Update April 25

In This Week’s Update:

  • CMS Health Equity Strategy
  • Toolkit: Preparing for the end of the PHE
  • Consumer Experiences with Healthcare Costs
  • Healthcare Cost Growth Targets and Health Equity
  • Approaches to Increase Primary Care Spending
  • State Updates: CA, KS, KY, MA, MI, MN, NE, RI,  VT & WA

CMS’ Best Practices to Address Systemic Inequities 

Last week CMS outlined an action plan to advance health equity. As part of the plan, CMS Administrator Chiquita Brooks-LaSure charged each CMS Center and Office to build health equity into their core work and aim to better identify and respond to inequities in health outcomes, barriers to coverage, and access to care. Building on the agency’s commitment to make health equity the first “pillar” of its strategic vision, Administrator Brooks-LaSure also invited health care industry leaders to make commitments to advance health equity and work with CMS to share best practices to address systemic inequities in the delivery of care and will convene leaders to ensure sustained progress. The first of these convenings will take place this summer and focus on ways to improve maternal health outcomes. 

Toolkit: Preparing For End of the Continuous Coverage Requirement

SHVS updated its Unwinding the Continuous Coverage Requirement: Developing a Communications Plan toolkit. The toolkit provides a communications planning guide designed to support state Medicaid agencies as they prepare for the upcoming end of the continuous coverage requirement and outlines phases of planning to organize state efforts. The toolkit has been updated to reflect the renewal of the federal public health emergency. As a reminder, SHVS has an entire resource page that serves as an accessible one-stop source of health equity information for states.

Healthcare Affordability: Majority of Adults Support Significant Changes to the Health System

The Robert Wood Johnson Foundation commissioned a study to better understand consumers’ concerns about the affordability of healthcare and their appetite for change. All of the reports can be found in one place on the Foundation’s website. There are rich insights into respondents’ feelings about the cost of healthcare, their perceptions of inequities in affordability of healthcare, where they feel blame and responsibility lie as well as their reactions to specific policy ideas and appetite for change. There is widespread support for policies to lower healthcare costs as consumers continue to make sacrifices such as delaying or forgoing care. Those with lower incomes, who are disproportionately people of color, report feeling the strain of high healthcare costs more than others, illustrating that lowering costs can help advance health equity. 

Ensuring Healthcare Cost Growth Targets Promote Health Equity

In a new blog post from the Milbank Memorial Fund, Grace Flaherty and Deepti Kanneganti of Bailit Health explore where in the cost growth target implementation process states can consider or incorporate health equity. States may also deploy complementary policies to promote health equity, such as quality and health equity targets. An increasing number of states work with health insurers, providers, consumers, and other stakeholders to set annual targets for statewide healthcare cost growth. As they engage in this work, states can ensure that their efforts to slow cost growth do not exacerbate the deep and well-documented inequities in the health care system but, instead, help address them.

Increasing Investment in Primary Care through Medicaid Managed Care

With support from the Commonwealth Fund, the Center for Health Care Strategies (CHCS) is hosting a webinar that will explore approaches to increase primary care spending at the state level, including within Medicaid. Speakers will provide a national overview of primary care investment efforts and highlight Oregon’s experience incorporating multi-payer primary care spending requirements into Medicaid policy. The webinar is part of a learning series from CHCS that is examining the tools and levers that states can use to advance comprehensive primary care strategies and equitably improve the health of Medicaid enrollees.

State Updates

  • California – The California Department of Public Health unveiled new Spanish- and English-language WhatsApp chatbot tools to offer reliable information about COVID-19 to Californians, especially those in the Latino community. When using this service, Spanish- and English-speakers will receive up-to-date information about the safety of vaccines, how to book vaccination appointments, and how to obtain digital records of vaccinations.
  • Kansas – Governor Laura Kelly signed into law a bill that allows advanced practice registered nurses to practice independently in an effort to increase access to care, particularly in rural areas of the state.
  • Kentucky – Governor Andy Beshear signed into law SB276 which requires the Cabinet for Health and Family Services to conduct an annual review of all medications, services, and forms of treatment for enrollees with a diagnosis of sickle cell disease that are eligible for coverage under the state’s medical assistance program.
  • Minnesota – The Minnesota Department of Health released new data showing mixed news regarding health insurance coverage in Minnesota during 2021. While actions taken by state officials helped drop the state’s uninsured rate to the lowest level ever measured, racial disparities in coverage worsened.
  • Nebraska
    • The Nebraska Department of Health and Human Services (DHHS)  announced it will soon launch a new benefit application, the iServe Nebraska Portal, that will provide a modern and easy-to-use system for Nebraskans to apply for DHHS benefits and services. The new portal is a single online application for Nebraskans to apply for Medicaid and Economic Assistance benefits. Those applying for benefits will only need to enter their basic information once to understand what benefits they qualify for and apply for them.
    • DHHS also released a request for proposals for Nebraska Heritage Health, the state’s managed care program, on April 15. DHHS will award statewide contracts to two or three Medicaid MCOs to serve approximately 342,000 individuals. MCOs will provide integrated physical health, behavioral health, pharmacy, and dental services. Implementation is set to begin July 1, 2023.
  • Rhode Island – The Office of the Health Insurance Commissioner, in collaboration with health care leaders from across the state, announced the signing of a compact to accelerate the adoption of advanced value-based payment (VBP) models in Rhode Island and made available 2020 performance data against the state’s health care cost growth target.
  • Vermont – The Agency of Human Services is soliciting input on experiences with mobile crisis services through a survey. The survey is seeking feedback on how the Agency should allocate federal funds for mobile crisis intervention services. 
  • Washington – Governor Jay Inslee signed legislation that now aligns state law and the federal No Surprises Act (NSA) and addresses coverage of treatment for emergency conditions. In addition, the Department of Insurance developed a webpage that includes links to consumer notices and other information for residents. As a reminder, SHVS has a  webpage that compiles SHVS resources for states on implementation of the NSA.
  • Massachusetts and Michigan – Both states received approval to expand Medicaid coverage for pregnant enrollees and will extend the period during which enrollees are eligible for postpartum care services from 60 days to 12 months as of April 1. For more information on the American Rescue Plan (ARP) state option to extend postpartum coverage, see this SHVS issue brief.