November 23 Update

In This Week’s Update:

  • Strategies for Overcoming Barriers to Health Equity
  • Podcast Interview With Dr. Fauci
  • COVID-19 State Updates: CA, DC, MD, MN, NE, NY, PA, VA & WI
  • Other State Updates: MN, OK, OR & WA
  • U.S. Maternity Care Versus Other Developed Countries
  • Health Care Workforce Policy Toolkit
  • Lessons from RI in Increasing Childhood Vaccinations


Strategies for Overcoming Barriers to Health Equity

Last week State Health and Value Strategies (SHVS) published a new issue brief, State Strategies for Overcoming Barriers to Advance Health Equity. The COVID-19 pandemic has highlighted longstanding health inequities which have resulted in an increased risk of sickness and death for people of color and has propelled a nationwide focus on understanding and addressing health inequities. The issue brief explores impediments and accelerants to advancing health equity as states are increasingly being called upon to drive change. You can find additional resources on the SHVS Health Equity Resources page.


Podcast Interview With Dr. Fauci

Also last week, as the nation marked the grim milestone of 250,000 deaths and the COVID-19 pandemic surged across the country, a special episode of the Kaiser Health News (KHN) “What the Health?” podcast featured an interview with Dr. Anthony Fauci. Fauci sat down for an interview with KHN Editor-in-Chief Elisabeth Rosenthal, a fellow physician. As a reminder, SHVS has created a one-stop resource of COVID-19 information for states designed to support states seeking to make coverage and essential services available to all of their residents, especially high-risk and vulnerable people, during the COVID-19 pandemic.


COVID-19 State Updates: CA, DC, MD, MN, NE, NY, PA, VA & WI

  • California – Governor Gavin Newsom announced plans to immediately direct $62 million in one-time funds from the State’s Disaster Response Emergency Operations Account to counties around the state to continue providing housing to current Project Roomkey participants. After consultation with the legislature, the administration is making these available immediately to local governments with Project Roomkey sites so that clients living in motel or hotel rooms under the program will not be forced to return to street homelessness while the COVID-19 pandemic continues to affect California.
  • District of Columbia – The DC Health Benefit Exchange Authority (the state-based exchange) and the Greater Washington Hispanic Chamber of Commerce announced findings from an online survey of residents. Approximately 92 percent of District residents report being worried about the coronavirus pandemic. More than half (56%) are concerned about losing their health insurance, and four out of five residents worry they or their family members could contract COVID-19. The survey also shows that overall COVID-19 concern levels are higher among African American and white residents (both 93%) compared to Hispanic residents (81%).
  • Maryland  
    • Governor Larry Hogan announced that since the Maryland Department of Health launched MD COVID Alert last week, more than 1 million Marylanders have subscribed to the COVID-19 exposure notifications express system. 
    • Governor Larry Hogan also announced the commitment of $70 million in CARES Act funding for new investments in initiatives to protect the health, safety, and well-being of Marylanders during the COVID-19 pandemic. The funding includes support for personal protective equipment, unemployment insurance measures, relief for renters, mass vaccination planning, and support for food banks and foster care.
  • Minnesota – Minnesota announced that, according to a new national report, the state has ranked the best in the nation in sharing essential COVID-19 information through its online dashboard. The report analyzed the quality and breadth of COVID-19 information shared by all 50 states and found that Minnesota had the strongest COVID-19 data dashboard in the nation. SHVS is tracking states’ reporting of health equity data in their COVID-19 dashboards and new state activity related to data collection, including examples of collecting additional data measures and creating task forces to advance health equity.
  • Nebraska – The Department of Health and Human Services is reminding residents that secondary outcomes from the COVID-19 pandemic, including economic stress, are colliding with depression and a rising suicide risk. The department is sharing information and resources for affected residents to get help to prevent suicide.
  • New York – Governor Andrew Cuomo announced a new web application that will help struggling New Yorkers locate benefits to assist them during their time of need. Developed through a public-private partnership with, the user-friendly social services discovery application will help individuals who are either new to or unfamiliar with the state’s social programs network access needed services.
  • Pennsylvania – Governor Tom Wolf announced that more than 500,000 Pennsylvanians have added their phone to the fight to stop the spread of coronavirus by downloading the COVID Alert PA mobile application.
  • Virginia – Governor Ralph Northam signed Virginia’s revised biennial budget to finalize CARES Act funding allocations for previously announced state initiatives to address COVID-19.
  • Wisconsin – Wisconsin Governor Tony Evers and the state Department of Health Services (DHS) pledged an additional $80 million to support Wisconsin’s skilled nursing facilities through the end of the year. In addition, to address critical staffing shortages, DHS is partnering with the Departments of Safety and Professional Services and Workforce Development to enhance existing efforts to strengthen the workforce in Wisconsin’s health care and long-term care settings.


