January 27 Update

In This Week’s Update:

  • New SHVS Publication on Supportive Housing
  • State Updates: AZ, CA, CO, CT, NJ & PA
  • Variations in C-section Rates
  • State of Babies 2019 Yearbook
  • Examining Bundled Payments


SHVS Publication on Supportive Housing

State Health and Value Strategies (SHVS) published a new issue brief, State Investments in Supportive Housing, authored by Manatt Health. Research shows that access to affordable, safe, and stable housing can improve health outcomes and reduce health care costs. The issue brief provides an overview of the federal authorities under which states are able to cover nonclinical housing-related services and invest in supportive housing for high-need Medicaid enrollees. As a companion to the issue brief, Manatt also developed State Investments in Supportive Housing: An Inventory of State Efforts, which provides an in-depth look at states that are leveraging federal authorities to offer supportive housing benefits.


State Updates: AZ, CA, CO, CT, NJ & PA

  • Arizona – The Arizona Health Care Cost Containment System (AHCCCS) developed a summary document that details how the proposed federal Medicaid fiscal accountability rule could affect Arizona’s Medicaid program. In case you missed it, SHVS hosted a webinar on the proposed rule last week. A slide deck and recording are available on the SHVS website.
  • California – Covered California, California’s state-based marketplace, announced new enrollment data and continued to reach out to consumers about the new state penalty and additional financial help that went into effect with the new year. As of January 22, more than 318,000 consumers had newly signed up for health insurance through Covered California during the current open enrollment period (OEP), which surpassed last year’s total of 295,000. The OEP for the state runs through January 31.
  • Connecticut – Governor Ned Lamont signed two executive orders that will directly address health care costs, primary care spending, and quality of care for individuals, businesses, and state government. The orders direct the Office of Health Strategy to establish statewide health care cost growth and quality benchmarks and a primary care spending target, and the Department of Social Services to improve public transparency of Medicaid costs and quality.
  • New Jersey
    • Governor Phil Murphy signed several bills into law last week to help improve the health, affordability, and access to care for New Jerseyans. A2431 helps limit out-of-pocket prescription drug expenses by requiring health insurers to provide plans that limit patient cost-sharing on prescription drugs. S3265 imposes a permanent ban on flavored vape products, including menthol. Lastly, A5977 establishes a Regional Health Hub Program as a replacement to the state’s Medicaid Accountable Care Organization (ACO) demonstration project and designates existing ACOs as regional hubs. The hubs will support the state’s health priorities by providing health care data infrastructure and analysis, supporting care management, and convening community stakeholders in close coordination with the state’s Office of Medicaid Innovation.
    • First Lady Tammy Murphy announced the partnership between the Murphy Administration, the Nicholson Foundation, and the Community Health Acceleration Partnership to develop a comprehensive, statewide maternal and infant health strategic plan. The strategic plan will aim to reduce New Jersey’s maternal mortality rate by fifty percent and eliminate racial disparities in birth outcomes.
  • Pennsylvania – Governor Tom Wolf introduced an online form for Pennsylvanians to provide feedback on mental health barriers, services, and how the state can better support people’s mental health needs.


Variations in Cesarean Section Rates

A cesarean section can be a life-saving procedure for a woman with a complicated pregnancy—but in some countries, too many women deliver by C-section, even when it is not necessary. In other countries, women cannot get a C-section when they need it. Why does this huge difference persist? On a recent episode of The Commonwealth Fund’s podcast The Dose, Pierre Barker, who heads global partnerships at the Institute for Healthcare Improvement, explains why some countries have a much higher C-section rate than others. Barker and his colleagues use a method called quality improvement to change the approach taken by health care systems around the world when it comes to C-sections.


State of Babies 2019 Yearbook

ZERO TO THREE and Child Trends jointly published the State of Babies Yearbook: 2019, which, for the first time, compares national and state-by-state data on the well-being of infants and toddlers. The State of Babies Yearbook: 2019 seeks to bridge the gap between science and policy with a state-by-state snapshot of how babies and their families are faring. The national and state profiles provide the building blocks for strong policies which support parents and caregivers in nurturing the youngest children and placing them firmly on a path to success in school and in life. The data presented in the Yearbook will help to increase policymakers’ awareness of the unique needs of infants, toddlers, and their families and provide early childhood policymakers with the information they require to advance national and state policies responsive to the needs of young children and their families.


Unraveling the Complexity in the Design and Implementation of Bundled Payments

Because bundled payments—in which health care providers receive a lump sum payment for a set of services—require different types of collaboration among payers, providers, and others, their design and implementation is complex. In a new Milbank Quarterly article, Sander Steenhuis of the Talma Institute at Vrije Universiteit Amsterdam and colleagues report on their systematic literature review of the payment model, in which they identify and categorize 53 key elements that affect the bundled payment contract development process.