Few Medicaid Enrollees Who Use Tobacco Daily Receive Cessation Medication. New Federal Rules Could Make It Worse.
This blog discusses Medicaid-funded tobacco cessation services and how federal rules will affect access for enrollees.
Scaling Food Is Medicine Through Primary Care: Three Strategies for States
This blog shares three strategies for states to improve access to Food Is Medicine interventions in Medicaid through primary care.
Fact-Checking the White House Fraud Ledger: Trusted Numbers or Legerdemain?
This blog provides an overview of the White House Fraud Ledger and potential drawbacks, including misleading information.
One Big Beautiful Bill, One Big Rural Maternity Crisis
This blog discusses how H.R. 1 will affect rural maternal health access and outcomes.
That’s Medicaid: When a Chronic Condition Turns Critical
This commentary shares how Medicaid covered Paul's kidney transplant and follow-up care, enabling him to get back on his feet and become privately insured.
That’s Medicaid: When You Can Live as a Family (Del.)
This commentary discusses how Medicaid coverage has helped meet Franki's medical needs, such as daily nursing, therapy, and medical equipment for her Down syndrome and chronic conditions.
States Are Sending Initial Outreach Notices About Medicaid Work Reporting Requirements. What Do They Look Like?
This blog discusses public awareness of Medicaid work reporting requirements and themes from state outreach efforts.
That’s Medicaid: When Health Is More Than Healthcare (Ore.)
This commentary shares how health organizations in Oregon partnered to provide Medicaid enrollees with healthy and nutritious foods from local farms.
Maternity Care Billing Changes Begin in 2027 With Potential for Better Transparency and Payments Across the Continuum of Care
This blog discusses upcoming changes to the maternity care billing structure and how Medicaid will be impacted in the states.
CMS Issues New Rule Again Going Beyond H.R. 1 Requirements to Further Restrict State Use of Medicaid Provider Taxes
This blog examines CMS' proposed rule on provider taxes and how it will affect state Medicaid spending.
Strengthening Access to Community Health Worker Services in New York Through Medicaid
This blog discusses opportunities to expand access to CHWs through Medicaid and Medicare coverage, with a state example.
Getting More Value from IT Systems and Vendors
This podcast convenes Medicaid directors to discuss effective implementation of technology in Medicaid to further program goals.
CMS’ Approach to Work Reporting Requirement Won’t Work for People with Substance-Use Disorders or Mental Health Conditions
This blog discusses CMS' interim final rule on medical frailty and its impact on those with substance-use disorders and mental health conditions.
New Federal Medicaid Work Reporting Requirements Rule Threatens Coverage for Vulnerable Americans
This report reviews the Centers for Medicare & Medicaid Services' interim final work requirement rule, including which states are subject to it and implementation guidelines.
Revalidation of “High-Risk” Medicaid Providers: Early Lessons from Minnesota
This blog discusses Medicaid provider revalidation and how states like Minnesota are screening providers.
Medicaid HCBS Waivers: Where You Live Dictates Your Care
This blog discusses the state variation in Medicaid HBCS Waivers and strategies to advocate for waiver services.
How H.R. 1 Cuts and Changes to Medicaid Played out in 2026 State Legislative Sessions
This blog discusses how states have approached implementing H.R.1 policies, including adoption of work reporting requirements and changes to immigrant eligibility.
States Ask a Federal Court to Protect Medically Frail Individuals from CMS Overreach
This blog discusses CMS' interim final rule regarding medical frailty and the recent complaint states have filed to prevent the implementation of its provisions.
Ten New States Join the CCBHC Medicaid Demonstration
This blog discusses the success of the CCBHC Medicaid demonstration, the ten newly added states, and the potential impacts of H.R.1.
That’s Medicaid: When Your World Changes
This commentary discusses how Medicaid covered Sarah's prenatal care after she was diagnosed with a pre-existing condition and enabled her to finish school and become employed full-time.
Young Children’s Uninsurance is On the Rise – What Can Be Done to Protect Child Health?
This blog discusses how states and children's advocates can protect young children from losing health coverage.
Federal Government Issues Section 1115 Medicaid Waiver Financing Guidance Which Goes Far Further Than H.R. 1
This blog discusses the new federal guidance regarding budget neutrality requirement for Medicaid section 1115 demonstrations.
Medical-Dental Integration for Individuals with Diabetes
This blog explains medical-dental integration, the policy landscape, and what it can look like in practice.
That’s Medicaid: When You Meet Families Where They Are
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Steering the Ship in Transitions: The Role of Senior Deputies
This podcast shares insights from Medicaid directors on how to prioritize core responsibilities, smoothly transition leadership, and keep enrollees at the center of their work.
