In This Week’s Update:
- New SHVS COVID-19 Resources
- COVID-19 State Updates: AZ, CA, GA, MA, MN, NC, NE, NV, OR, PA, WA & WI
- Other State Updates: LA, NJ, NM, WA & WI
- Medicaid Insurers Participation in Marketplaces
- Maryland Primary Care Program
- Adapting Outpatient Visits During COVID-19
New SHVS COVID-19 Resources
Last week, State Health and Value Strategies (SHVS) published several new COVID-19 related products for states. As states and Medicaid programs face significant fiscal uncertainty as a result of the COVID-19 public health crisis, Analyzing the Fiscal Impact of COVID-19, the Economic Downturn, and Recent Policy Changes: 50-State Databook provides projected changes in federal and state Medicaid and CHIP expenditures during calendar years 2020 and 2021 across all fifty states and the District of Columbia for a range of scenarios and policy responses. The Databook is a follow-up to a June 4 webinar from SHVS.
Also last week SHVS, published two expert perspectives:
- Update on Federal Mandates to Cover COVID-19 Testing Services: New Guidance for States, Plans, and Insurers examines new guidance published by the Departments of Health & Human Services, Labor, and Treasury that attempts to answer implementation questions from states, plans, and insurers, including the definition of “medically necessary,” surveillance or workplace-related testing, coverage of hospital “facility fees,” and protections against provider balance billing.
- Addressing Equity through COVID-19 Response: Communications Approaches in States highlights examples employed by DC Health Link, the Oregon Health Authority, and beWellnm, as well as the community-centered outreach they are each using to actively enroll and connect consumers to care.
Additionally, SHVS published an analysis of New Hampshire’s directed payment program that was approved by CMS. Many states face a July 1 deadline for directed payments; states considering the option to direct some capitation dollars toward providers to sustain them through the pandemic will need to submit an initial request, even if it is in draft form, by the deadline (see the CMCS informational bulletin for additional information).
COVID-19 State Updates: AZ, CA, GA, MA, MN, NC, NE, NV, OR, PA, WA & WI
- Arizona – In partnership with the Arizona Department of Health Services and the Arizona Health Care Cost Containment System (AHCCCS), the Crisis Response Network launched the Resilient Arizona Crisis Counseling Program to provide free and confidential support and connections to resources for Arizona residents affected by the COVID-19 pandemic.
- Covered California is extending the current special-enrollment deadline through July 31.
- Governor Gavin Newsom unveiled the California COVID Assessment Tool, or CalCAT, a “model of models” that contains assessments of the spread of COVID-19, short-term forecasts of disease trends, and scenarios of the course of the disease from modeling groups across the country.
- Georgia – The Georgia Department of Public Health (DPH) released a new video explaining the state’s COVID-19 contact tracing efforts, asking residents to ‘answer the call’ if DPH reaches out.
- Massachusetts – The Health Connector announced in an Administrative Bulletin an extension to the special enrollment period in response to the COVID-19 emergency through July 23, 2020 to assist uninsured Massachusetts residents seeking health coverage.
- Minnesota – MNSure, Minnesota’s state-based marketplace, announced that 99,688 Minnesotans have come to MNsure.org and enrolled in private health insurance through a special enrollment period (SEP) or received eligibility for a public assistance program (Medical Assistance or MinnesotaCare) since March 1.
- Nebraska – The Nebraska Department of Health and Human Services will be issuing emergency supplemental allotments to Supplemental Nutrition Assistance Program (SNAP) recipients who receive benefits for the month of June on July 7.
- Nevada – Governor Steve Sisolak announced that Heather Korbulic, interim director of the Nevada Department of Employment, Training and Rehabilitation, will be transitioning back into her role as the Executive Director of the Silver State Health Insurance Exchange.
- North Carolina
- The Department of Health and Human Services (DHHS) released improved online applications for Medicaid and Food and Nutrition Services to help both North Carolina families and county departments of social services during the COVID-19 pandemic.
- DHHS was awarded $1.5 million by the Federal Emergency Management Agency (FEMA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) to support and expand the Hope4NC program, which connects North Carolinians to mental health supports to help cope and build resilience during times of crisis, with a focus on historically marginalized communities.
- Oregon – The State of Oregon reached an agreement with several health insurance companies to continue providing expanded telehealth options through at least December 31, 2020.
