November 26 Update: Additional HRA Guidance; Ingredients for Successful Housing First Initiatives; Opportunity for Former Medicaid Directors

Last Monday, the Treasury Department and the Internal Revenue Service released additional guidance regarding health reimbursement arrangements (HRAs) and other account-based health benefits. The guidance addresses the interaction between the tri-department HRA proposed regulations released October 23 and existing provisions such as the employer mandate. State Health and Value Strategies will be addressing the implications for states of these proposals in a webinar on Wednesday, November 28 at 2:00p.m. (see the link below to register).

Also last week, Sabrina Corlette at Georgetown’s Center on Health Insurance Reforms penned an Expert Perspective on the proposed marketplace program integrity rule, which sets forth a set of new standards for the Affordable Care Act marketplaces. Updates follow.

  • Colorado – Governor Hickenlooper appointed two board members to the Board of Directors of Connect for Health Colorado, the state’s official health insurance marketplace. Lorez Meinhold, a Senior Policy Director at Keystone Policy Center, was newly named to the board while David Padrino, the Chief of Staff to the Lieutenant Governor and the state’s Deputy Chief Operating Officer, was re-appointed to a board seat he held previously.
  • Delaware
    • Governor John Carney signed an Executive Order establishing health care spending and quality benchmarks for the state. The order creates a subcommittee of the Delaware Economic and Financial Advisory Council that will focus on bettering health care spending and quality across the state by working closely with the Delaware Health Care Commission.
    • As part of the State Innovation Model initiative, the Delaware Health Care Commission awarded the first value-based payment reform mini-grant to Christiana Care Health System to test a new reimbursement model. The model is designed to foster behavioral health integration within primary care practices focusing on a subset of Medicaid members with chronic behavioral health conditions.
  • Kentucky – The Centers for Medicare & Medicaid Services approved Kentucky’s section 1115 demonstration project, “Kentucky Helping to Engage and Achieve Long Term Health” following a review of the second round of comments.
  • New Mexico – At a recent beWellnm (the state’s official health insurance marketplace) board meeting, the board reviewed three motions to authorize the CEO to continue efforts related to the move to a state-based exchange.
  • Oregon – A new study conducted by the Oregon Health Authority found that high-dose influenza vaccine reduces hospitalization for the virus among Oregon seniors. The study showed that high-dose flu vaccine was 31 percent more effective at preventing senior flu-related hospitalizations than the standard-dose flu vaccine during the 2016-2017 season.

Upcoming Webinar – Save the Date!

HRA Proposed Regulations: State Implications and Responses

Wednesday, November 28, 2018 2:00 p.m. to 3:00p.m. ET

State Health and Value Strategies will host a webinar for state officials to discuss the implications of the newly proposed regulations on health reimbursement arrangements (HRA) and possible state responses. The proposed rule represents the third of the three policy changes initiated by the October 12, 2017 Executive Order, which also called for loosening the rules on short-term limited-duration coverage and association health plans. Like those changes, the HRA proposed rule could have profound implications for health insurance markets, consumers, and Marketplaces. The webinar will feature Jason Levitis, who led ACA implementation at the U.S. Treasury Department, as well as experts from Georgetown University’s Center on Health Insurance Reforms and Manatt Health.

Registration (required) at the following link:

Lessons Learned: How to Launch a Successful Housing First Program

The Camden Coalition’s blog The Hotspot profiled their lessons learned from standing up their Housing First initiative. The multi-partner citywide program follows a national model that adopts a recovery-oriented approach to ending homelessness by centering on moving individuals experiencing chronic homelessness into permanent housing and providing support services without preconditions, such as sobriety or mandated treatment. Preliminary findings show more than a 60 percent reduction in inpatient visits and emergency room use for enrolled patients and the blog post features the five “keys to success” the Coalition has identified since launching the initiative in 2015.

Wanted: Former Medicaid Director to Act as Strategic Advisor

The National Association of Medicaid Directors (NAMD) announced a new contract opportunity to support its Leadership Development portfolio. NAMD is looking to engage a Senior Strategic Advisor: a former Medicaid Director who has recently left his/her position and wants to continue to make meaningful and positive contributions to the critical health care program that is Medicaid. Among other responsibilities, the advisor will work one-on-one with interested Medicaid Directors and their senior teams to provide strategic guidance and support and engage, coach and orient new Medicaid Directors to an increasingly complex, politicized and sophisticated health care program. NAMD has also posted an expression of interest form for those states interested in receiving support from the contracted Senior Strategic Advisor.