October 15 Update: Drop in average premiums; New tool for analyzing the opioid epidemic; Chart book of Medicaid expansion benefits

The Centers for Medicare & Medicaid Services (CMS) announced this week that the average premiums for individual health coverage on healthcare.gov, the federal marketplace, will drop by 1.5 percent for 2019, marking the first-time average premiums have fallen since the implementation of the federal exchange in 2014. Kaiser Health News published an article that examines the factors contributing to the average decline in premiums.

Also this week, CMS took several steps to support both Florida and Georgia in response to Hurricane Michael. Health and Human Services Secretary Alex Azar declared a public health emergency in Florida on Wednesday, before Michael made landfall, and a public health emergency in Georgia on Thursday. Our thoughts are with all those who are struggling in the aftermath of the hurricane and working in both states to care for affected residents. Updates follow.

  • Alabama – Governor Kay Ivey announced that CMS has approved a new statewide care-management program, the Integrated Care Network (ICN). The ICN program offers more community options for Medicaid long-term care recipients who live in a nursing facility, or receive services in their homes through Medicaid’s Elderly and Disabled waiver or the Alabama Community Transition waiver.
  • Florida – The Agency for Health Care Administration and the Department of Health announced that 20 hospitals in Florida have achieved the federal Healthy People 2020 Maternal and Child Health goal of reducing Cesarean section (C-section) rates for first-time mothers with low-risk pregnancies. Florida’s C-section rate for 2017 is 37.2 percent, while the Healthy People 2020 goal is 23.9 percent.
  • Idaho – The Department of Health and Welfare (DHW) will hold several meetings next week on different aspects of DHW’s Infant Toddler Program (ITP), which coordinates early intervention services for children zero-to-three who have a development delay. The regional meetings will focus on the branding and marketing strategies for ITP as well as recruitment, and education and outreach to parents.
  • Louisiana – Registration is underway for the Department of Insurance’s 2018 Annual Health Care Conference on October 23. The conference will feature local and national health care experts discussing issues including the future of the individual health market in Louisiana, and how the health insurance industry will be affected by recent federal initiatives, including the newly released rules on short-term plans and association health plans.
  • Oregon – Oregon Health Authority (OHA) Director Patrick Allen released a statement in response to the U.S. Department of Homeland Security’s proposed public charge rule change in which he states that OHA is closely monitoring the proposed rule change, studying its impacts, and working with community partners to support affected Oregonians. SHVS recently held a webinar reviewing the proposed rule and its potential impacts for Medicaid and other health-related public benefits.
  • Pennsylvania – Governor Tom Wolf and cabinet officials from the Department of Human Services and the Department of Drug and Alcohol announced grant funding from the federal government to support kinship navigator programs to help address the opioid crisis in the state. The grant will help the state increase support for grandparents, other family members and children affected by the opioid crisis by funding kinship navigators, who can help caregivers access available benefits and services.
  • Utah – The Utah Department of Health released a report based on surveys of students that finds mental health and exposure to e-cigarettes continues to be of concern in adolescent health. The state conducts the survey every two years and uses the results to identify trends in risk behaviors or evaluate programs that increase protective factors.
  • Vermont – The Vermont Individual Mandate Working Group posted a draft report for public comment. The preliminary report highlights recommendations on how the individual mandate would potentially be administered and enforced in the state, including those related to defining “minimum essential coverage” in the state and which populations are exempted from mandatory health coverage.

Upcoming Webinar—Save the Date!

Safeguarding Financial Stability of Provider Risk-Bearing Organizations

Tuesday, October 23, 2018 3:30 to 4:30 pm ET

An increasing number of provider organizations are entering into risk-based contracts with payers where they are accepting the financial risk of care. This financial liability is often shared with payers, and maximum risk exposure is typically capped. SHVS is hosting a webinar that will explore state options for regulating provider risk-bearing organizations. During the webinar, technical experts from Bailit Health will review approaches states could take to overseeing their risk-bearing organizations and highlight examples from states that have elected to regulate to protect against provider insolvency.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e6b147943035f6608768d09afd4a2c562

New Tool Provides In-Depth County Level Data on Impact of Opioid Epidemic Across the United States

NORC at the University of Chicago and the U.S. Department of Agriculture Rural Development released a community assessment tool that illustrates the impact of the opioid epidemic on counties across the United States and the epidemic’s relation to socioeconomic factors such as unemployment, poverty, education, and disability. The National Opioid Misuse Community Assessment Tool, an interactive data visualization, integrates overdose mortality rates for counties in each of the 50 states with data on unemployment, poverty, and disability, among others. Users can compare county-level information to the rest of a state and to the nation and see a visual representation of how the data has changed over time. The tool provides fact sheets to support community planning and response efforts. Data covers the time period from 2007 through 2017.

Getting to Know the Centers for Disease Control and Prevention’s 6|18 Initiative

A recent post for the Journal of Public Health Management and Practice blog, highlights five things to know about the Centers for Disease Control and Prevention’s (CDC) 6|18 Initiative now underway in 34 states, territories, and localities across the country. The blog post, authored by the Center for Health Care Strategies, CDC and the Robert Wood Johnson Foundation, reviews how the 6|18 Initiative is fostering collaboration between departments of public health and state Medicaid agencies and describes the ways in which states are leveraging the initiative to increase access to Medicaid coverage. The Initiative focuses on six high-burden health conditions and 18 associated evidence-based interventions designed to control costs and improve health outcomes.

Chart Book Profiles Benefits of Medicaid Expansion

Our friends at the Center on Budget and Policy Priorities published a chart book based on the growing body of research that documents the benefits of Medicaid expansion. The charts included illustrate how Medicaid expansion has led to wider health coverage, better access to health care, better health outcomes, greater financial security, increased support for employment, improved substance use treatment and improvements in the fiscal health of rural hospitals. The chart book also includes several charts that document how Medicaid is more efficient and cost-effective compared to private insurance. If you are interested in the underlying research on the benefits of Medicaid expansion, we recently published a literature review produced by Manatt Health that highlights articles published between January and August 2018 that report on the positive impacts of Medicaid expansion.