National Diabetes Prevention Program Implementation in Medicaid: Evidence Roundup
This blog discusses how the National Diabetes Prevention Program can be leveraged to prevent diabetes and manage care costs for Medicaid enrollees.
Developing a Primary Care-Specific Risk Adjustment Model: Lessons from MassHealth
This blog discusses Massachusetts Medicaid (MassHealth) implemented a primary care population-based payment model to improve patients’ experience and quality of care.
That’s Medicaid: When You’re Able to Feel Comfortable
This commentary shares how Medicaid covers primary care, dental visits, and immunizations for Regina's daughter when Regina was underemployed.
Medicaid Managed Care: The Big Five in Q1 2026
This blog discusses United Health Group, Elevance, CVSHealth/Aetna, and Centene enrollment data, reporting an average 3.8% decline in Medicaid enrollment for the first quarter.
What Do We Know About State Materials & Consumer Outreach on Medicaid Work Reporting Requirements?
This blog shares states' progress on notifying residents of Medicaid work reporting requirements.
Food is Medicine in Medicaid: How States Can Expand Nutrition Services
This factsheet discusses Food Is Medicine services in Medicaid and opportunities for state and federal policy.
Insurance for a Healthier Future: How Medicaid Supports Us All
This brief discusses the benefits of Medicaid on the health and wellbeing of everyone and offers policy recommendations for states to preserve access to preventive and life-saving care.
Congress Wanted to Protect People Living in Areas With High Unemployment From Losing Healthcare Due to Work Requirements. Will it Actually Happen?
This blog discusses hardship exemptions and the process for states to offer them to those living in areas with high unemployment rates as they implement work requirements.
Race/Ethnicity Data in CMS Medicaid (T-MSIS) Analytic Files: 2023 Data Assessment
This blog analyzes T-MSIS race and ethnicity data and indicates levels of concern by state.
How Can Medicaid Integrate Community Health Workers into Children’s Healthcare?
This factsheet discusses how integrating community health workers into Medicaid—which covers nearly half of all children in the U.S.—can help close gaps in care.
State Medicaid Opportunities to Expand Continuous Glucose Monitor Access
This blog offers opportunities for states to expand access to continuous glucose monitors.
Long-Standing State-Based Efforts to Combat Fraud Against Medicaid Continue to Improve
This blog discusses Medicaid fraud and ongoing state efforts to mitigate it.
Partnering with Community-Based Organizations to Support Medicaid Beneficiary Advisory Councils
This blog outlines how community-based organizations can best support Medicaid Beneficiary Advisory Councils and considerations for engaging with community partners.
Understanding Medicare-Medicaid Integration for Dually Eligible Individuals
This factsheet provides an overview of both programs and opportunities to improve integration for dually eligible enrollees.
That’s Medicaid: When You’re Able to Move Forward
This story tells how Medicaid supplemented Gene's health coverage after an accident left him quadriplegic at age 17.
South Dakota’s Community Health Worker Data Show Promising Results
This blog shares findings of CHW cost-effectiveness captured from South Dakota's analysis of Medicaid claims data.
State Perspectives on Potential Medicaid Disability Service Reductions
Despite federal assurances that people with disabilities enrolled in Medicaid will not lose or experience coverage changes as a result of H.R.1, some states expect service disruptions. This blog shares survey insights into how states are preparing for potential funding reductions to disability services and where they anticipate challenges.
CMS Announces Third Round of Drugs for Medicare Price Negotiations
This blog discusses CMS negotiation of Medicare Maximum Fair Prices and its impact on state healthcare spending.
Harnessing the TAF Analysis Reporting Checklist to Elevate Transparency in Medicaid Research
This blog provides a TAF Analysis Reporting Checklist to assist researchers in conducting and reporting studies using TAF data.
That’s Medicaid: When Education Is Within Reach
This commentary shares how Medicaid covered LaVerne's prenatal care while she pursued her bachelor's degree in nursing, allowing her to focus on finishing her education.
New CMS Innovation Center Models on Prescription Drugs and Chronic Conditions: Key Information for State Medicaid Agencies
This blog provides state Medicaid agencies with an at-a-glance overview of the CMS Innovation Center's models including target populations, implications for Medicaid, and more.
Advancing Medicaid Primary Care Population-Based Payment Models: Four Lessons for States
This blog discusses ways states are considering alternate payment models to strengthen primary care for people enrolled in Medicaid.
What New Long-Term Services and Supports Data Show About Rebalancing—and How States Can Respond
This blog discusses state opportunities, trends, expenditures, and enrollment for Medicaid long-term services rebalancing to shift toward home- and community-based services.
New Federal Opportunities to Lower Prescription Drug Prices
This blog discusses two recently announced federal programs aimed at lowering prescription drug prices, their goals, and considerations for states.
