September 30 Update

In This Week’s Update:

  • Health Equity Webinar Recap
  • State Updates: CT, MD, ME, MI, PA, & WI
  • New Coverage Data from Census Bureau
  • Kentucky’s Medicaid Work Requirements
  • Health-Care Led Jail Reentry Pilot


Health Equity Webinar Recap

Last week, State Health and Value Strategies hosted the fourth webinar in its series on health equity through managed care. During the webinar, Health Equity and Medicaid Managed Care: MCO Contract and Performance Requirements, Oregon and Michigan shared examples and lessons learned from implementing managed care contractual requirements designed to reduce health disparities. The discussion highlighted strategies for states to work with managed care to advance health equity, and if you missed the webinar, the slides are available on the SHVS website, as well as a recording. You can register for the last webinar in the series on October 22 which will feature a Medicaid managed care organization sharing their experience addressing health inequities among plan enrollees.


State Updates: CT, MD, ME, MI, PA, & WI

  • Connecticut – Access Health CT, the state-based marketplace, is hosting a series of community-based educational sessions, known as “Healthy Chats.” These events will help Connecticut residents become familiar with the open enrollment period that starts on November 1, 2019, including understanding costs and the financial help that is available, choosing an insurance plan, and how and where to enroll.
  • Maine – Governor Janet Mills and the Maine Health Access Foundation announced the award of a $750,000 grant from the Robert Wood Johnson Foundation to improve health insurance coverage in Maine. The grant will help to fund outreach and marketing, consumer education, and enrollment assistance in 2019 and 2020, through a unified campaign to encourage Mainers to sign up for expanded MaineCare (Medicaid) or affordable insurance through the marketplace.
  • Maryland – Governor Larry Hogan announced that the Maryland Insurance Administration has approved an average 10.3 percent premium rate decrease for individual health insurance plans with an effective date of January 1, 2020. The new rates reflect the impact of the state reinsurance program, which has helped to lower rates and stabilize the individual health insurance market after years of major premium increases. Coupled with last year’s decrease of 13.2 percent, the two-year cumulative impact is a rate decrease of more than 22 percent versus 2018 premiums.
  • Michigan – Governor Gretchen Whitmer signed into law a bill revising the reporting requirements for Medicaid recipients who will be subject to work requirements. SB362 reflects a bipartisan effort to address overly burdensome reporting requirements. In a signing statement, the governor called on the legislature to take additional steps to prevent coverage losses by enacting a provision that automatically suspends work requirements if data shows that significant numbers of Michiganders are on track to lose their health care due to the new compliance requirements.
  • Pennsylvania
    • Department of Human Services (DHS) Secretary Teresa Miller participated in Politico’s Health Care Innovators: Addressing Social Determinants of Health panel to discuss increasing access to primary care, supporting innovation in whole-person care and value-based purchasing, and fostering a health care system that addresses disparities in health care delivery and health equity. DHS is working toward creating a unified system to better connect health care providers and social services organizations to improve coordination between both groups to better monitor referrals, individuals’ use of and progress with services, and to work together toward better long-term health outcomes.
    • Insurance Commissioner Jessica Altman announced the addition of Pennsylvania Health and Wellness and Oscar Health to the list of commercial insurers in Pennsylvania that have agreed to align prior-authorization processes for opioid prescriptions and access to medication-assisted treatment with those now being used by both Medicaid fee-for-service and managed care programs in the state. Both Oscar Health and Pennsylvania Health and Wellness are new entrants to the Pennsylvania insurance market, offering coverage to individuals and families on and off the health insurance exchange.
  • Wisconsin – Last week, Governor Tony Evers kicked off the first meeting of the Caregivers Task Force in Milwaukee. The task force was formed as part of Executive Order #11 issued by the governor in February. The group is looking for ways to attract and retain a strong direct care workforce, provide greater access to care, and improve the quality of caregiving in the state.


Webinar on U.S. Census Bureau New Coverage Data

The State Health Access Data Assistance Center (SHADAC) is hosting a webinar on Tuesday, October 1 that will provide an overview of the 2018 health insurance coverage estimates from two key, large-scale federal data sources: the American Community Survey (ACS) and the Current Population Survey (CPS). New 2018 data on health insurance coverage from ACS show a nationwide increase in uninsurance from 8.7 percent in 2017 to 8.9 percent in 2018. State-level estimates within the ACS indicated uninsurance also grew significantly in eight states, while decreasing significantly in just three. The webinar will examine the new estimates with technical insight from experts at the U.S. Census Bureau, which administers both the ACS and CPS, and from SHADAC researchers. Attendees will learn about when to use which estimates from which survey, and how to access the estimates via Census reports and state-level estimates from the ACS using SHADAC tables. Register here for the webinar.


Survey of Kentuckians’ Understanding of Medicaid Work Requirements

The Commonwealth Fund published an issue brief detailing the findings from a study that examined several aspects of Kentucky’s Medicaid work requirements, and the potential impact of the policy on employment and health insurance. Researchers conducted phone surveys in November and December 2018 with 500 low-income Kentuckians (including 297 who reported having Medicaid coverage) and asked about their understanding of, and experiences with, the state’s work requirements and their current work or other community engagement activities. The researchers found that nearly half (46%) of Kentuckians enrolled in Medicaid said they had not heard anything about the state’s plans for a new work requirement. Minorities and those with less education were less likely to have heard about the policy. While a federal judge blocked implementation right before the work requirement was scheduled to take effect, eighty percent of low-income Kentuckians reported they were unsure whether the requirement was in effect, and only 8 percent knew the policy was not in effect. 


Lessons Learned from a Health-Care Led Jail Reentry Pilot

In an article published in NEJM Catalyst the Camden Coalition shared lessons, challenges, and outcomes from Camden RESET, a jail-based reentry pilot that enrolled individuals while they were incarcerated to provide person-centered wraparound care management. Camden RESET, funded by Arnold Ventures, was the result of the Camden Coalition looking to build on what they had learned through the Camden Core Model about people who repeatedly cycle in and out of correctional facilities. When these individuals are released back into the community, many rely extensively on hospitals, rather than on outpatient primary or specialty care, for their health care needs. The Camden Coalition wanted to understand whether, and how, they could be effective in improving the health and well-being of this population. In the article, the authors draw on the Camden RESET care team’s experiences, program participants’ perspectives, and data analysis to share lessons learned from the pilot. Key takeaways include: the importance of cross-sector data sharing relationships; authentic healing relationships with providers give participants the ability to build trust, hope, and competence; and investing time and resources in building partner organizations’ capacity helps build complex care ecosystems.