June 10 Update

In This Week’s Update:

  • Telling the Stories of Medicaid
  • New SHVS Publication: Measuring Health Disparities
  • SHVS Buying Value Benchmark Repository
  • State Updates: CO, DC, DE, ME, ND, NJ, OR, PA, TX, VA, & WI
  • State Health Care Transformation with Federal Support
  • Improving Dental Health for Rural Kids

New RWJF Medicaid Storytelling Effort

That’s Medicaid is a Robert Wood Johnson Foundation-led effort showcasing stories of people who have been covered by Medicaid at critical points in their lives, underscoring the importance of stable insurance coverage in building a nationwide culture of health. These stories are examples of Medicaid’s effect on the ground in various states, supplementing data and quantitative research. You can browse the first batch of stories and learn more at ThatsMedicaid.org, and share it with your lawmakers, staff and others. The effort will add more stories monthly to highlight the importance of Medicaid for people in all states; you can submit story suggestions from your state via the website.

New SHVS Publication: Measuring Health Disparities

State Health and Value Strategies has published a new issue brief, How States Can Use Measurement as a Foundation for Tackling Health Disparities in Medicaid Managed Care. The brief profiles a handful of states that have begun the work of identifying, evaluating, and reducing health disparities among marginalized groups within their Medicaid managed care programs. The brief also offers an approach for other states interested in measuring disparities in health care quality in Medicaid managed care as a step towards achieving health equity, such that all Medicaid managed care enrollees have a fair and just opportunity to be as healthy as possible. On Thursday, June 20 at 2:00 p.m. ET SHVS will host Advancing Health Equity in Medicaid Managed Care: An Introduction for States, the first webinar in a series on health equity and Medicaid managed care. The first webinar will review the foundational principles of health equity, barriers to its realization, and the impact of health disparities. Register here (required).

SHVS Buying Value Benchmark Repository

Also this week, SHVS updated the Buying Value Benchmark Repository, a database of non-HEDIS and modified HEDIS measures and related performance data, to add the Minnesota Community Measurement’s (MNCM) measures. MNCM submitted 12 measures to the Repository focused on mental health, diabetes care, and asthma care. The Repository now has 49 measures in use by six states and regional health improvement collaboratives. Visit www.buyingvalue.org to access the database. Updates follow.