Children and Youth with Significant Behavioral Health Needs Will Benefit from States Committing to Provide Intensive Home- and Community-Based Services
This blog discusses how state investment into home- and community-based services can enable children and youth with behavioral health needs to thrive.
Black-White Racial Differences in Asthma Medication Receipt among Medicaid-Enrolled Children
This report assesses the disparities in prescription and receipt of asthma medications between Black and White Medicaid-enrolled children.
Support for Community-Based Organizations New to Medicaid
This blog provides state examples of utilizing Medicaid intermediaries to support the infrastructure and capacity of community-based organizations.
That’s Medicaid: When You Need to Get an Education
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Exploring Artificial Intelligence and Automation in Medicaid
This report uses data from 45 states and stakeholder interviews to recommend policy actions for state Medicaid agencies when using AI.
Medicaid Beneficiary Advisory Councils: A Guide to Evaluating Process and Impact
This blog offers three steps for states to integrate evaluation processes into Beneficiary Advisory Council efforts.
That’s Medicaid: When Care Empowers You
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
That’s Medicaid: When You’re Determined to Live a Productive Life
That's Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Three Opportunities for States to Improve Healthcare for Medicaid Members with Disabilities
This blog offers strategies for improving Medicaid services for people with disabilities to reduce disparities.
The Role of Community Health Workers in Pediatrics
This blog discusses how to deploy CHW-led interventions in pediatric care.
Six Lessons Researchers Should Consider When Partnering with Community Advisory Boards
This blog highlights six lessons from listening sessions with CAB members and Urban researchers for other organizations seeking to partner with or strengthen a community advisory board.
Aligning Work Requirements Across SNAP/Medicaid to Support Public Benefit Continuity
This brief shares opportunities for the Supplemental Nutrition Assistance Program and Medicaid to support work requirements implementation and facilitate continuous access to food and coverage.
Medicaid Opportunities to Improve Gestational Diabetes Outcomes
This blog post explores how states are expanding access to continuous glucose monitoring for pregnant people.
That’s Medicaid: When You Can Live Without Limits
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Medicaid-Covered Dental Visits During and After Pregnancy
This brief provides findings on Medicaid-covered dental visits and dental-related emergency department visits during pregnancy and one year postpartum.
Elevating Community Voice in Shaping Medicaid Priorities
This blog discusses challenges and strategies for integrating community voice and engagement into the development of Medicaid policies.
Strengthening Cross-Agency Collaboration to Support Work Requirements Implementation
This blog explains how partnerships between state agencies can improve Medicaid work requirements implementation.
That’s Medicaid: When A Crisis Strikes
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Medicaid Beneficiary Advisory Council Recruitment Tip Sheet
This blog offers strategies for recruitment and outreach for Medicaid Beneficiary Advisory Councils.
That’s Medicaid: When Coverage Is Lost Overnight
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
How Will We Know If States Are Ready to Implement Budget Reconciliation Provisions and Work Requirements?
This blog discusses a new report from Georgetown's Center for Children and Families, which analyzes states' compliance with certain Medicaid performance indicators to assess their readiness for implementing work requirements and provisions in the budget reconciliation bill.
Improving Access to Children’s Preventive Care: Medicaid Opportunities in School Settings
This blog discusses expanding children's access to preventive services through Medicaid and school-based health services.
That’s Medicaid: Support For Mental Health
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
That’s Medicaid: When a Family Needs a Blessing
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Promoting Healthy Foundations: Medicaid Opportunities to Support Community Health Workers in Child Healthcare
This brief discusses how Medicaid can help community health workers improve child health and wellbeing.
Beneficiary Advisory Council Engagement Framework: A Guide to Strengthening Medicaid Member Collaboration
This blog provides strategies to strengthen Beneficiary Advisory Councils with state examples.
What Are Insurance Premiums, Deductibles, and Copays? Reviewing Common Health Insurance Terminology
This blog explains common health insurance terminology to improve consumer understanding.
That’s Medicaid: When A Diagnosis Throws Life Off Course
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
A Summary of National Medicaid Work Requirements
This fact sheet summarizes national Medicaid work requirements, its implementation, and exemptions.
Engaging Members and Community-Based Organizations in Medicaid Work Requirements Implementation
This brief outlines strategies states can use to partner with Medicaid members and CBOs in implementing work requirement policies that reflect community input.
Federal Budget Law Spells Trouble for Patients with Diabetes
This blog shares the budget reconciliation's effect on diabetes coverage and treatment.
Honoring Medicaid at 60: Program Origins, Funding, and State Impacts
This blog discusses the progression of the Medicaid program in recognition of its 60th anniversary.