- Pennsylvania – The Pennsylvania Department of Health and the Pennsylvania Emergency Management Agency are partnering with CVS Health to offer COVID-19 testing services to skilled nursing facilities statewide, free of charge.
- Washington – Insurance Commissioner Mike Kreidler extended his emergency order directing all state-regulated health insurers to make additional coverage changes to aid consumers during the COVID-19 pandemic. His order is in effect until July 19 and requires health insurers to continue providing telehealth, cover and waive cost-sharing for all medically necessary diagnostic testing for flu and certain other viral respiratory illnesses, and treat drive-up testing sites for COVID-19 as provider visits with no cost-sharing.
- Governor Tony Evers and Insurance Commissioner Mark Afable announced a new free online website, WisCovered.com, to help Wisconsinites who need help getting health insurance. Available in English, Spanish, and Hmong, WisCovered.com helps put people in touch with assistance via phone from organizations like Covering Wisconsin and United Way’s 211. It also includes information about how to access health insurance on HealthCare.gov, BadgerCare Plus (Medicaid), and more.
- The Wisconsin Department of Health Services launched a new data dashboard consisting of maps and tables that toggle between counties and Healthcare Emergency Readiness Coalition (HERC) regions. The counties and regions are color-coded to indicate overall COVID-19 activity status: low, medium, or high.
Other State Updates: LA, NJ, NM, WA & WI
- Louisiana – The Department of Health released a Request for Information seeking technical assistance and consulting services for the state’s Medicaid program.
- New Jersey – The Department of Health released a Request for Applications from local health departments for funding to help them study patterns of overdose in their communities to better inform preventive and recovery initiatives. Local health departments are eligible to receive grant awards of $100,000 to establish Overdose Fatality Review Teams.
- New Mexico – The New Mexico Department of Human Services’ Behavioral Health Services Division announced that it has partnered with OpenBeds, a provider of a technology platform that identifies, unifies, and tracks behavioral health and social services resources to facilitate rapid digital referrals, to launch the New Mexico Behavioral Health Referral Network.
- Washington – Insurance Commissioner Mike Kreidler sent guidance to all health insurers in Washington state reminding them that it is against state law to discriminate against an enrollee based on their gender identity.
- Wisconsin – On July 1, the Department of Health Services will award $1.2 million in grants to 15 local county Birth to 3 Programs across the state that will pilot new and innovative efforts to improve outcomes for participating children. These grants will allow local areas to explore new and better ways to address the unique needs of children with developmental delays and disabilities.
Effects of Medicaid Health Plan Dominance in the Health Insurance Marketplaces
As more people become unemployed, lose their employer-sponsored insurance, and need cost-effective alternatives due to the COVID-19 pandemic, the marketplaces will likely be a valued resource for health insurance coverage. In a new issue brief, researchers from the Urban Institute share findings from interviews with stakeholders in six states with one or more Medicaid insurers participating in the marketplace for the 2020 plan year and found that previous concerns about the Medicaid insurers’ networks, pricing, and effect on other insurers’ participation have largely dissipated.
Updates from Maryland Primary Care Program
The Maryland Primary Care Program (MDPCP) aims to make strategic investments in primary care practices and build a resilient statewide infrastructure to prevent and manage chronic disease. Launched last year by the state’s Department of Health in collaboration with the Center for Medicare and Medicaid Innovation, the program is a systematic, evidenced-based, multipayer commitment. A new issue brief by the MDPCP’s Chad Perman, Robert Patterson, and Howard Haft, describes the program’s evolution and core components. Primary care clinicians who voluntarily joined the program serve roughly half of the state’s residents. A companion article, by Martha Hostetter and Sarah Klein, looks at how Maryland has leveraged the program’s infrastructure during the COVID-19 pandemic. State leaders have been able to effectively communicate with practices about the state’s response and help clinicians identify patients most at risk for COVID-19.
How Practices Are Adapting to the New Normal of COVID-19 for Outpatient Visits
The COVID-19 pandemic has dramatically changed how outpatient care is delivered in health care practices. To decrease the risk of transmitting the virus to either patients or health care workers within their practice, providers had been deferring elective visits when possible. They are also converting in-person visits to telemedicine visits. In the third report in a series published by the Commonwealth Fund that looks at the effect of COVID-19 on outpatient care, researchers describe visit trends through June 20. Researchers analyzed data on changes in visit volume for the more than 50,000 providers, and the charts in the report illustrate how declines in visits vary by patient type, geographic area, clinical specialty, insurer, and size of provider organization.