January 24 Update

In This Week’s Update:

  • Using Data Dashboards to Track Health Coverage
  • Medicaid’s Response to Opioid Epidemic
  • Payment Strategies to Improve Health Outcomes 
  • Behavioral Health Integration
  • State Updates: CO, CT, LA, MN, NC, NJ, NY & UT


Using Data Dashboards to Track Health Coverage

This week CMS released the July 2021 monthly report on state Medicaid CHIP eligibility and enrollment data. As of July 2021, 83,614,777 individuals were enrolled in Medicaid and CHIP. To help states plan for restarting eligibility redeterminations for Medicaid enrollees when continuous enrollment is discontinued, State Health and Value Strategies has published a new tool: Tracking Medicaid Coverage Post the Continuous Coverage Requirement: Using Data Dashboards to Monitor Trends. The issue brief examines the current status of data collection to assess Medicaid enrollment and retention and describes some of the best practices states should consider when developing a data dashboard to display this type of information. For those interested in a summary of the brief, see the companion expert perspective, Tracking the Data on Medicaid’s Continuous Coverage Unwinding.


As a reminder, SHVS has created a resource page to serve as an accessible one-stop source of information for states in unwinding when the Medicaid continuous coverage requirement ends. In addition to other resources, you will also find our recently released Planning for the End of the Continuous Coverage Requirement: A Communications Toolkit for States. The toolkit provides a communications planning guide and template communications resources designed to support state Medicaid agencies as they prepare for redetermining Medicaid enrollees. I hope you find these tools helpful in maximizing coverage retention as your state plans for this momentous coverage event.


State Medicaid Agencies’ Multifaceted Response to the Opioid Epidemic

Experts at Milbank Memorial Fund wrote a blog post highlighting state Medicaid agencies’ response to address the opioid epidemic. The blog draws on findings from their recent AcademyHealth report, State Medicaid Agencies’ Multi-Faceted Response to the Opioid Epidemic. Medicaid is the single largest payer for opioid use disorder (OUD) treatment. State Medicaid programs covered an estimated 38 percent of nonelderly adults with OUD in 2017, and 54 percent of those who received treatment for OUD. To advance knowledge about the multiple facets of state Medicaid policy adoption and implementation, the report’s authors conducted in-depth interviews in 2019 with policy officials from nine states—Kentucky, Maryland, Michigan, North Carolina, Ohio, Pennsylvania, Virginia, West Virginia, and Wisconsin.


State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid

State Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. A new issue brief published by the Kaiser Family Foundation summarizes Medicaid budget survey data to answer three key questions: 1) What delivery system and payment reform initiatives are in place across states; 2) How are states using financial incentives and non-financial incentives as part of efforts to improve quality and outcomes; and 3) How are states leveraging managed care plan contracts to advance delivery system and payment reform initiatives?


Benefits of Behavioral Health Integration for Primary Care Providers

A blog post by the Bipartisan Policy Center (BPC) points to task force recommendations that would incentivize and better prepare primary care providers to address the behavioral health needs of their patients. Nearly 40 percent of patients turn to their primary care clinicians for mental health and substance abuse services, yet many of these providers report feeling ill-equipped to handle these needs. The blog post highlights BPC’s Behavioral Health Integration Task Force report with federal policy recommendations that would create a clear pathway for primary care and behavioral health integration, with a strong focus on providing primary care providers with the supports they need to handle some of the mild to moderate behavioral healthcare needs of their patients.


State Updates

  • Colorado – Connect for Health Colorado, the state’s health exchange, announced that they will open a disaster relief special enrollment period for residents impacted by recent wildfires and the spike in COVID-19 cases. The disaster relief special enrollment period will be open until March 16, 2022.
  • Connecticut – Governor Ned Lamont announced that he has issued an executive order directing all nursing homes in Connecticut to require visitors to either show proof that they have been fully vaccinated against COVID-19 or have recently tested negative for the virus in order to enter the facilities.
  • Louisiana – The Louisiana Department of Health released a request for proposals for an organization interested in serving as the single pharmacy benefit manager (PBM) for the state’s five Medicaid managed care organizations (MCOs), serving approximately 1.7 million members. Each MCO currently contracts with a separate PBM.
  • Minnesota
    • The Minnesota Department of Human Services (MNDHS) released a Medicaid managed care request for proposals (RFP) for the state’s Families and Children Medical Assistance and MinnesotaCare Basic Health programs for the 80 counties covering the state outside of the Twin Cities. The state will award contracts to at least two MCOs in each county. Contracts will run for one year beginning on January 1, 2023, with five optional years. Proposals are due April 1, 2022.
    • MNDHS also released a request for proposals for home and community-based service employment providers to develop and implement a business model that phases out subminimum provider wages and transitions to competitive wages by April 1, 2024. Proposals are due January 31, 2022.
  • New Jersey
    • Governor Phil Murphy signed an executive order requiring covered workers at healthcare facilities and high-risk congregate settings to be up to date with their COVID-19 vaccinations, including having received a booster dose. All covered workers will no longer be permitted to submit to testing as an alternative to vaccination, except for the purposes of providing an accommodation for individuals exempt from vaccination. 
    • Governor Murphy signed a series of bills to combat the state’s opioid crisis and expand harm reduction efforts. Building on investments included in the Governor’s budget in recent years, the package creates multidisciplinary local overdose fatality review teams, which will provide insight into the circumstances surrounding fatal drug overdoses, and removes long-standing barriers to expanding access to harm reduction services and supplies.  
  • New York – NY State of Health, the state’s health insurance marketplace, and the New York State Department of Financial Services announced that the open enrollment period for 2022 Qualified Health Plans will remain open, consistent with the recent announcement that the federal government is extending the Public Health Emergency effective January 16, 2022. New Yorkers need to enroll by February 15 for coverage starting March 1.
  • North Carolina
    • The recently adopted North Carolina state budget includes funds to provide a one-time bonus to eligible home- and community-based direct care workers and support staff who provide services to Medicaid and NC Health Choice enrollees. The budget also includes a provision to implement a home- and community-based direct care worker wage increase for eligible employees who provide services to Medicaid and NC Health Choice enrollees.
    • The North Carolina Department of Health and Human Services signed an order that will enable NC Medicaid enrollees to obtain free at-home tests for COVID-19 from their local pharmacies. Enrollees will be able to select an at-home test at their preferred pharmacy and present their NC Medicaid ID card to the pharmacy which will bill Medicaid on the patient’s behalf.
  • Utah – The Utah Department of Health submitted to CMS two amendments to the state’s Primary Care Network 1115 demonstration waiver, which offers primary care services to certain non-disabled adults. The first amendment would provide temporary medical respite care to homeless Medicaid adults. The second amendment would expand Medicaid coverage for fertility preservation services for individuals with cancer. Federal comments for both amendments will be accepted through February 12.