September 21 Update

In This Week’s Update:

  • New SHVS COVID-19 Resources
  • CMS Medicaid Fiscal Accountability Rule
  • COVID-19 State Updates: AZ, MN, NC, NY, OR & WA
  • Other State Updates: CA, MD, NJ, OR & WI
  • New SHVS Webinar: Measures for Quality and Equity
  • The Role of Racial Justice in Building a Culture of Health
  • Toolkit: Improving Care for Complex Care Populations


New SHVS COVID-19 Resources

Last week State Health and Value Strategies (SHVS) published and updated several resources on its COVID-19 page:

  • SHVS published a new expert perspective, Maintaining Medicaid and CHIP Coverage Amid Postal Delays and Housing Displacements. The expert perspective highlights strategies that state Medicaid and Children’s Health Insurance Program (CHIP) agencies may consider to help mitigate coverage losses and remain connected to beneficiaries.
  • SHVS also updated an expert perspective, Advances in States’ Reporting of COVID-19 Health Equity Data. The expert perspective provides an update on states’ reporting of health equity data related to cases, mortality, hospitalizations, and testing, as well as updates on new state activity related to data collection. All states now report race or ethnicity data for either COVID-19 cases or mortalities.
  • Last week SHVS hosted a webinar that reviewed examples of specific strategies states implemented between April and August 2020 to increase payments to Medicaid providers in financial distress as a result of decreased health care utilization. A slide deck and recording are posted on the SHVS website.


CMS Medicaid Fiscal Accountability Rule

In a tweet last week, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced that, due to concerns raised by states and providers about unintended consequences of the proposed Medicaid Fiscal Accountability Rule, CMS would be withdrawing this rule from the regulatory agenda. When the rule was released in November 2019, states, providers, and other stakeholders raised concerns, with many citing the far-reaching implications for state budgets, provider viability, and beneficiary access. With the withdrawal of the rule, states and providers will have more certainty on the mechanisms to finance their Medicaid programs.


COVID-19 State Updates: AZ, MN, NC, NY, OR & WA

  • Arizona – Given anticipated budgetary limitations due to the COVID-19 pandemic, the Arizona Health Care Cost Containment System (AHCCCS) announced that it has elected to shift course and focus on a series of smaller-scale, cost-effective initiatives within the parameters of the existing Medicaid program and refrain from the pursuit of a broader Whole Person Care Initiative in conjunction with its five-year Section 1115 Waiver renewal request this December. The smaller-scale initiatives will include sourcing a new closed-loop referral system for providers to identify social risk factors and manage referrals and awarding a contract to a single statewide housing administrator to manage all AHCCCS permanent supportive housing subsidies, beginning October 2021.
  • Minnesota – The Department of Human Services released a bulletin announcing Long-Term Services and Supports (LTSS) policy amendments related to the COVID-19 emergency. The bulletin provides information to lead agencies about policy amendments and instructions to implement amended LTSS policy related to assessment, reassessments, and continuation of services to people during the COVID-19 emergency.
  • New York – Governor Andrew Cuomo announced that the COVID-19 Special Enrollment Period for uninsured New Yorkers will be extended through December 31, 2020.
  • North Carolina – The Department of Health and Human Services has been awarded a $35 million State Opioid Response grant from the Substance Abuse and Mental Health Services Administration. Because the COVID-19 pandemic has made it more difficult for some individuals to access treatment for substance use disorder, North Carolina has experienced a spike in opioid overdoses. The grant will help the department increase access to treatment and services.
  • Oregon and Washington – Governor Gavin Newsom announced that Washington and Oregon, members of the Western States Pact, will participate with California in piloting a project to test promising exposure notification technology. These states join other members of the Western States Pact, Colorado and Nevada, along with states and universities across the country, in piloting this technology, which will test the Exposure Notification Express mobile application pioneered by Google and Apple. The app confidentially notifies individuals who may have been exposed to someone who tested positive for the virus.


