In This Week’s Update:
- New SHVS Resources: Equity in Managed Care and Increasing Response Rates among Underrepresented Groups
- State Updates: AZ, CA, CO, KS, LA, ME, NM, OH, OK, OR & TX
- Strategic Vision for the CMS
- Incorporating Equity into Trauma-Informed Care
- State Strategies to Increase COVID-19 vaccines in rural areas
Resources on Equity in Managed Care and Increasing Response Rates Among Underrepresented Groups
State Health and Value Strategies (SHVS) published two new resources for states. The first, Promoting Health Equity in Medicaid Managed Care: A Guide for States, describes recommended process steps for states to integrate a focus on health equity in their Medicaid managed care programs. The guide focuses on the internal agency commitments and changes that are necessary to address systemic barriers to accessing high quality health care and improving health outcomes, particularly among populations that experience persistent health inequities.
The second is an expert perspective, New York State of Health Pilot Yields Increased Race and Ethnicity Question Response Rates highlighting an effort by New York’s state-based marketplace, NY State of Health, to improve the completeness of race and ethnicity data that applicants share when applying for Medicaid; Child Health Plus, the state’s Children’s Health Insurance Program (CHIP); the Essential Plan, New York’s Basic Health Program (BHP); or Qualified Health Plan (QHP) coverage through its Marketplace. Updates follow.
- Arizona – The Arizona Health Care Cost Containment System, through the Children’s Behavioral Health Services Fund, is now providing behavioral health care services to elementary and secondary school students regardless of insurance coverage. Services can include counseling, therapy, and other treatments for common mental illnesses like anxiety, depression, and other mental health issues students face. Students enrolled in a pre-K through grade 12 public institution who have little to no health care insurance only need a referral from a participating school to take advantage of the program.
- Governor Gavin Newsom’s administration announced the next phase of its homeless housing initiative, Homekey, with the release of funds from the Governor’s $2.75 billion investment to expand the program to purchase and rehabilitate buildings and convert them into up to 14,000 more permanent, long-term housing units for people experiencing or at-risk of homelessness. The California Department of Housing and Community Development released the latest Notice of Funding Availability for local governments to apply for Homekey funding.
- Covered California announced a special enrollment period for Californians who will soon be losing the federal financial help that is allowing them to continue receiving health insurance through COBRA. When the American Rescue Plan’s COBRA subsidies cease at the end of September, consumers who are still eligible to continue their COBRA coverage can choose to pay the full premium or switch to Covered California, either immediately or during the upcoming open-enrollment period, to have new coverage for all of 2022.
- Colorado – The Colorado Department of Public Health and Environment updated its COVID-19 website to include a new vaccine breakthrough data visualization. The new visualization provides proportional case, hospitalization, and death rates by vaccination status as well as toggles that allow the user to display breakthrough data by vaccine type and demographic information like age, gender, and race/ethnicity.
- Kansas – Governor Laura Kelly sent a letter to Congressional leadership urging Congress to pass legislation that would create a program filling the coverage gap in Kansas and other states that have not expanded Medicaid. In the letter, Governor Kelly states that passing H.R. 4595, the Medicaid Saves Lives Act, or including similar provisions in the pending budget and reconciliation process, would allow eligible residents of non-expansion states like Kansas to access full Medicaid coverage at no additional cost to states or the federal government and would provide health care to approximately 165,000 Kansans.
- Louisiana – The Louisiana Department of Health (LDH) announced that Patrick Gillies joined LDH as the new Medicaid Executive Director. Gillies has more than 20 years of experience in health care administration on both the state and federal levels.
- Maine – The Maine Department of Health and Human Services announced the hiring of a director for the Maine Center for Disease Control and Prevention’s Office of Population Health Equity, a newly established office devoted to identifying and addressing health disparities throughout Maine. Ian Yaffe, who currently serves as Chief Operating Officer of DHHS’ COVID-19 Social Supports Program, was selected following a national search.
- New Mexico – The New Mexico Human Services Department submitted its general fund budget request of $1.4 billion for the next fiscal year. The department is proposing 14 program expansions and changes that are designed to improve programs and services to New Mexicans, such as extending postpartum Medicaid benefits, implementing evidence-based and trauma responsive behavioral health care, and developing a Crisis Now System of Care to promote use of 988, a nationwide mental health crisis and suicide prevention number.
- The Ohio Department of Medicaid projected a go-live date for the Next Generation managed care launch for July 1, 2022. While the initial timeline targeted implementation for January 2022, it did not anticipate the persistence of COVID-19 and its impact on individuals served by the program and their providers.
