May 28 Update

In This Week’s Update:

  • New Medicaid Podcast
  • State Updates: CT, CO, MD, ME, MI, OR & WA
  • Webinar – Connecting Justice-Involved Pop. to Medicaid
  • Monitoring and Evaluating Work Requirements
  • Medicaid Expansion and Maternal and Child Health
  • Extending VBP Models Into Medicaid Drug Purchasing

New Medicaid Podcast

If you love listening to podcasts, you may want to check out the first episode of a new podcast that the Center for Health Care Strategies and the National Association of Medicaid Directors just announced. Made possible with support from the Robert Wood Johnson Foundation, Medicaid Leadership Exchange, will feature Medicaid directors sharing candid insights into leadership strategies that have, and haven’t, worked for their agencies.

State Updates: CT, CO, MD, ME, MI, OR & WA

  • Connecticut – Governor Ned Lamont, State Comptroller Kevin Lembo, and legislative leaders announced they reached consensus on a legislative proposal that could provide Connecticut residents with more affordable health care. Under a new “Connecticut Option,” individuals and small businesses would have the choice of buying a health care plan that could save them up to 20 percent in premiums. The proposal also includes other measures that seek to increase affordability and improve the quality of health care in the state.
  • Colorado – Governor Jared Polis signed into law HB19-1168 which authorizes the commissioner of insurance to apply for a Section 1332 waiver to implement a reinsurance program. SHVS has updated its map that tracks state Section 1332 activity to reflect the legislation being signed into law.
  • Maine – Governor Janet Mills announced that her Administration will convene an Opioid Response Summit on July 15, 2019. The summit, Turning the Tide: Maine’s Path Forward in Addressing the Opioid Crisis, will bring together members of the public, health providers, experts, affected individuals and families, and law enforcement officials from across Maine to foster collaboration on the state’s ongoing response to the opioid crisis.
  • Maryland – The Maryland Health Benefit Exchange, the state’s official health insurance marketplace, is seeking applications for the Maryland Easy Enrollment Health Insurance Program (MEEHP) Advisory Group. The new program, signed into law by the Governor earlier this month, will use the tax filing process to help enroll uninsured Marylanders into health coverage offered through Medicaid or private health insurance carriers.
  • Michigan – The Michigan Department of Health and Human Services announced the appointment of Kate Massey to serve as deputy director for Medical Services Administration and Medicaid Director. Kate comes to her new role from Magellan Complete Care of Virginia, where she was the chief executive officer.
  • Oregon – The Oregon Health Authority (OHA) released a report that shows promising short-term outcomes of raising the age of purchase for tobacco and vaping products from 18 to 21 years. OHA found a significant decrease in youth (aged 13 to 17) and young adults (aged 18 to 20) who have started using tobacco since a new law took effect January 1, 2018.
  • Washington – The Washington Health Benefit Exchange, the state’s official health insurance marketplace, released its Spring Health Coverage Enrollment Report. The report provides a breakdown of the 1.6 million customers–one in four Washingtonians–who used Washington Healthplanfinder to access 2019 health insurance coverage.


Upcoming Webinar – Emerging Strategies for Connecting Justice-Involved Populations to Medicaid Coverage and Care

Tuesday, June 18 from 1:00 to 2:00 p.m. ET

State Health and Value Strategies, in partnership with Manatt Health, is hosting a webinar for states that provides an overview of the opportunities available to connect justice-involved populations to Medicaid coverage and care. States are exploring opportunities to engage justice-involved populations–including juveniles and adults–in Medicaid coverage, case management and health care both immediately prior to and following their release from prison or jail. States’ interests are motivated by the high needs and high related health costs of these individuals–who are often eligible for Medicaid upon release, especially in states that have expanded Medicaid. Despite the current prohibition on drawing down federal Medicaid financing to fund health care for people while they are incarcerated, there are a number of strategies states can deploy to meaningfully connect justice-involved populations to critical coverage as well as medication and physical and behavioral health care services when re-entering the community. The webinar will provide an overview of Medicaid enrollment and suspension processes to make sure an individual has active Medicaid coverage and “in-reach” planning pre-release that helps with engagement and care management post-release.

Registration (required) at the following link:


Federal Guidance on Monitoring and Evaluating Work Requirements

A new brief, prepared by Manatt Health, with support from the Robert Wood Johnson Foundation, provides an overview of March 2019 guidance from the Centers on Medicare & Medicaid Services (CMS) on the monitoring and evaluation of “eligibility and coverage” Section 1115 Medicaid demonstrations, including work/community engagement (CE) waivers. The brief distills key information on its new requirements and highlights practical considerations for states. While monitoring and evaluation requirements and resources are referenced more broadly, the brief has a particular focus on demonstrations with a work/CE component and is a complement to Monitoring and Evaluating Work and Community Engagement Requirements in Medicaid: Data Assets, Infrastructure and Considerations for States, an earlier resource guide also produced by Manatt Health with Robert Wood Johnson Foundation support.


Medicaid Expansion Fills Gaps in Maternal Health Coverage Leading to Healthier Mothers and Babies

A report by Center for Children and Families at Georgetown University reviews new research showing the significant improvements in access to health coverage for women of childbearing age achieved through the adoption of the Affordable Care Act’s Medicaid expansion. The American College of Obstetricians and Gynecologists recommends women have access to continuous health coverage in order to increase preventive care, reduce avoidable adverse obstetric and gynecologic health outcomes, increase early diagnosis of disease and reduce maternal mortality rates. Research also finds that Medicaid expansion plays an important role in reducing the significant and persistent racial disparities in maternal and infant health. And finally, new studies show that healthier mothers mean healthier infants—another benefit for states that expand Medicaid.


Extending VBP Models Into Medicaid Drug Purchasing: Challenges And Opportunities

A new Health Affairs blog post examines the various models states are employing to extend value-based purchasing (VBP) initiatives into their drug purchasing efforts in Medicaid. State Medicaid agencies are deploying VBP in both their fee-for-service and managed care programs as part of an overarching strategy to leverage their purchasing power to reduce costs and improve quality. Virtually every state has implemented at least one VBP model, and approximately two-thirds of states with managed care programs have imported the model into managed care by requiring plans to engage in VBP with network providers. The blog post provides an overview of three VBP models and features examples of specific state approaches to controlling drug costs while maintaining Medicaid beneficiary access to new and innovative therapies. The post also highlights considerations to implementing VBP approaches in drug purchasing strategies.