November 21 Update

In This Week’s Update:

  • Unwinding Deadline Request
  • SHVS Resource Page
  • Developing a Payment and Spending Strategy to Advance Health Equity: Checklist for Medicaid Decision-Makers
  • 2022 March of Dimes Report Card
  • Comparing Federal Government Surveys that Count the Uninsured: 2022
  • State updates: AL, CA, CO, DC, IA, MN, NJ, NC, OK, OR, TX, VA & WI


Unwinding Deadline Request

Last week, the National Association of Medicaid Directors (NAMD) sent a letter to Congress requesting certainty around the timing and fiscal resources available to support the eligibility redeterminations that will follow the end of the continuous coverage requirement. In the letter, NAMD asks that Congress provide at least 120 days advance notice and also confirm that existing federal guidance on the redetermination period will not change. Since HHS did not provide 60-day notice that the public health emergency would end January 10, 2023, we can assume the PHE will be renewed again unless Congress passes legislation codifying a specific end date.


Developing a Payment and Spending Strategy to Advance Health Equity: Checklist for Medicaid Decision-Makers

Medicaid agencies make daily decisions about how to spend program dollars and use this opportunity to guide payment strategies to advance health equity. State agencies can involve a variety of stakeholders, including people served by Medicaid, to develop a comprehensive approach to guide spending and payment decisions focused on health equity. A new issue brief provides a checklist of eight key questions that can help state purchasers and other payers develop a robust payment and spending strategy focused on advancing health equity. Each question includes concrete state examples for adopting health equity-focused payment models. The brief, authored by the Center for Health Care Strategies (CHCS), is a product of Advancing Health Equity, a national initiative supported by the Robert Wood Johnson Foundation that is working with states to pursue payment innovations that support health equity. The initiative is led by the University of Chicago in partnership with CHCS and the Institute for Medicaid Innovation.


2022 March of Dimes Report Card

March of Dimes released its 2022 Report Card which shows that the U.S. preterm birth rate increased to 10.5% in 2021—a 4% increase in just one year and the highest recorded rate since 2007. The preterm birth rate has steadily increased since 2014, earning the country a D+ grade in the Report Card. The data also show persistent racial disparities across maternal and infant health measures that were compounded by the COVID-19 pandemic, making the U.S. among the most dangerous developed nations for childbirth. The report shows that the number of preterm births increased from 364,487 to 383,082 for women of all races. Black and Native American women are 62% more likely to have a preterm birth and their babies are twice as likely to die as compared to White women. In 2021, preterm birth rates for Black mothers increased from 14.4% to 14.7% and increased from 11.6% to 12.3% for Native American/Alaskan Native mothers.  What’s more, while Asian women saw a 3% decline in births, they had the largest increase (8%) in preterm births compared to all other women. As a reminder, SHVS recently published a compendium of strategies to improve maternal health outcomes which synthesizes research about the national state-of-play, including state examples, across four domains: maternal health models, quality improvement, workforce and benefits, and eligibility and enrollment/coverage expansion.


Comparing Federal Government Surveys that Count the Uninsured: 2022

With the release of new insurance coverage estimates from surveys conducted by the U.S. Census Bureau, the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention, the State Health Access Data Assistance Center (SHADAC) has updated an annual Comparing Federal Government Surveys that Count the Uninsured brief. In the brief, SHADAC presents current and historical national estimates of uninsurance along with the most recent available state-level estimates from these surveys (where possible). SHADAC also discusses the main reasons for variation in the estimates across the different surveys as well as possible reasons for incomparability of estimates across and within the surveys.