- The Ohio Joint Medicaid Oversight Committee of the Ohio General Assembly reported that per member per month Medicaid costs are expected to rise between 3.1 percent and 4.0 percent in fiscal 2022 and between 3.1 percent and 4.1 percent in fiscal 2023, according to an analysis by actuarial firm Optumas.
- Oklahoma – The Oklahoma Health Care Authority has created a mobile-friendly version of MySoonerCare.org, Oklahoma’s Medicaid online enrollment portal. The secure website allows more Oklahomans to apply and renew their SoonerCare benefits from their smartphones. Nearly 30 percent of attempted or completed applications received in July were done by Oklahomans using a smartphone. Before the update, applicants and members would navigate the application as they do with a traditional desktop browser, which resulted in having to log in and out or quit the application process until they could access a computer.
- Oregon – The Oregon Health Authority is encouraging families with newborns to take advantage of the free, optional nurse home visiting program known as Family Connects Oregon, which continues its roll-out in communities statewide. Family Connects Oregon, which launched in February 2020 following the passage of legislation, provides voluntary, universally offered nurse home visiting services to all families with newborns living in the state, no matter their income, location or insurance status. Oregon is the first in the country to offer these services statewide and require private insurance providers to pay for them.
- The Texas Health and Human Services Commission (HHSC) released a draft of its request for proposals (RFP) for STAR Health, which provides integrated physical and behavioral health services to children and young adults in the foster care system. Dental, vision, pharmacy, and personal care services are also included. The final RFP is scheduled for release on October 25, 2021. HHSC will award one, six-year contract with up to three two-year renewals.
- In anticipation of the upcoming solicitation and resulting contract for STAR+PLUS, which serves individuals who have disabilities or are age 65 or older, HHSC issued a request for public comment seeking input on the proposed Best Value Criteria the agency will use to evaluate and select the successful respondent.
A Strategic Vision for the Centers for Medicare and Medicaid Services (CMS)
In a new blog post CMS Administrator Chiquita Brooks-LaSure reflects on her first 100 days as CMS Administrator and lays out the strategic vision for the agency: “CMS serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes.” Administrator Brooks-LaSure highlights that the work CMS undertakes over the next few years should be aligned with one or more of six strategic pillars: advancing health equity by addressing the health disparities that underlie our health system; building on the ACA and expanding access to quality, affordable health coverage, and care; engaging partners and the communities that are served throughout the policymaking and implementation process; driving innovation to tackle our health system challenges and promote value-based, person-centered care; protect CMS programs’ sustainability for future generations by serving as a responsible steward of public funds; and fostering a positive and inclusive workplace and workforce, and promoting excellence in all aspects of CMS’s operations.
Incorporating Racial Equity into Trauma-Informed Care
With support from the Robert Wood Johnson Foundation, the Center for Health Care Strategies published a new brief that outlines six considerations for health systems and provider practices looking to integrate a focus on racial equity to enhance trauma-informed care approaches and promote racial justice. It draws from the experiences of two organizations participating in the Advancing Integrated Models initiative, also funded by the Robert Wood Johnson Foundation. In recent years, trauma-informed care has become a valuable tool to assist health care providers in delivering more person-centered care. Trauma-informed care seeks to both acknowledge the role trauma plays in people’s lives and the impact it has on their health and well-being, and to engage in practices that prevent re-traumatizing individuals. As the health care sector, like many industries, faces its own racial reckoning, trauma-informed approaches to care should not overlook the critical impact of racism and racialized trauma on patient health and staff well-being. The work of trauma-informed care requires a nuanced understanding of not only how trauma impacts the lives and care of patients, but the root causes behind that trauma. Health care organizations that adopt a trauma-informed approach to care should acknowledge and be held accountable for the historical and present-day trauma experienced by patients and staff from communities of color.
State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities
The National Governors Association released a paper that pulls together considerations and examples of promising practices for governors, including building vaccine confidence through consistent, transparent and factual communication; establishing straightforward pathways for individuals to access vaccines; and, developing and streamlining sustainable systems to strategically allocate and distribute vaccines to rural and frontier populations. Governors have the authority to pull together stakeholders and the ability to address the long-standing and emerging issues impeding vaccine confidence, access and uptake in rural communities. Because trusted messengers are vital to increasing confidence, governors might consider convening state experts and local partners to establish a strong foundation of trust. They may also allocate resources to build on existing programs and processes and create new, sustainable strategies that will both improve vaccination rates as the pandemic continues and prepare future public health initiatives.