January 22 Update

In This Week’s Update:

  • New unwinding communications resources
  • SHVS Unwinding Resources
  • Emerging Approaches in Oral Healthcare
  • Consent Management Processes for Implementation of Data Exchange
  • New CMS Model to Advance Integration in Behavioral Health
  • State updates: CA, CO, ME, MT, NC, NJ, OR, PA, TX, WA, WI & WV


New Unwinding Communications Resources

Last week, State Health and Value Strategies (SHVS) published a suite of communications resources to help states encourage renewal completions in the final months of unwinding the Medicaid continuous coverage requirement. The new messages and social graphics were informed by consumer research which SHVS conducted to determine the persuasiveness of message themes. The resources are currently available in English, but stay tuned for translations into 15 additional languages. 


SHVS Unwinding Resources

Also last week, SHVS hosted a webinar to discuss CMS’ recently released suite of Medicaid unwinding-related guidance that includes a focus on ensuring eligible children maintain Medicaid and CHIP coverage. The webinar reviewed high-value strategies outlined in CMS’ guidance that states can implement to promote continuity of coverage for children, and discussed key considerations for state policymakers. The webinar slides and recording are available. SHVS also published a new States of Unwinding post which highlights the strategies states are implementing to preserve coverage for children, among other unwinding-related efforts. Updates follow. 


Emerging Approaches in Oral Healthcare

A new issue brief from the Center for Health Care Strategies describes opportunities for state Medicaid programs to promote and expand access to minimally invasive care (MIC), which uses preventive care and restorative services to address tooth decay and is an approach to deliver high quality oral healthcare to people while avoiding invasive surgical interventions. MIC is one strategy states can use to increase access to oral healthcare, including opportunities to expand the oral healthcare workforce, advance health equity, and integrate oral health into overall healthcare. The brief begins with a high-level summary of MIC services, then explores considerations and recommendations for Medicaid to advance the use of MIC, including: (1) expanding access to nontraditional settings; (2) advancing equity; (3) supporting the oral healthcare workforce; (4) promoting opportunities for clinical integration; and (5) identifying payment strategies.


Consent Management Processes for Implementation of Data Exchange 

As California seeks to provide whole person care through implementation of CalAIM, the state’s 1115 demonstration, providers need access to data that enables the provision of tailored and coordinated care. However, information necessary for providing coordinated services often remains isolated due to physical and legal constraints. A paper published by the California Health Care Foundation, and authored by BluePath Health and Stewards of Change Institute, outlines the key components required to expand consent management services and emphasizes the importance of informed consent in facilitating data sharing. Recommendations include accelerating the adoption of state legal interpretations of consent to share, advancing technology and policy for consent management, developing standardized consent forms, and establishing statewide consent management programs in collaboration with sister agencies.


New CMS Model to Advance Integration in Behavioral Health  

CMS announced a new model to test approaches for addressing the behavioral and physical health, as well as health-related social needs, of people with Medicaid and Medicare. The goal of the Innovation in Behavioral Health (IBH) Model is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance-use disorder by connecting them with the physical, behavioral, and social supports needed to manage their care. The model will also promote health information technology (health IT) capacity building through infrastructure payments and other activities. 