State updates: AL, CA, CO, DC, IA, MN, NJ, NC, OK, OR, TX, VA & WI

  • Alabama – Alabama Medicaid will increase the annual physician office visit maximum to 32 for Medicaid enrollees receiving cancer treatment during the calendar year. This increase will be available for each calendar year in which the recipient is receiving cancer treatment and is applicable for all cancers.
  • California – Covered California launched its new television advertising campaign on Monday to promote enrollment and encourage the uninsured throughout the state to sign up for quality health insurance. The multi-language campaign builds on the successful theme of “This Way to Health Insurance,” which has helped Covered California enroll a record-high 1.7 million people.
  • Colorado – The Colorado Department of Health Care Policy and Financing invited interested stakeholders to participate in an Older Adult Stakeholder Meeting to hear the findings of an environmental scan of evidence-based practices that could be used to develop innovative systems of care pilot programs. The goal of the environmental scan is to develop pilot programs that pair older adults with college students (or similar) who need affordable housing; provide college credits for college students employed as home and community-based (HCBS) service providers; provide low/no cost child care to HCBS direct support professionals (DSPs); and provide total compensation packages for DSPs.
  • District of Columbia – The DC Health Benefit Exchange Authority (DCHBX) Executive Board unanimously voted to adopt recommendations based on work of the DCHBX Standard Plans Working Group to help address health disparities in pediatric mental health treatment. Starting in Plan Year 2024, children covered by a standard plan on DC Health Link will only have to pay a $5 copay, with no deductibles, for outpatient mental health visits, including specialist visits, and no limit on the number of visits. Additionally, this vote reduces prescription copays for child mental healthcare to $5, with no deductibles.
  • Iowa
    • Iowa Medicaid issued a request for feedback on proposed telehealth and home and community-based service recommendations to continue and discontinue after the end of the federal PHE. Iowa Medicaid is encouraging members, providers and stakeholders to provide feedback on the proposed plan.
    • Iowa Total Care is piloting a new doula program in three counties. Partnering with Health ConnectOne (HCOne) and The Doula Network (TDN), the Doula Program aims to provide birthing parents with culturally sensitive doula services to ease the burden of access, address cultural barriers, and improve maternal and infant health outcomes. HCOne and TDN provide customized coaching, training, technical assistance, and program development services to doula partners so the doulas can support communities and families.
  • Minnesota – MNsure CEO Nate Clark highlighted that tax credits in southeastern Minnesota are going up by $120/month, on average, in 2023 for eligible households in a 10-county area. On average, eligible households in southeastern Minnesota are projected to save $860/month, or about $10,320/year, thanks to the larger tax credits in 2023. Eligible Minnesotans will pay about 10% less on premiums next year than they pay currently.
  • New Jersey – The New Jersey Department of Health announced $116.5 million in grants that will help strengthen public health infrastructure across the state. The first grant, in the amount of $75 million, was awarded to the New Jersey Association of City and County Health Officials to administer grants to eligible county, municipal and regional local health departments across the state. The goal of these funds is to support the development or expansion of long-term health infrastructure improvements with a key emphasis on health equity, diversity, inclusion, and accessibility.
  • North Carolina – The North Carolina Department of Health and Human Services is releasing a white paper describing strategies to reduce firearm violence and misuse. The white paper provides a framework for how to address firearm violence and misuse which requires good data to identify trends, risk and protective factors and prioritize layered, evidence-informed and consensus-driven approaches that reduce firearm misuse, injuries and deaths.
  • Oklahoma – The Oklahoma Health Care Authority released a request for proposals seeking at least three contracts to provide comprehensive integrated health services including, but not limited to, medical, behavioral health, and pharmacy services to serve Medicaid populations through SoonerSelect. Responses are due by February 8, 2023.
  • Oregon
    • The Oregon Department of Consumer and Business Services is asking for the public’s help before the 2022 public hearing on prescription drug prices. The department has set up a brief survey for consumers to share their stories about rising prescription drug prices and wants to hear about how increased costs have affected individuals and their families. The public hearing will be held on Thursday, December 1 via Zoom, and will include opportunities for public comment, with Oregon legislators serving as moderators for panel presentations.
    • The Oregon Heath Authority launched a new program in partnership with Color Health to offer free telehealth visits statewide for those at increased risk for severe COVID-19 illness. Through this program, any person in Oregon, regardless of health insurance status, can make a no-cost telehealth appointment with a clinician. During the appointment, they can find out if they are eligible for COVID-19 oral antiviral medicine.
  • Texas – The Texas Health and Human Services Commission announced it is seeking public input on contract requirements for transitioning the state’s Medicaid vendor drug program to managed care. The program oversees outpatient drug benefits for Medicaid fee-for-service, Medicaid managed care, and CHIP, including management of a single program-wide formulary, preferred drug list, and prior authorization. Management of these functions will transfer to each Medicaid managed care plan on September 1, 2023. Public input is open until December 4.
  • Virginia – Virginia Medicaid will launch Cardinal Care, the new brand that includes all health coverage programs for all Virginia Medicaid members, on January 1, 2023. The new program will aim to eliminate gaps in care as enrollees’ needs change over time, streamline the enrollment process, and simplify program information. Enrollees’ transition to Cardinal Care will be automatic, and Cardinal Care will continue to offer members the same programs and services and will not reduce or change any existing coverage.
  • Wisconsin – The Wisconsin Department of Health Services announced that Medicaid cost coverage for nursing homes will increase from 77% for fiscal year 2022 to 91% for fiscal year 2023. The increase implements one of the key recommendations from the Governor’s Task Force on Caregiving, tying a significant amount of the increase to direct care nursing and supporting the healthcare workforce in both wages and benefits.