State Updates: CO, DC, DE, ME, ND, NJ, OR, PA, TX, VA, & WI

  • Colorado – As part of its State Innovation Model (SIM) efforts, the Colorado Department of Health Care Policy and Financing announced new messaging for the “Let’s Talk Colorado” campaign that focuses on men, who are at high risk for untreated mental health issues and suicide. This customized messaging was prompted by the SIM-funded call-to-action report that identified a need for specific outreach to men, who are not as likely to seek the whole-person care they need.
  • Delaware – Delaware Insurance Commissioner Trinidad Navarro announced that the Delaware Department of Insurance has posted Delaware’s 1332 Waiver Application for public comment. Comments will be accepted until June 29, 2019. SHVS has an updated map to include a link to the draft application.
  • District of Columbia – The District of Columbia Department of Health Care Finance (DHCF), in collaboration with the District of Columbia Department of Behavioral Health (DBH), applied for an 1115 Medicaid Behavioral Health Transformation Demonstration from the Centers for Medicare and Medicaid Services (CMS). The proposed demonstration will expand coverage for behavioral health services and promote links between levels of behavioral health care to improve outcomes for the nearly one-third of Medicaid beneficiaries with a behavioral health diagnosis.
  • Maine – The Department of Health and Human Services released an update on Medicaid expansion enrollment. The current snapshot of enrollment allows improved tracking of trends in enrollment over time. As of May 31, 23,590 people are currently enrolled through the MaineCare expansion, including 19,173 adults without children and 4,417 parents and caretaker relatives.
  • New Jersey
    • Governor Phil Murphy announced a package of bills to safeguard the principles of the Affordable Care Act (ACA) in New Jersey, as well as establish and fund a State-Based Exchange (SBE). The bills would write into state law the basic protections for health care consumers that are part of the ACA, including protections for no-cost preventive care, prohibiting exclusions for preexisting conditions, allowing children to stay on their parents’ plan until age 26, and protecting maternity care as essential health benefits, among others. A key bill in the package authorizes the Department of Banking and Insurance to create a SBE and establishes the assessments to fund the SBE.
    • The New Jersey Department of Health (DOH) released surgical/cesarean birth rates by hospital among women considered at low risk for birth complications. DOH also launched a new New Jersey Maternal Data Center website, which includes this latest data, information on why it is important to avoid surgical births, and resources related to birth outcome improvements.
  • Oregon – The Oregon Health Authority released a new report, which found that members with mental illness use the emergency department for physical health reasons at a rate two-and-a-half times greater than members without mental illness. The report highlights this health disparity and encourages coordinated care organizations to take a “deeper dive” into their data to develop strategies specific to the needs of members with mental illness.
  • Pennsylvania – Governor Tom Wolf  announced details of the five projects selected to support improved health outcomes in North Philadelphia’s Health Enterprise Zone (HEZ), an eight-mile area in Philadelphia with a large Medicaid population but poor health outcomes. Each project will use community health workers to address health disparities in children, older adults, and those who are frequent users of medical services by increasing health promotion and education in the HEZ.
  • Texas – The Texas Health and Human Services Commission released a draft request for proposals for the state’s STAR Health managed care program for foster children. New statewide contracts are expected to run from September 1, 2021, through August 31, 2024.
  • Virginia – Governor Ralph Northam announced a goal to eliminate the racial disparity in the maternal mortality rate in Virginia by 2025. The governor outlined the goal during a ceremonial bill signing of House Bill 2546, which codifies the Maternal Mortality Review Team in Virginia, and House Bill 2613, which adds perinatal anxiety to the list of information providers must give patients.
  • Wisconsin – Governor Tony Evers, the Wisconsin Department of Health Services (DHS), and the Office of the Commissioner of Insurance (OCI) launched a Health Care Coverage Partnership aimed at enrolling more Wisconsinites in high-quality, affordable health insurance coverage. The partnership will focus on supporting outreach and enrollment, improving coordination between DHS and OCI, and promoting overall well-being.
  • Colorado and North Dakota – CMS deemed both state Section 1332 applications for reinsurance programs complete. A map from SHVS has been updated to reflect this latest development.

 

State Health Care Transformation with Federal Support

The Milbank Memorial Fund published the first issue brief in a new series, Research Into Practice, that seeks to make research findings from Milbank Quarterly studies and their policy implications more accessible to policymakers and practitioners. The practice brief, States Tackling Health Care System Transformation with Federal Support, reviews the major themes that emerged from three Milbank Quarterly articles evaluating Round 1 of the Center for Medicare and Medicaid Innovation’s State Innovation Models (SIM) Initiative. In analyzing the findings from the SIM evaluations, the brief examines the role of state government in transforming health care systems and the levers they have to control health care expenditures as payers (for Medicaid), purchasers (for state employees), regulators, and sponsors.

 

Partnering with Head Start to Provide Dental Care to Rural Populations

An article published on the Rural Health Information Hub profiles an innovative project to provide dental care to Head Start Children on reservations in South Dakota. The Delta Dental of South Dakota Foundation partnered with seven Head Start programs to bring dental care to young children through the Early Childhood Caries (ECC) Prevention Project. American Indian children in South Dakota are more likely than white children to have untreated tooth decay: 42% of Native children compared to 16% of white children. In addition to health care barriers like lack of transportation options, there is a shortage of dental professionals on the reservations. For example, the Pine Ridge Indian Reservation has three dental hygienists for about 40,000 residents. Dental hygienists in tribal Head Start centers provide cleanings, fluoride varnish and educate parents and Head Start staff on dental hygiene. In three years, 1,133 children and their parents completed an ECC visit. An additional 2,780 children received preventive care.