May 18, 2018: New SHVS issue brief on Medicaid buy-in; Trends in state telehealth policy & reimbursement; Medicaid ACO’s take on social determinants

This week State Health and Value Strategies (SHVS) published Medicaid Buy-In: State Options, Design Considerations and Section 1332 Waiver Implications, which explores opportunities for states to leverage their Medicaid programs to strengthen coverage. SHVS hosted a companion webinar on Tuesday (if you missed it, you can download the slide deck and the recording) and has created a map to track state activity around Medicaid buy-in programs. The map includes links to relevant legislation and groups states by whether they are pursuing a buy-in program or have established a task force to study the impact of a buy-in program.

Also this week, in a follow-up to the release of the Trump Administration’s Blueprint to Lower Drug Prices, Secretary Azar was interviewed on Pulse Check and discusses some of the details in the plan. In addition, the Department of Health and Human Services released a request for information seeking comment on the Blueprint. Updates follow.

  • Connecticut – A report by the Connecticut Health Foundation examines the impact of Medicaid expansion in Connecticut. The report profiles individuals covered and summarizes trends of how members have used their coverage.
  • Maryland — The Centers for Medicare & Medicaid Services (CMS) approved Maryland’s Total Cost of Care All-Payer Model, known as the “Maryland Model,” contract. The new model will extend beyond hospitals to the entire health care system.
  • New Jersey – Governor Phil Murphy announced that he notified CMS that the Department of Banking and Insurance will perform the plan management functions of the health insurance marketplace and review for compliance with the Affordable Care Act and New Jersey law all plans to be sold on the health exchange in New Jersey for plan year 2019.
  • New York — NY State of Health, the state’s official health plan marketplace, released detailed data on the more than 4.3 million New Yorkers who enrolled in health plans during its fifth open enrollment period that ran from November 1, 2017 through January 31, 2018.
  • Ohio
    • The state was notified this week by CMS that their Section 1332 waiver application was deemed incomplete. We have updated our map with a link to the letter from CMS.
    • CMS announced it is accepting public comments on Ohio’s 1115 demonstration waiver request to implement a work and community engagement requirement on Medicaid beneficiaries. Comments must be submitted by June 14, 2018.
  • Pennsylvania — The Department of Corrections is partnering with the Department of Human Services and the Pennsylvania Justice Network to streamline the process for applying for medical assistance coverage for inmates returning to the community within the state. With implementation of the intra-agency data exchange, the process for applying for benefits is automated for all reentrants who consent to the application submission.
  • West Virginia — The West Virginia Department of Health and Human Resources announced funding to expand the statewide capacity of Quick Response Teams, composed of emergency response personnel, law enforcement officers and a substance use treatment or recovery provider who contact individuals within 24 to 72 hours of their overdose in an attempt to get them into a treatment program.
  • Virginia – Governor Ralph Northam vetoed a bill that would have authorized health insurance carriers to offer short-term health plans lasting up to 364 days.
  • Vermont
    • On Wednesday Governor Phil Scott signed legislation legalizing the importation of prescription drugs from Canada.
    • The House and Senate passed a bill establishing a state individual mandate, with an enforcement mechanism to be enacted during the 2019 legislative session which would then go into effect in 2020.

State Telehealth Laws and Reimbursement Policies: A Comprehensive Scan of the 50 States and District of Columbia

The Center for Connected Health Policy released its biannual report on state telehealth laws and reimbursement policies. The report highlights key challenges and opportunities regarding state telehealth reimbursement and coverage in both Medicaid and private insurance and describes key trends in telehealth implementation across the country. In particular, the spring 2018 update finds that more state Medicaid programs have expanded reimbursement policies with regard to telehealth services originating from the patient’s home and more states have passed legislation allowing teleprescribing of medications, including for controlled substances used in medication assisted therapy treatment. The report also includes individual state profiles that provide additional details on the types of telehealth modalities and sites of care that are reimbursed in each state.

Prioritizing Social Determinants of Health in Medicaid Accountable Care Organizations: A Q&A with Two Pioneering States

The Center for Health Care Strategies interviewed two state Medicaid ACO programs that are addressing social determinants of health (SDOH) in order to improve health outcomes and contribute to potential savings: Minnesota’s Integrated Health Partnerships and Rhode Island’s Accountable Entities. The interview is a follow-up to a webinar held in February and highlights key questions that were raised during the event, including those related to developing health equity and SDOH-related metrics, incorporating community health workers into ACO programs, and funding for community-based organizations to help meet ACO quality and cost goals.

How Housing Impacts the Health of People Living With HIV/AIDS

A blog post on the Robert Wood Johnson Foundation’s Culture of Health Blog describes preliminary lessons learned from researchers studying the impact of stable housing on the well-being of people living with HIV/AIDS. Supported through RWJF’s Interdisciplinary Research Leaders Program, a team of researchers is assessing the health impact of affordable housing programs and identifying promising strategies for effective case management of people living with HIV/AIDS in 10 counties in West Alabama, nine of which are in rural communities. While evaluating community and policy advocacy programs and interviewing elected officials to gain a better understanding of the policy environment, the team identified key lessons related to addressing disruptions in consistent care, stigma in rural areas, and how the rate of homelessness and inadequate housing affects health outcomes for people living with HIV/AIDS.