12 Million Households Receive Both Medicaid and SNAP. The Reconciliation Bill Puts Them At Risk.
This blog discusses the impact of the reconciliation bill on families that utilize both Medicaid and the Supplemental Nutrition Assistance Program.
That’s Medicaid: When You Hit Rock Bottom
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
That’s Medicaid: When Access to Care Ultimately Saves Your Life
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Medicaid Payment Approaches to Strengthen Disability-Competent Primary Care
This blog provides strategies for state Medicaid agencies and primary care providers to improve access to disability-competent care.
That’s Medicaid: When Insurance Is Lost
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Estimated 10-Year Spending Effects of the DUALS Act of 2024
This brief provides potential 10-year cost and enrollment estimates following enactment of the DUALS Act.
Medicaid Innovation in Improving Access to Behavioral Healthcare
This webinar shares how state leaders are tackling behavioral health challenges and using Medicaid to improve high quality care in their state.
Strengthening Behavioral Health Systems Through Medicaid: Three Strategies for State Action
This blog shares opportunities for states to leverage Medicaid to improve behavioral healthcare and outcomes.
Reflections on Leadership from Long-Serving Medicaid Directors
This podcast features insights from former Medicaid directors on running state Medicaid programs and approaches to leadership.
Rural Hospital Revenue Could Drop by $87 Billion over 10 Years Because of the Reconciliation Bill and Expiring Enhanced Tax Credits
This blog discusses the impact of the reconciliation bill and the expiration enhanced premium tax credits on rural hospitals.
Listening, Learning, Leading: Stakeholder-Driven Change in Medicaid
This podcast discusses how stakeholders have shaped Medicaid throughout the years.
That’s Medicaid: When You Want to Make a Difference
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
What Is a “Countercyclical” Policy or Program? How Medicaid Protects People When the Economy Falters
This blog explains countercyclical policies and its effect on Medicaid and economic spending.
Shaping Vaccine Cost and Coverage for Medicaid-Eligible Individuals
This blog provides strategies for state health agencies to reduce barriers to vaccination.
That’s Medicaid: When the Unexpected Happens
That’s Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Tracking State-Specific Estimates of the Impacts of Proposed Medicaid Cuts
This blog tracks state-specific impacts of proposed Medicaid cuts included in the reconciliation bill.
Medicaid Cuts and the States: Tracking State-Specific Estimates of the Impacts of Proposed Changes
This blog provides continuous updates on state impacts for federal spending proposals, including the One Beautiful Bill Act.
Shifting Immigration Policies Jeopardize Immigrant Families with Children
This report examines difficulties for immigrant families that affect their access to healthcare and basic needs programs.
Understanding Medicaid’s Federal-State Partnership
This podcast analyzes the founding collaboration of Medicaid and how to better leverage it to benefit enrollees.
Stronger Together: North Dakota Medicaid and Families Partnering for Impact
This podcast explores how state health officials are partnering with North Dakota families to improve programs for children with disabilities and their families.
State-Specific Estimates of Proposed Medicaid Cuts
This blog tracks state-specific impacts of proposed Medicaid cuts.
That’s Medicaid: When You Advocate for Your Needs
That's Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Analyzing the Effect of Per Capita Caps on the Medicaid Expansion Population
This Urban Institute report includes results of a per capita cap on the Medicaid expansion population.
Analyzing the Impact of Potential Medicaid Cuts: Overview of a Toolkit for States
This blog post analyzes potential state policy changes and the ten-year impact of Medicaid cuts.
That’s Medicaid: When You Need the Essentials
That's Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
State Flexibility To Add Adult Dental Care to Essential Health Benefits
This blog summarizes recent action on EHB updates and adult dental coverage and discusses operational considerations for states.
Parents and Healthcare Providers Value Medicaid
This blog discusses why families value Medicaid and how critical the program is for their health.
Medicaid Work Reporting Requirements: More Than Meets the Eye
This blog provides an overview on a bill passed in the House of Representatives to estimate the effects of implementing work requirements for Medicaid coverage.
Strategies to Optimize the Medicaid Oral Health Workforce
This blog highlights four levers that states used to provide improved access to oral health services for Medicaid enrollees.
Proposed Cuts to Medicaid and SNAP Would Affect Young Families’ Budgets and Wellbeing
This blog discusses how proposed cuts to federal programs like Medicaid and SNAP could negatively affect families' access to necessities.
Policy Imperative to Modify the Medicare “Use in the Home” Policy
This blog discusses the effect of the "use in the home" policy on accessibility.
That’s Medicaid: When You Care for a Family
That's Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Exercising Self-Governance Through an Indian Managed Care Entity: The Eastern Band of Cherokee Indians Tribal Option
This blog post covers information on the EBCI Tribal Option and its value-added services.
