This week State Health and Value Strategies (SHVS) published a new issue brief, Toward Hospital Global Budgeting: State Considerations, which digs into an innovative approach to shift hospitals from paying for volume to paying for value. The issue brief includes case studies of three states: Maryland, which pioneered global budgeting; Pennsylvania, which is preparing to launch its model; and Vermont, which offers an interesting twist on the concept. I hope the issue brief provides you with some ideas of how global budgeting might be a tool for payment reform in your state.
This week also saw states taking the lead on implementing solutions to address challenges in their insurance markets: two states signed into law individual mandates; several states made progress on Section 1332 waivers to implement reinsurance programs; and the biggest news of all is that Virginia will expand Medicaid. For more of the exciting details of how states are forging ahead, see the updates that follow.
- Illinois – A bill (HB2624) that would restrict the sale of short term health plans was passed by the Illinois legislature this week.
- Maine –The Department of Health and Human Services submitted a five year extension application for the Maine Medicaid Section 1115 Health Care Reform Demonstration for individuals with HIV/AIDS which provides a comprehensive set of services to those who are both HIV positive and are at or below 250 percent of the federal poverty level. The federal public comment period ends June 29, 2018.
- New Jersey
- Governor Phil Murphy signed authorizing legislation to pursue a Section 1332 waiver for reinsurance and the state also posted its draft application. We have updated our map tracking 1332 activity with the relevant links. Governor Murphy also signed a bill that will require all New Jersey residents to have health coverage or pay a penalty.
- The Governor announced the creation of the New Jersey State Health Benefits Quality and Value Taskforce, which will first focus on identifying specific near-term opportunities for reform and then turn to long-term and innovative reforms for the broader health benefits system. The Task Force will be comprised of state and national health policy and purchasing experts, union and employer stakeholders and experts from within the administration.
- New York
- The Department of Health announced that the state passed its first federal test of the Delivery System Reform Incentive Payment, or DSRIP, on four key statewide performance measures. The report also highlights areas of improvement.
- At an All Payer Database Stakeholder meeting, the Department of Health launched NYS Health Connector, a web-based application that allows quick access to a wide range of health information, such as the costs of various medical procedures and the frequency those procedures are performed at hospitals, in addition to health care service and utilization data.
- North Carolina
- The Department of Health and Human Services released a policy paper, Supporting Provider Transition to Medicaid Managed Care, with information for health care providers regarding the transition to Medicaid managed care, expected to launch in 2019.
- Earlier this month the Department of Health and Human Services also released Prepaid Health Plans in North Carolina Medicaid Managed Care, a policy paper that identifies key programmatic details ahead of the competitive procurement for the new Medicaid managed care program. Health Management Associates has a thorough review of the paper in their HMA Weekly Roundup this week.
- Vermont – Governor Phil Scott signed into law a billthat establishes a state individual mandate, with an enforcement mechanism to be enacted during the 2019 legislative session which would then go into effect in 2020.
- Virginia – Governor Ralph Northam is expected to sign the state budget, which, as he announced in a press release, includes the expansion of Medicaid that will extend health care coverage to 400,000 people and also includes language authorizing the state to develop and pursue a 1332 waiver application.
- Washington — The Washington Health Care Authority announced the successful bidders of the state’s integrated Medicaid managed care procurement.
Behavioral Health and Medicaid Managed Care: Scholarships Available for States to Attend NASHP Ancillary Meeting
The National Academy for State Health Policy (NASHP) and SHVS are convening a one-day policy workshop designed to support states in fostering sound Medicaid managed care policies and approaches for behavioral health services. This meeting will take place in conjunction with the NASHP Annual State Health Policy Conference in Jacksonville, Florida on August 15th. State teams that consist of two mid-to senior-level managers of managed care contracts and policy with a focus on behavioral health are invited to apply for scholarships to support travel and lodging to attend this meeting. This workshop will feature national experts and dynamic discussion, and is a great opportunity for selected teams to defray the cost of travel to the NASHP conference. Interested state teams can reach out to Natalie Williams at firstname.lastname@example.org for more information, and to access the electronic application.
The 1115 Impact: The Role of Medicaid Section 1115 Waivers in Complex Care
The National Center for Complex Health and Social Needs will be hosting a webinar on June 14 focusing on state opportunities to use Section 1115 waivers to advance efforts in complex care. Webinar participants will learn about how Section 1115 waivers can include reforms that go beyond routine medical care and include evidence-based interventions that impact social determinants and improve health and wellbeing. The webinar will also highlight experiences from Kentucky and North Carolina.
Promoting Cross-Sector Partnerships to Achieve Better Health
Our friends at the Center for Health Care Strategies published a report that explores the many ways that states are collaborating across agencies to improve population health while accomplishing reciprocal goals in areas like transportation and education. It provides important lessons on how cross-sector partnerships can successfully advance health outcomes through empowering local communities, facilitating cross-sector learning and collaboration, supporting data-sharing, and cultivating cross-sector leadership. The report also includes a companion set of case studies that details successful partnerships in varied geographic areas across the country and provides a ground-level look at innovative cross-sector initiatives in five states.