January 21 Update: 2020 Payment Notice; SNAP Benefits In Doubt; Centering Care Strategies; Medicaid and Early Childhood Partnerships; Rural Care Coordination Toolkit

Last Thursday the Centers for Medicare & Medicaid Services (CMS) released the proposed annual Notice of Benefit and Payment Parameters for plan year 2020. The Notice proposes regulatory and financial parameters for qualified health plans on the Exchanges, plans in the individual, small group, and large group markets, and self-funded group health plans. SHVS’s technical experts are reviewing the Notice and evaluating potential implications for states, so watch this space for upcoming programming.

Also last week, as the partial government shutdown continues, states issued Supplemental Nutrition Assistance Program (SNAP) benefits for February early to avoid the benefits being unavailable next month if the shutdown continues. As Kaiser Health News explains, it is unclear whether there will be funding for SNAP benefits for March and states and localities are concerned about the food insecurity families on SNAP are likely to face if the partial shutdown persists.

State Updates

  • Alabama – The Alabama Department of Health kicked off the 2019 campaign of Scale Back Alabama, the state’s weight loss and physical activity challenge. This year’s challenge begins with weigh-in week, January 21-27 and those succeeding in losing at least 10 pounds during the week of April 1–7 have a chance to win cash prizes.
  • Iowa – In her State of the State address, Governor Kim Reynolds prioritized creating an integrated and coordinated health care system in the state by making recommendations to continue building on current mental health reform efforts and developing a comprehensive system to address mental health issues in children.
  • Kansas – Governor Laura Kelly signaled her commitment to expanding Medicaid in her 2020 budget proposal by recommending $14.2 million to expand coverage to 150,000 low-income Kansans. She will send an expansion plan proposal to lawmakers by January 29.
  • Maine – The Maine Department of Health and Human Services highlighted state Medicaid expansion activities in a new blog post. Since implementation began last week, 529 individuals have been granted expansion-related coverage. The Department has also received approximately 2,000 phone calls each day since the governor’s executive order implementing expansion was signed.
  • Minnesota – In his first executive order, Governor Tim Walz established the One Minnesota Council on Diversity, Inclusion, and Equity. In an effort to include voices from different backgrounds, the order builds on a council formed by Governor Mark Dayton and expands its scope to address geographic diversity as well as important considerations around equity in Minnesota. The council will be chaired by the Governor himself and will involve all commissioners in his cabinet.
  • New Hampshire – Governor Christopher Sununu signed an executive order establishing the New Hampshire Opioid Overprescribing and Misuse Project Advisory Council. The council will help facilitate and coordinate the state’s efforts in addressing the opioid crisis and will provide recommendations to the governor annually.
  • New Jersey – The New Jersey Department of Health awarded more than $2.3 million to primary care providers to enhance primary, behavioral and mental health care for children and adolescents through telehealth consultation and new education programs. The funds will also go toward provider recruitment and enrollment in the network, training and technical assistance to hubs and participating providers, and the creation of an online referral database and virtual communications.
  • New York – In advance of the January 31 open enrollment deadline, NY State of Health, New York’s state-based marketplace, is hosting a series of free online health insurance enrollment webinars in January. During the webinars, trained enrollment assistors will answer questions and guide participants through the enrollment process. The webinars will be offered in English, Spanish and Mandarin.
  • Ohio – CMS is accepting comments on Ohio’s section 1115 waiver application for substance use disorder (SUD) inpatient and residential treatment in managed care and fee-for-service for adults and children. The federal comment period is open through February 16, 2019.
  • Oregon – The Oregon Health Authority and Oregon Department of Education announced a new resource to help communities in Oregon assess factors among adolescents that can lead to risky sexual practices and increase the risk of sexual violence. The online mapping tool displays information to promote skills-based learning to prevent sexual violence in youth.
  • Wisconsin – Governor Tony Evers signed two health-related executive orders last week. One order directs the Department of Human Services to develop a plan to expand Medicaid in the state. In another order, he directs state agencies to implement plans to ensure people with pre-existing conditions can get health insurance and protect against attempts to undermine the insurance marketplace with short-term plans that do not comply with Affordable Care Act requirements.


Upcoming Webinar – Managing Managed Care: Best Practices for Medicaid Pharmacy

Wednesday, January 23, 2:00 to 3:00 p.m. ET

The prescription drug benefit continues to grow as a portion of Medicaid expenditures. State Medicaid programs commonly rely on contracted Managed Care Organizations (MCOs) and their subcontracted Pharmacy Benefit Managers (PBMs) to manage the prescription drug benefit offered to Medicaid enrollees. What tools do states have available to ensure the MCOs and the PBMs are managing the drug benefit effectively and efficiently? State Health and Value Strategies will host a webinar addressing the complexities of state Medicaid oversight of the pharmacy benefit in the managed care environment. The webinar will offer states real world tips on how to best monitor and evaluate operational and financial performance of their MCOs and their subcontracted PBMs.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e8505028c75e4c8f94d2bf9f09954d200

How To Center Care Around Patients’ Goals and Needs?

Tara Oakman has written a blog post for Health Affairs to share findings from a meeting with health care stakeholders convened by the Robert Wood Johnson Foundation and AcademyHealth to identify actionable strategies for focusing health and health care systems on the goals and needs of the people they serve, particularly populations who face the most significant barriers to good health. In the post Tara and her co-author Lauren Gerlach highlight strategies identified at the meeting that present opportunities for health philanthropists. The strategies include strengthening communication skills by providing communications training for health system staff so they have the skills to respectfully and effectively engage their patients in a discussion of their medical and nonmedical needs and their preferences and goals for care. Stakeholders at the convening also identified the need to develop a more inclusive health care system—one that employs health professionals of all backgrounds and engages a broad range of community partners—as key to advancing patient-centered care.

Early Childhood and Medicaid Partnerships: What Works

The Center for Health Care Strategies (CHCS) published last week a new issue brief that shares insights from the Medicaid Early Childhood Innovation Lab, a national initiative that assisted six pilot sites in pursuing Medicaid-driven strategies to support young children and their families, led by CHCS. Early childhood development is a critical period of human development as the brain undergoes its most rapid growth from ages 0 to 3 and the experiences of early childhood are significant drivers of long-term health and wellbeing. Medicaid covers nearly half of all children ages 0 to 5, putting it in a unique position to improve future population health by supporting early childhood interventions. Such interventions should address physical health and mental health as well as the social needs affecting the family unit. The brief outlines three of the Medicaid Early Childhood Innovation Lab sites’ activities to inform the development of cross-sector partnerships between Medicaid and early childhood.

Rural Care Coordination Toolkit  

Created in partnership with the NORC Walsh Center for Rural Health Analysis and the University of Minnesota Rural Health Research Center, the Rural Health Information Hub recently published an updated rural care coordination toolkit that includes substantial revisions to the implementation module. The toolkit is designed to help rural communities identify and implement a care coordination program and provides links to resources and best practices. It is made up of several modules that concentrate on different aspects of care coordination programs. The updated implementation module delves into considerations for workforce and staffing, different populations, quality improvement, and adopting a whole-person mindset.