Recent Federal Marketplace Proposal Imposes New Requirements for States and Consumers
This blog examines potential changes if CMS implements proposed changes to ACA marketplace and insurance rules.
Assessing Potential Coverage Losses among Medicaid Enrollees Under Medicaid Work Requirements
This report analyzes the potential coverage losses from Medicaid work requirements based on two state examples.
Providers to Experience Revenue Loss and Uncompensated Care Increases if Medicaid Expansion Support Decreases
This brief examines how providers would be affected by proposed cuts to Medicaid expansion.
That’s Medicaid: When You Have a Second Chance at Life
That's Medicaid shares stories of people covered by Medicaid at critical points in their lives, underscoring the importance of stable health insurance coverage.
Navigating Natural Disasters: Key Strategies for Medicaid Agencies to Support Members
This blog post offers three options for state Medicaid agencies to proactively address enrollee needs during natural disasters along with state examples.
Reducing Federal Support for Medicaid Expansion Would Shift Costs to States and Likely Result in Coverage Losses
This research report estimates the health coverage impact if states were to preserve Medicaid funding or drop Medicaid expansion if the federal matching rate reduced by 90 percent.
Launching Medicaid Advisory Committees and Beneficiary Advisory Councils: A Checklist for States
This blog provides a checklist states can reference to establish and design effective BACs.
Medicaid Community Member Engagement Landscape Assessment Guide
This blog shares the Medicaid Community Member Engagement Landscape Assessment Guide, a tool designed to help state Medicaid agencies systematically document existing efforts to engage community members.
2024 NHIS Data Early Release: Quarter 3 (July – September) Estimates Show Coverage Continued to Shift at the End of the Unwinding
This blog post documents relevant changes to coverage since the Medicaid unwinding, such as uninsurance rates by age.
Families as Partners: Transforming Child Health Care Together
This blog post highlights how learning from families and youth can better support the millions of children and youth with special healthcare needs on Medicaid and CHIP.
Release of Updated CMS Guidance on Continuous Eligibility for Medicaid/CHIP Children and Youth
This blog summarizes new guidance from CMS' updated SHO letter, specifically relating to CHIP.
Update on Medicaid Section 1115 Waivers
This blog post summarizes states with approving and pending Medicaid 1115 waivers.
Three State Snapshots of Pediatric Palliative Care: California, Massachusetts, and Vermont
This blog examines how California, Massachusetts, and Vermont are leveraging Medicaid and Title V programs to ensure children living with a serious illness can access pediatric palliative care.
States Enhance Medicaid Payment for Interprofessional Consultation: Opportunities for Maternal and Child Behavioral Health
This blog discusses how Medicaid payment for interpersonal consultation services improves behavioral health services provided to maternal and child populations.
Addressing Oral Health Disparities in Rhode Island
This blog examines Rhode Island's oral health transformation approach and highlights strategies to improve the overall health and wellbeing of Medicaid enrollees.
Release of New E&E Guidance Related to Renewal Forms and Medicaid/Separate CHIP Transitions
In this blog post, SHVS summarizes CMS' latest Informational Bulletins and their requirements.
Medicaid Managed Care and Early Childhood Development: A 12-state Scan
This analysis examines 12 Medicaid managed care state websites' transparency of enrollment, payment, and quality data specific to young children to measure their performance.
Partnerships Between Health and Public Housing Authorities: Examples from Arizona, Louisiana, and Washington
This blog reviews examples of state partnerships with public housing authorities (PHAs) that support public housing to improve health and social outcomes.
Underlying Factors of Medicaid Inequities: Conversations with Experts on Racism and Medicaid
This brief reviews discussions with experts on how the Medicaid Equity Monitoring Tool (MET) can address the effects of systemic racism in Medicaid.
CMS Releases Updated HRSN Framework for Medicaid and CHIP
This commentary reviews key updates to health-related social needs (HRSN) compared to those previously outlined in the past bulletin.
The Role of Medicaid Continuous Enrollment in Improving Children’s Health and Wellbeing: State Toolkit
This toolkit can inform planning related to implementing continuous enrollment policies, adopting alternative payment models to encourage providers to embrace innovative pediatric care delivery practices, and developing an oversight and quality improvement strategy to promote improved health and wellbeing outcomes for young children.
Changes in How Medicaid Engages Individuals with Lived Experience: Resource Roundup
This blog shares resources detailing how Medicaid, policymakers, plans, and healthcare providers increasingly engage community members to inform program design and implementation.
Recruiting for the BAC: Template Materials
This toolkit includes materials state agencies can use to recruit members for the Beneficiary Advisory Council (BAC), including a recruitment flyer, template social media graphics, core messages, website copy, and newsletter copy.
Balancing Structure and Flexibility for Effective Public Health Planning
This blog reviews key strategies for effective planning and underscores planning as a foundational activity for resilient and adaptable health departments.