Other State Updates: MN, OK, OR & WA

  • Minnesota – MNsure, the state-based marketplace, announced that since the start of MNsure’s open enrollment period on November 1 nearly 102,000 Minnesotans have signed up for 2021 private health insurance coverage—approximately 10 percent more than this time last year.
  • Oklahoma – The state is designing a statewide health information exchange to allow health information to flow securely to and from authorized organizations and individuals in Oklahoma. The health information exchange is expected to launch in the fall of 2021.
  • Oregon – The Oregon Division of Financial Regulation released data on the most expensive drugs for carriers in the state. Cancer and rheumatoid arthritis brand-name drugs continue to be the most costly in the state. The data will be used to inform drug transparency efforts, and responses from a public hearing focused on drug prices and consumer experiences will be shared with legislators.
  • Washington  
    • The Washington Health Benefit Exchange is reminding residents to sign up for coverage during the open enrollment period and that free in-person help is available. As of Nov. 16, over 188,000 Washingtonians have signed up for 2021 coverage, including over 6,000 new customers. Overall plan selection has increased about 4 percent from last fall at this point. Among new customers, 36 percent have selected a Cascade Care plan. These plans offer deductibles that are on average $1,000 less than other plans, and cover more services prior to meeting a deductible, including primary care visits, mental health services, and generic drugs.
    • Governor Jay Inslee appointed Umair A. Shah, MD, MPH as the new Washington state secretary of health starting Dec. 21. Dr. Shah currently serves as executive director and local health authority for Harris County Public Health in Texas.  


Maternal Mortality and Maternity Care in the United States Compared to Ten Other Developed Countries

Although most are preventable, maternal deaths have been increasing in the United States since 2000. As U.S. policymakers and health care delivery system leaders seek ways to reverse this trend, countries that have achieved lower maternal mortality rates may offer possible solutions. A new issue brief published by the Commonwealth Fund provides an overview of differences in maternal mortality, maternal care workforce composition, and access to postpartum care and social protections in the U.S. compared to ten other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. The issue brief draws from the most recently available data from the Centers for Disease Control and Prevention, the Organisation for Economic Co-operation and Development, and earlier Commonwealth Fund studies.


Informing Health Care Workforce Policy By Leveraging Data: A Toolkit For States

Ensuring an adequately trained and well-distributed health workforce is critical to maintaining the health and well-being of the population. Imbalances in supply and distribution make it challenging for already overburdened providers to meet the needs of their communities and threaten states’ ability to effectively prepare a workforce response in times of public health crises. State policymakers need accurate health care workforce data to assess the supply, demand, and distribution of health care providers and to plan for the future. The National Governors Association published a new toolkit that: describes how health care workforce data can be used to address questions regarding access to care; provides a series of considerations for states to improve their health care workforce data collection; and presents examples of states that have leveraged data effectively to inform policy.


Addressing the Decline in Childhood Immunizations During COVID-19: Rhode Island’s Cross-Sector Response

The Center for Health Care Strategies published a Q&A with Ben Shaffer, Rhode Island’s Medicaid director, that explores how cross-sector partnerships in the state helped accelerate a response to declining vaccination rates during COVID-19. Rhode Island was well-positioned to respond to the needs of young children and families during COVID-19 as a result of its longstanding commitment to children’s health and critical statewide infrastructure that supports an ongoing focus on children. After the initial public health response to the pandemic, state leaders began actively monitoring key children’s health indicators to look for signs of secondary impacts from the COVID-19 pandemic. The Q&A reviews the strategies the state employed in partnership with its managed care plans to increase childhood immunizations. For more information on how states can address delayed care during the pandemic, see the expert perspective Ensuring Medicaid MCO Enrollees Receive Necessary Care During COVID-19.