Other State Updates: CA, MD, NJ, OR & WI

  • California
    • Covered California announced that the statewide average rate increase for dental coverage in 2021 will be 2.3 percent. The standard benefits for all Covered California enrollees include dental coverage for children, but not for adults. Consumers can purchase optional family dental coverage as an “add-on” to their Covered California health plan.
    • Governor Gavin Newsom announced the first round of awards for Homekey, California’s $600 million program to purchase and rehabilitate housing (including hotels, motels, vacant apartment buildings, and other properties) and convert them into permanent, long-term housing for people experiencing or at risk of experiencing homelessness. Nearly $76.5 million was awarded by the Department of Housing and Community Development for 10 projects in seven California communities totaling 579 units.
  • Maryland – Governor Larry Hogan announced that Maryland Insurance Commissioner Kathleen A. Birrane has approved an average 11.9 percentage premium rate decrease for individual health insurance plans with an effective date of January 1, 2021. As a result, for the third consecutive year, all individual insurance rates in Maryland under the ACA will see significant decreases.
  • New Jersey – Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride announced $3.5 million in grant funding for community organizations to serve as state Navigators to provide free outreach, education, and enrollment assistance to residents shopping for health insurance during this year’s open enrollment period (OEP). The increased investment is made possible by the state’s move to its own health insurance marketplace, Get Covered New Jersey, for the upcoming year. New Jersey’s OEP will run from November 1, 2020 to January 31, 2021.
  • Oregon  
    • The Oregon Health Authority released the 2019 CCO Metrics Report, which shares the results of Oregon’s pay-for-performance quality incentive program for its Coordinated Care Organizations (CCOs). To earn their full incentive payment, CCOs must meet benchmarks or improvement targets on at least 12 of the 16 measures, achieve a performance goal related to enrollment in patient-centered primary care homes, and report data for two electronic health records metrics.
    • Governor Kate Brown convened the first meeting of the Racial Justice Council to address systemic racism in Oregon. The Council is an advisory group to the Governor with subgroups focused on criminal justice reform and police accountability, health equity, economic opportunity, housing and homelessness, environmental equity, and education. The council will provide principles and recommendations that center racial justice and economic recovery to the Governor to inform the 2021-2023 Governor’s Recommended Budget and legislative agenda.
  • Wisconsin – The Department of Health Services issued a press release announcing that Wisconsin callers to the National Suicide Prevention Lifeline are much more likely to speak with a Wisconsin-based counselor with the opening of a new Wisconsin call center funded by a grant from the department.


New SHVS Webinar: Measures for Quality and Equity

Monday, September 28, 2020, 3:00 to 4:00 p.m. EST

SHVS is hosting a webinar that will feature technical experts from Bailit Health discussing the Buying Value suite of resources to support state use of performance measures as they assess and improve value with managed care plans and accountable provider entities. Buying Value consists of two free Excel-based tools. The Buying Value Measure Selection Tool assists states, employers, consumer organizations, and providers in creating and maintaining aligned quality measure sets. The tool includes nearly 750 measures, including up-to-date versions of 13 federal and national measure sets, a set of disparities-sensitive measures, and six state measure sets. The Buying Value Benchmark Repository is a database of non-HEDIS measures in use by state purchasers and regional health improvement collaboratives, and associated performance data for benchmarking purposes. The repository includes nearly 60 measures from seven measure sets. It contains measures focused on preventive care, social determinants of health, and more. During the webinar, DaShawn Groves, project manager at the D.C. Department of Health Care Finance, will share the District’s experience using the Buying Value suite in the development and monitoring of population health management initiatives in the Medicaid program. This webinar will include a question and answer session during which webinar participants can pose their questions to the experts on the line.

Registration (required) at the following link:


The Role of Racial Justice in Building a Culture of Health

Authored by the Robert Wood Johnson Foundation (RWJF), a new Health Affairs blog post shares highlights from the RWJF 2020 Sharing Knowledge forum, which focused on racial injustice and health. In partnership with the National Collaborative for Health Equity, the meeting showcased rigorous research that examined the foundations of racism as well as the current impacts in society. This blog post outlined several of the key takeaways from the conference on the foundations of racism, its current impacts, and the tools and actions that will be most effective moving forward.


Improving Outcomes and Reducing Cost of Care for Complex Care Populations with Behavioral Health and Social Support Needs: Toolkit for Governors

To assist governors in pursuing improved outcomes and reduced cost of care for complex care populations with behavioral health and social support needs, the National Governors Association (NGA) Center for Best Practices, in collaboration with RWJF and the Commonwealth Fund, conducted an intensive, multi-state technical assistance project and published a new toolkit based on the project. The toolkit features lessons learned from Arizona and Michigan, which served as models for the participating states, and supplements the NGA road map for building complex care programs and the roadmap for a housing as health care approach for this population. States participating in the multi-state technical assistance project gained a firsthand understanding of innovative, evidence-based policies, programs, and practices through a deep dive exchange of lessons learned with governors’ senior advisors in Medicaid, behavioral health, and criminal justice from states leading in complex care work. The toolkit includes approaches from those states and resources from other pioneering states, as well as national and local efforts shared in this project.