Leveraging Medicaid Managed Care to Address Health-Related Social Needs
This webinar highlights state approaches addressing health-related social needs (HRSN) in Medicaid managed care programs, followed by a discussion with state Medicaid officials.
Behavioral Health Integration in Medicaid Managed Care: Evidence Roundup
This blog connects evidence and implementation resources with emerging state and federal policies about behavioral health to better support patients.
What Do the New Census Data Say About Insurance Coverage for Children and Adults? A Look at Both the National and State Level
This commentary examines national- and state-level data on healthcare coverage from the 2023 American Community Survey (ACS).
Recruiting for the BAC: Template Materials
These customizable resources support state agencies in recruiting members for the Beneficiary Advisory Council (BAC).
Resources to Help States Prepare for Open Enrollment
This toolkit includes resources designed to help states effectively promote information about Marketplace enrollment and health plan options to consumers during the annual open enrollment period.
Oregon’s Medicaid Expands Care for Older Adults, Adults with Disabilities, and Caregivers
This blog highlights the new Oregon Project Independence Medicaid (OPI-M) waiver, which allows more at-risk Medicaid-eligible older adults and people with disabilities to receive long-term services and supports.
New Guidance from CMS Lifts Up Medicaid’s EPSDT Pediatric Benefit
This blog reviews the significance of promoting Early and Periodic Screening, Diagnostic and Treatment (EPSDT) awareness.
CMS Guidance on Health Coverage Requirements for Children and Youth Enrolled in Medicaid
This expert perspective provides an overview of CMS’ new Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) guidance, which represents CMS’ most comprehensive discussion of EPSDT requirements in over a decade.
Communicating the BAC and MAC: Template Explainer
This customizable slide deck template supports internal state agency communication about the Beneficiary Advisory Council (BAC) and Medicaid Advisory Committee (MAC) and a summary of the new advisory groups' functions, objectives, composition, and outcomes.
Health Insurance Coverage Estimates Remain Steady for Adults but Rise for Children
This blog explores changes in national-level coverage rates by demographic characteristics such as age, employment, race and ethnicity, immigration status, poverty status, and Medicaid expansion status.
CMS Releases Guidance Outlining Expectations for State Compliance with Medicaid and CHIP Renewal Requirements
This blog reviews what CMS expects from states and how CMS will assess states' Medicaid/CHIP renewal progress to comply with the new requirements.
CMS Issues Guidance to States on Early and Periodic Screening, Diagnostic and Treatment Requirements
This blog examines CMS guidance to implement Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements.
Enhancing Medicaid Equity Through Health Literacy: Practical Strategies
This webinar gathered Medicaid stakeholders from communities and state agencies to discuss practical steps to address health literacy through improved communications, national cultural and language access standards (such as CLAS), and community engagement.
Medicaid & CHIP Mental Health Parity: Latest Federal Actions Explained
This blog examines the following steps to strengthen the Mental Health Parity and Addiction Equity Act (MHPAEA) in Medicaid and CHIP.
2023 ACS Tables: State and County Uninsured Rates, with Comparison Year 2022
This interactive map shows uninsurance rates by state and sub-state geographies, demographic characteristics for 2023, and comparison year 2022.
Exploring Rising Uninsured Rates for Low-Income Children
This blog reviews recent survey data findings on how the insurance coverage of low-income children changed between 2022 and 2023 both nationally and at the state level.
How MODRN Aims to Improve Quality Measurement and Inform Medicaid Policy
This blog examines MODRN's early contributions to quality measurements and how it benefits states and university partners.
Unpacking the Unwinding: Medicaid to Marketplace Coverage Transitions
This blog highlights the aftermath of the Medicaid unwinding and state efforts to smooth coverage transitions.
New Tools, Implementation Questions on Multi-Year Continuous Eligibility
This blog examines how state implementation choices will impact the success of multi-year continuous eligibility for children.
2023 ACS: After Two Years of Decline, Uninsured Rates Increased for Children; Public and Private Coverage Rates See Variations Across the States
This blog walks through state-level findings regarding different types of health insurance and changes by age category.
Federal Judge in Tennessee Sides with Individuals Terminated from Medicaid, Finds Numerous Violations in Tennessee Medicaid Eligibility Process
The Tennessee lawsuit alleged four major types of failures by the state.
Back-to-School Season is Key to Reconnecting Kids to Health Coverage
This dual-language toolkit provides families with information on Medicaid and CHIP and how to apply or re-apply.
CMS Issues Guidance on Renewal Timeliness Post-Unwinding
This blog post reviews and links to the CMCS Informational Bulletin (CIB) and accompanying slide deck.
Community-Based Assistance Programs Support Applicants Where They Live
This blog examines community-based assistance programs and resources in each state.
