In This Week’s Update:
- New CDC maternal mortality statistics
- No Surprises Act interim final rule
- Trends in Medicaid managed care
- Oregon’s kindergarten readiness metric
- Improving Child Physical Abuse Detection & Reducing Disparities
- State updates: IA, MN, NC, NJ, NY, OR, PA & WI
CDC maternal mortality rates for 2020
The Centers for Disease Control and Prevention released a report on maternal mortality rates for 2020 that documents a 14 percent increase in the number of maternal deaths between 2019 and 2020. The inequities within the report were stark: Black women experienced the most deaths as one-third of the pregnant women and new mothers who died in 2020 were Black, though Black Americans make up just over 13 percent of the population. State Health and Value Strategies has several resources on opportunities for states to address the maternal morbidity and mortality crisis: an issue brief that highlights approaches to reducing disparities in birth-related health outcomes in Medicaid and an analysis of the American Rescue Plan Act’s option to extend postpartum coverage.
No Surprises Act interim final rule
A federal judge issued a ruling in favor of a challenge to the No Surprises Act interim final rule (IFR) setting aside key parts that create a new federal independent dispute resolution (IDR) process. While the Court ordered that the challenged provisions of the IFR be vacated, with nationwide effect, the overall IDR process will continue, as will the law’s provisions protecting consumers from balance billing. For those interested in an analysis of the ruling, Health Affairs Forefront published a blog post. As a reminder, SHVS has created a resource page on the No Surprises Act where you can find our recent toolkit for states communicating about surprise billing protections.
Trends in Medicaid Managed Care
The Kaiser Family Foundation has published a brief that describes ten themes related to the use of comprehensive, risk-based managed care in the Medicaid program and highlights significant data and trends. Understanding these trends provides important context for the role MCOs play in the Medicaid program overall as well as during the ongoing COVID-19 public health emergency (PHE) and in its expected unwinding. While we can track state requirements for Medicaid managed care plans, plans have flexibility in certain areas including in setting provider payment rates and plans may also choose to offer services beyond those required in the Medicaid state plan or waivers. States also make decisions about which populations and services to include in managed care arrangements leading to considerable variation across states.
Moving Toward Prevention: Oregon Kindergarten Readiness Metric
Early childhood is a critical time for growth and development, and the services and support children and their families receive early on can have a large impact on health outcomes later in life. Because COVID-19 has exacerbated existing health disparities, including for young children, state officials are looking for new ways to support healthy child development and advance health equity. Oregon has launched a new kindergarten readiness metric in its Medicaid program and has promoted healthy child development for decades, with a particular focus on the social-emotional health of young children. The state’s new kindergarten readiness incentive metric focused on social-emotional health renews that commitment and helps solidify the connection between a child’s health and their success in school and beyond.
Improving Child Physical Abuse Detection & Reducing Disparities Within and Between Hospital Settings
Accurate, timely diagnosis of child physical abuse is key to preventing repeated and escalating abuse—however, nearly one in three young children diagnosed with an abusive injury had prior medical visits during which there was a missed opportunity to diagnose abuse and to intervene to protect the child from further harm. Children’s Hospital of Philadelphia PolicyLab has published a solutions-focused brief that reviews data on disparities in child abuse evaluation in hospital settings, reports the results of efforts to address this critical issue, and proposes recommendations for policymakers to improve evaluations for child physical abuse, decrease disparities and protect children who have been abused from further harm.
- Iowa – The Iowa Department of Human Services released a request for proposals for Medicaid managed care organizations (MCOs) to serve the state’s Medicaid program, the Children’s Health Insurance Program known as Health and Well Kids in Iowa and the Iowa Health and Wellness Plan. Contracts are set to begin July 1, 2023 and are worth approximately $6.5 billion annually.
- Minnesota – MNsure, the state’s official health insurance marketplace, issued a request for proposals from licensed broker agencies interested in partnering with MNsure as broker enrollment centers.
- New Jersey – The Murphy administration introduced a new “Expanded Access” initiative, which allows residents at certain income levels to continue to enroll in free or nearly free health coverage through Get Covered New Jersey. The new Expanded Access Special Enrollment Period allows qualifying consumers with an annual household income of up to 200 percent of the federal poverty level to enroll in a health plan throughout the year.
- North Carolina – The North Carolina Department of Health and Human Services announced that key COVID-19 vaccine information is now available in the state’s most used languages. In addition to a dedicated Spanish webpage for COVID-19 vaccines, vacunate.nc.gov, NCDHHS now has COVID-19 vaccine materials in the state’s five other most used languages of Arabic, Chinese, Korean, Russian and Vietnamese.
- New York – Governor Kathy Hochul announced 39 new #VaxForKids pop-up sites to increase vaccination rates among children and adolescents. In January, Governor Hochul had announced that 80 sites would take place over a six-week period. At the conclusion of the six weeks, 261 sites have been established. Events were hosted in 32 counties, 72 schools, and 105 zip codes, spanning every region of the state.
- Oregon – The Oregon Health Authority (OHA) announced the submission of its 1115(a) demonstration waiver renewal application to CMS. The application focuses on improving coverage in communities of color, providing benefits to individuals transitioning between coverage systems, increasing value-based payments, and improving equity of care. OHA now enters negotiations with CMS over the application’s proposals.
- Pennsylvania – Pennie, the state’s official health insurance marketplace, announced record-breaking enrollment numbers with nearly 375,000 Pennsylvanians enrolled through Pennie at the end of open enrollment. Of those, more than 111,000 customers are new to the marketplace since January 2021.
- The Wisconsin Department of Health Services (DHS) will submit a request to CMS for an additional 30 days of Medicaid coverage for postpartum healthcare services. Currently, enrollees receive 60 days of coverage after giving birth; approval of the request by CMS would increase coverage to 90 days.
- DHS announced that $3.4 million in grants has been awarded to 43 organizations to promote health equity in COVID-19 vaccinations in Wisconsin. These organizations will use the funds to serve as trusted messengers within their communities to help reduce barriers to vaccine access within under-resourced communities.