State updates: CA, CO, ME, MT, NC, NJ, OR, PA, TX, WA, WI & WV

  • California 
    • The California Department of Health Care Services (DHCS) announced the awarding of $70.5 million to 101 nonprofit entities across the state as part of the Health Equity in Behavioral Health Recovery Services (HEAR US) project. These investments will help expand access to, and use of, behavioral health recovery services among communities of color and other historically marginalized communities. 
    • DHCS launched the Behavioral Health Virtual Services Platform—two free behavioral health services applications for all families with kids, teens, and young adults ages zero through 25. The new apps will offer free coaching, educational content, care navigation services, peer communities, and more. 
  • Colorado – Governor Jared Polis announced that in its second year of operation, the Colorado Option, the state’s public option made available through a section 1332 waiver, saw a 188% increase in enrollment and now represents 34% of enrollment through the Marketplace.  
  • MaineThe Office of MaineCare Services will conduct a survey to learn about the healthcare children covered by MaineCare, the state’s Medicaid program, received and enrollees’ experience with their child’s MainCare in the last six months. 
  • Montana – The Department of Public Health and Human Services (DPHHS) announced one-time incentive payments and targeted, historic wage increases to recruit and retain employees at Montana’s state-run healthcare facilities. To assist applicants, DPHHS has launched a new website at Work4DPHHS.com and launched a new public awareness campaign to promote the Hiring Incentive Program. DPHHS is using $300,000 in American Rescue Plan Act funds to support the new Hiring Incentive Program.
  • New Jersey 
    • The New Jersey Department of Health released the Hospital Financial Transparency Annual Report. The Department supports increased accountability and transparency through the public reporting and posting of hospital financial data for all hospitals, which is intended to enhance the ability of the Department, as well as interested stakeholders, to monitor overall hospital financial health and wellness more effectively as part of broader work related to healthcare costs and affordability. 
    • Governor Phil Murphy signed A5235/S3627 to expand health insurance coverage requirements for infertility services. The bill requires that certain private sector health insurers provide coverage for any services related to infertility in accordance with the American Society for Reproductive Medicine guidelines and as determined by a physician. Covered services include, but are not limited to, different types of in vitro fertilization, intrauterine insemination, genetic testing, and embryo transfers. 
  • North Carolina – The North Carolina Department of Health and Human Services (NCDHHS) announced details of the new Children and Families Specialty Plan, a statewide health plan to ensure access to comprehensive physical and behavioral health services for Medicaid-enrolled children, youth and families. NCDHHS released an updated policy paper about the plan, as NCDHHS prepares to launch the plan later this year.  
  • Oregon – The Oregon Health Authority (OHA) is currently drafting administrative rules for “OHP Bridge – Basic Health Program,” a new health insurance program that expands Oregon Health Plan (OHP) to cover adults with income just above the OHP income limit. OHA is seeking input from future members and providers of OHP Bridge on the administrative rules through a Rules Advisory Committee and a public comment process and is also offering stakeholders the opportunity to meet with OHP Bridge staff. 
  • Pennsylvania – Department of Human Services Secretary Dr. Val Arkoosh announced the launch of a survey to collect feedback from Medicaid enrollees about their experience completing their annual renewal. The survey is being conducted in partnership with the University of Pittsburgh’s Medicaid Research Center, and feedback collected will be used to inform renewal outreach strategies moving forward. Participants will be contacted via text message.
  • Texas – Governor Greg Abbott and the Texas Health and Human Services Commission announced that CMS has approved Texas’ request to extend Medicaid and CHIP coverage from two to 12 months after pregnancy. Texas projects approximately 137,000 individuals will benefit from 12-months postpartum coverage in fiscal year 2025. 
  • Washington – The Washington State Health and Human Services Enterprise Coalition—a cohort of Washington state health and social service agencies—has published an annual update to its Washington State Action Plan for Removing Barriers to Health and Human Services. The update details progress toward the goals of: (1) removing enrollee barriers to accessing benefits, and (2) ensuring that the state and its programs have a comprehensive view of enrollees, and share information across organizations to proactively offer other benefits for which the enrollee may qualify.
  • West Virginia – The West Virginia Department of Human Services approved the Highmark Health Options West Virginia (HHO WV) application to become a managed care organization (MCO) option for Medicaid eligible West Virginians. HHO WV Blue Cross and Blue Shield-branded health plans will be an option for West Virginia Medicaid enrollees beginning in June, for a July 1, 2024 coverage date.
  • Wisconsin – The Wisconsin Department of Health Services is requesting proposals from vendors who are seeking certification to contract as MCOs for the delivery of the Family Care Program and the Family Care Partnership Program. Family Care and Family Care Partnership are long-term care programs for low-income frail elders and adults with developmental, intellectual, or physical disabilities who have long-term care needs.