Integrated Health Partnerships—Minnesota’s Medicaid Accountable Care Organization Model
This blog explores the new integrated health partnership program and how it impacts communities in Minnesota.
Meeting LGBTQ+ Health Care Needs in Medicaid
This infographic highlights the unique healthcare challenges people in the LGBTQ+ community face and how Medicaid agencies can support high-quality LGBTQ+ healthcare.
GAO Releases Report on Federal Oversight and the Unwinding
This blog reviews the Government Accountability Office's (GOA) report entitled: “Medicaid: Federal Oversight of State Eligibility Redeterminations Should Reflect Lessons Learned after COVID-19.”
Explainer: Final Medicaid Managed Care and Access Rules
This report reviews and explains how the Access and Managed Care Rules will significantly improve access to care, data and payment transparency, and beneficiary engagement in healthcare.
What to expect from Census data this fall on Child/Adult Coverage Levels?
This blog reviews what can be anticipated from the upcoming release of the Census Bureau’s 2023 survey data in September based on current Medicaid unwinding statistics.
Tennessee to Begin Providing Diapers for Children Under Age 2 in Medicaid
This blog highlights key details from the new resources published by the state of Tennessee to help stakeholders assist families who may be eligible for the new diaper benefit.
Medicaid Drug Rebate Program News and Notes, 2024 Edition
This blog highlights recent Medicaid Drug Rebate Program (MDRP) policy developments.
It’s Still the Prices: Looking Under the Hood at Proposed 2025 Premiums
This blog examines the assumptions and justifications behind the 2025 premium increases for individual and small-group market health plans in the District of Columbia (DC), Maine, Maryland, Oregon, and Vermont.
Transparency in Medicaid Managed Care: CMS Posts the MCPARs
This blog examines CMS’s decision to post state Managed Care Program Annual Reports (MCPARs) and the transparency of continuing to do so going forward.
Toolkit: Multi-Year Continuous Enrollment to Medicaid and CHIP
This state toolkit intended to support decision-making in states interested in, actively pursuing, or implementing section 1115 demonstrations to provide continuous enrollment (CE) to Medicaid and CHIP populations, with a focus on multi-year CE for young children.
Language Supports Are an Area for Improvement for Medicaid and CHIP Agency Websites
This blog highlights current language and accessibility supports on state websites and suggests how states can make improvements.
CMS Proposes Rule to Codify 12-Month Continuous Eligibility and Improvements to Maternal Health
This blog discusses how the proposed rule would establish baseline organizational standards, include emergency services requirements, and provide Medicaid reimbursement for certain services outside a clinic.
Creating Supportive Partnerships Between Medicaid and Tribal Communities
This episode of the Medicaid Leadership Exchange podcast explores how Medicaid can better serve tribes by establishing clear lines of communication between tribal communities and Medicaid staff, featuring perspectives from two tribal leaders and an Arizona Medicaid leader.
Changes in Healthcare Cost Barriers with Medicaid Continuous Coverage and Enhanced Premium Tax Credits
This brief assesses changes in health insurance coverage and cost-related barriers to healthcare during the COVID-19 public health emergency following the implementation of policies that aimed to improve access to Medicaid and Marketplace coverage.
Improving Access in Medicaid Managed Care Using State Directed Payments
This blog examines what State Directed Payments are, how they can be used to improve access to care, and some changes in how CMS will allow and regulate them.
States are Harnessing the Benefits of Video to Boost Outreach and Enrollment
This blog reviews how many states across the nation are using videos to demonstrate helpful concepts related to enrolling in and renewing Medicaid and CHIP coverage.
Medicaid Opportunities to Improve Healthcare Access and Quality for LGBTQ+ Communities
This brief highlights key considerations to shape Medicaid policies that enhance health outcomes and quality of care for LGBTQ+ individuals.
Bridging the Gap: Partnerships Between Managed Care Plans and Homeless Service Providers
This blog discusses how MCPs can partner with homeless service providers to enhance care and services for people experiencing homelessness.
How Medicaid Can Better Support Families of Children with Special Healthcare Needs
This episode of the Medicaid Leadership Exchange podcast explores how Medicaid agencies can better serve children with special healthcare needs and their families.
The Unwinding: It’s Not Over Until It’s Over
This blog discusses extended timelines for states to process Medicaid renewals, the importance of reporting renewal outcomes, and updates to renewal data.
Back to Basics: Effective State Medicaid and CHIP Outreach to Families
This blog covers some of the quintessential outreach efforts performed by states to inform and educate individuals about Medicaid and CHIP benefits.
Realigning Primary Care Incentives in Medicaid
This blog reviews six key design choices in The Center for Health Care Strategies’ new resource, Developing Primary Care Population-Based Payment Models in Medicaid: A Primer For States.
