In This Week’s Update:

• Health Equity in National Payment Reform Efforts
• State updates: AK, AZ, CO, MI, ND, NJ, NY, NC, OK, OR, WA, WV & WI
• Event: Performance Measurement for State Medicaid
• Leveraging Medicaid for Children’s Health
• Health Equity and Premium Pricing

 

Health Equity in National Payment Reform Efforts

Last week, the Health Care Payment Learning and Action Network (HCP-LAN) announced its Health Equity Advisory Team (HEAT) to identify and support efforts to use alternative payment models to advance health equity. HEAT is the first explicit effort to link payment models to health equity through the HCP-LAN, a core activity of the Centers for Medicare and Medicaid Innovation (CMMI)’s work to reform health care payments. HEAT will give careful consideration to understanding barriers to health equity at the state level. 

Related Resource: State Strategies for Overcoming Barriers to Advance Health Equity

 

 COVID-19

• Colorado – Governor Jared Polis announced that 12 of Colorado’s counties have passed President Biden’s goal to have 70 percent of the eligible population vaccinated with at least one dose of the COVID-19 vaccine by Independence Day, July 4, including Denver County, the state’s most populous county.
• New Jersey – Governor Phil Murphy signed legislation enabling the end of the COVID-19 Public Health Emergency that has been in place since March 9, 2020. Immediately after signing the legislation, Governor Murphy signed Executive Order No. 244, ending the COVID-19 Public Health Emergency. Under the legislation, the majority of executive orders that were issued pursuant to the Public Health Emergency will expire 30 days from signing of the executive order.
• New York – Governor Andrew Cuomo announced that the statewide seven-day average positivity rate has declined for 66 consecutive days to 0.47 percent. The state will start closing drive-through COVID-19 testing sites across New York state as a result of the low positivity rates and an 88 percent decrease in drive-through testing demand from January to May, 2021.
• North Carolina – The North Carolina Department of Health and Human Services announced more than 80 percent of adults 65 and older in the state have received at least one dose of COVID-19 vaccine.
• West Virginia – Governor Jim Justice announced that over 60.1 percent of all West Virginians eligible to receive the COVID-19 vaccine have now received at least one dose. To date, 936,453 of 1,557,837 vaccine-eligible West Virginians have been given their first shot.
• Wisconsin – The Wisconsin Department of Health Services announced that the COVID-19 Racial and Ethnic Disparities page has been updated to include vaccination data, in addition to existing data on COVID-19 cases, hospitalizations, and deaths by race/ethnic group.

 

Other State Updates

• Alaska – The Department of Health and Social Services announced that a statewide initiative implemented in six hospitals was associated with a 28 percent reduction in severe complications related to high blood pressure and pregnancy. Over the past two years, the Alaska Perinatal Quality Collaborative partnered with the National Alliance for Innovation on Maternal Health Program to implement best practices to improve outcomes for pregnant and birthing Alaskans with high blood pressure. 
• Arizona – The state submitted an amendment to its current demonstration, the Arizona Health Care Costs Containment System (AHCCCS). Arizona is seeking waiver and expenditure authority to improve health care delivery and health outcomes for AHCCCS members who are homeless or at risk of becoming homeless by expanding existing evidence-based practices and reducing barriers to housing. The federal comment period is open through July 7, 2021.
• Michigan – The Michigan Department of Health and Human Services released for public comment its Title V Maternal and Child Health (MCH) Services Block Grant application, which includes its annual report for the program for FY 2020. Title V state action plans address several priority areas for the current five-year cycle (FY 2021-2025) to improve the health of the maternal and child population in Michigan, including reducing low-risk cesarean delivery and promoting breastfeeding and safe infant sleep.
• North Dakota – The North Dakota Department of Human Services, through its eight regional human service centers, has launched a comprehensive behavioral health crisis response system. The system provides support 24 hours a day, seven days a week to residents experiencing mental, substance use, or emotional challenges. The initiative also includes crisis response services for individuals with intellectual or developmental disabilities.
• Oklahoma – Following the launch of enrollment on June 1, over 100,000 individuals have enrolled in the state’s Medicaid expansion which begins July 1, 2021. The Oklahoma Health Care Authority is tracking enrollment in SoonerCare via a dashboard.
• Oregon – Oregon’s Medicaid Director, Lori Coyner, will leave her current role at the end of June to serve as the primary leader providing strategic guidance in developing Oregon’s next 1115 Medicaid waiver agreement with the federal government. Dana Hittle, who has served as Deputy Medicaid Director for the past two years, will serve as the Oregon Health Authority’s interim Medicaid Director.
• Washington – The Washington Health Care Authority (HCA) is seeking proposals from qualified vendors to aid the Compact of Free Association (COFA) Islander programs. HCA is seeking vendors interested in providing multilingual and culturally appropriate outreach, education, and enrollment assistance to Washington residents from the COFA nations of the Republic of Palau, the Federated States of Micronesia and the Republic of Marshall Islands.
• West Virginia – The West Virginia Department of Health and Human Resources announced the Breastfeeding Friendly Child Care designation for West Virginia child care providers. The initiative is a voluntary program open to licensed child care centers, registered facilities, and family child care providers. The designation aims to support child care providers in offering critical support for breastfeeding mothers, who often return to work during their baby’s first year of life with limited or no support. 

 

Upcoming Webinar

Highlights of the Buying Value Benchmark Repository: Innovative Homegrown Measures

Tuesday, June 22 2:00 to 3:00 p.m. ET

States are responsible for ensuring that their Medicaid programs deliver high-quality, high-value care, but there are not always nationally-endorsed measures focused on states’ areas of interest. This is especially true for equity-related measurement. State Health and Value Strategies is hosting a webinar that will explore innovative measures that states have developed to address their program priorities. The Buying Value suite of resources for states using performance measures to assess and improve the value of their managed care plans and accountable provider entities. Experts from Bailit Health will lead the webinar, which will feature state officials discussing their experiences developing and implementing homegrown measures included in the Buying Value Repository. 

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e6b675682b747ad6698b67d73e100b2c7

 

Medicaid’s Role in Supporting Children After the COVID-19 Pandemic

Throughout the pandemic, the nation’s children have suffered in myriad ways during some of the most critical ages for healthy development. Children of color, children with complex health care needs, and children in poverty have been the hardest hit. The National Association of State Medicaid Directors has released a report, Medicaid Forward: Children’s Health, providing a close look at the realities children are facing and the Medicaid innovations made across the country that are continuing to help millions of kids. Medicaid and the Children’s Health Insurance Programs, which cover about 2 in 5 American children and nearly half of all births, will be essential in the nation’s efforts to help children and their families recover from these impacts and build additional resilience for the future. NAMD is also hosting a webinar on Thursday, June 17 from 12:00 to 1:00 p.m. ET on the Medicaid Forward series and a report focused on children’s health.

 

Health Equity and the Pricing of Insurance Premiums

The American Academy of Actuaries Health Practice Council created the Health Equity Work Group to advance efforts reducing health disparities and improve health equity among groups that have been economically/socially marginalized. The Work Group is examining actuarial practices and methods in the health area to assess how they may affect health disparities and recommend appropriate changes. They also aim to educate actuaries and other stakeholders on health equity issues and apply an equity lens to the Academy’s health policy work. Health Equity from an Actuarial Perspective: Questions to Explore introduced the first phase of the work group’s efforts—identifying areas in which health actuaries are involved that may affect health equity and develop a list of questions and topics to explore further. 

 

Related resource: Health Equity from an Actuarial Perspective: A Deeper Dive Into Health Plan Pricing Questions