web-based information sessions to discuss changes taking place within the Children’s Medicaid System. A panel from the Office of Mental Health, Department of Health, Office of Children and Family Services, and Office for People With Developmental Disabilities will discuss the Children’s Medicaid Transition, how services are changing, what new services may be available and what that means for individuals receiving services.
  • North Carolina – The North Carolina Department of Health and Human Services releasedpolicy paper and a Request for Information (RFI) to invite feedback on the Healthy Opportunities Pilots, a program that will test and evaluate the impact of integrating evidence-based, non-medical services into the delivery of health care. The policy paper describes the preliminary Pilot program design for interested stakeholders, and DHHS is seeking feedback on Pilot design through the RFI.
  • Pennsylvania – Department of Human Services Secretary Teresa Miller released the Pennsylvania Child Abuse Fatality/Near Fatality Trend Analysis Report, a study of statewide child abuse fatality and near fatality data from calendar years 2015 and 2016. The report outlines and analyzes data from these years and establishes recommendations to prevent child abuse fatalities and near fatalities so children can grow up in safe, nurturing homes
  • Washington – Health officials offered a variety of interventions to lower infant mortality during a panel hosted by Results Washington, a performance management initiative housed within the Governor’s Office. The panel focused on disparities in infant mortality among Native American and African American communities and what the state can do to improve outcomes specifically for these populations.

Policies for Action Research Hub Will Examine Critical Medicaid Policy Issues

A new Policies for Action Research Hub, based at the Harvard T.H. Chan School of Public Health, combined with research collaborators at Columbia University and the Brigham & Women’s Hospital, will spend the next two and a half years examining critical issues related to Medicaid policy, the Affordable Care Act (ACA), and health care for low-income populations. With support from the Robert Wood Johnson Foundation, the Hub will focus its work on examining Medicaid work requirements, mortality changes under the ACA and public versus private coverage. It will also be conducting rapid-turnaround analyses to inform policy-making in real time, using existing data sources and credible research findings to specifically engage with current health policy proposals that hold potential to impact access to care for low-income and vulnerable populations. If you’re interested, the Hub is soliciting ideas for research questions to prioritize and help inform policy discussions, and can be contacted directly to share suggestions.

The Role for States in Mitigating Surprise Out-Of-Network Billing

A new report released by the Center for Health Policy at Brookings dissects why surprise out-of-network billing happens and details a suite of potential state policy responses and what impacts each would have. In proposing a state solution to surprise out-of-network billing, the authors chief objectives are to protect patients in a comprehensive manner and to restore more normal market dynamics to contracting for emergency department and ancillary clinicians, which should in turn reduce health care spending. The report, produced in partnership with the University of Southern California Schaffer Center for Health Policy & Economics, outlines two policy options for eliminating surprise out-of-network billing at the state level and that could also serve as a blueprint for action at the federal level.

Antipsychotic Use Among Children in the Foster Care System

The National Academy for State Health Policy published a new brief that explores successful state responses to the increase in antipsychotic prescription rates in Medicaid-enrolled children, including children in foster care. In August 2018, NASHP convened researchers and a cross-agency group of state officials to discuss state strategies to ensure the appropriate use of antipsychotic drugs in youth in foster care. Strategies discussed and shared in the brief include payment reforms, delivery system innovations, and quality supports for clinical care. Other areas for improvement include increasing monitoring rates for side effects, advancing psychosocial and trauma-informed care, enhancing patient engagement, and improving data collection and use.