Navigating Medicaid: Insights from a Parent Advocate
This podcast episode shares the story of a parent advocate working with Ohio Medicaid to break down silos and improve communication across state agencies serving families, especially those who have complex needs.
Section 1115 Demonstrations to Support the HRSNs of Pregnant and Postpartum Women
This report examines states’ use of Medicaid section 1115 demonstrations to cover housing, nutrition, and other HRSN services and supports for pregnant and postpartum individuals and young children who are experiencing or at risk of unmet HRSN.
Engaging Community Members in Medicaid Policy and Program Design
This fact sheet can help Medicaid agencies, health plans, providers, and other healthcare organizations involve community members more effectively in program and policy decision-making.
Social Media: A Critical Tool for States to Leverage as Unwinding Winds Down
This blog details why state agencies can and should post relevant enrollment and eligibility information on social media platforms to connect with those eligible for Medicaid/CHIP.
CMS Final Rules Part 3: Home and Community-Based Services
Part Three in this series of webinars provides a detailed overview of provisions in the Access Rule that aim to enhance access to HCBS, standardize quality measures and reporting requirements, and help address long-standing shortages in the direct care workforce.
Changes to the Child and Adult Core Measure Sets to Advance Equity
This commentary reviews changes beginning in fiscal year (FY) 2025 requiring states to report a subset of Child and Adult Core Set measures by race and ethnicity, sex, and geography. By requiring data disaggregation for key populations of interest, policymakers, advocates and researchers will have a new tool to measure, monitor and inform policies and practices that focus on health equity.
Promoting Health Equity Through State Medicaid Managed Care Strategies
This expert perspective highlights an MMC approach newly added to the Compendium of Medicaid Managed Care Contracting Strategies to Promote Health Equity.
Marketplace Enrollment Among Those Losing Medicaid Coverage During Unwinding
This blog reviews CMS marketplace enrollment data from February 2024, which was after the 2024 Open Enrollment Period had ended in nearly all states.
Changes Coming to Medicaid and CHIP Programs Promise to Simplify Enrollment and Renewal
This blog reviews changes to the Medicaid and CHIP programs to streamline enrollment for eligible individuals.
Driving Organizational Development in Medicaid: Three Key Lessons
This blog post highlights three key lessons for agencies to consider when embarking on an organizational development journey in Medicaid.
The Critical Role of Medicaid in Addressing Maternal Health Disparities
This podcast highlights the need to better address maternal health disparities, particularly for Black, American Indian, Alaskan Native women, and people living in rural communities.
Engaging Medicaid Members: New Requirements in the Medicaid Access Rule
This commentary examines what states will need to create and support a Beneficiary Advisory Council (BAC) composed solely of current and former Medicaid enrollees, their family members, and paid and unpaid caregivers under the Access Rule.
How Can States Better Serve Dually Eligible Populations?
This podcast explores the importance of integrating benefits for dual eligibles to create more person-centered care and services for members.
Introduction to Medicaid and CHIP Outreach Snapshot Blog Series
The first blog in this new series identifies landing pages for online Medicaid, CHIP, and marketplace application portals in each state and links to the application that can be printed and returned by mail.
The New Medicaid Managed Care Regulation’s “In Lieu of Services” Explained
This blog reviews changes to the Managed Care Rule, where the CMS updated the definition and oversight of ILOS in important ways that should both increase the flexibility to use ILOS as a tool for improving health and increase the integrity of ILOS spending.
New Rule Seeks to Improve Transparency of State Medicaid Provider Payment Rates
This blog post reviews the new provisions related to documentation of access to care and service payment rates from the Access Rule.
Building a Health Equity Focus into Value-Based Payment Design: Approaches for Medicaid Payers
This brief explores approaches to incorporating health equity in value-based payment design, creating payment models that positively impact health disparities, outcomes, and costs in Medicaid.
The Critical Role of Medicaid in Addressing Maternal Health Disparities
This episode of the Medicaid Leadership Exchange podcast highlights the need to better address maternal health disparities, particularly for Black, American Indian, and Alaskan Native women, and people living in rural communities.
Beneficiary Advisory Councils: Historic Opportunity for State Medicaid Programs
This blog details the Beneficiary Advisory Councils (BACs) established by the rule representing a historic opportunity to leverage the experiences of people enrolled in Medicaid to improve state Medicaid programs.
A Closer Look at the Access Provisions in Final Medicaid Managed Care Rule
This blog takes a closer look at the provisions of the rule relating to the adequacy of MCO provider networks: searchable provider directories, analyses of payments to network providers, appointment wait time standards, secret shopper surveys, and remedy plans.
Medicaid Supports Student Success in School Districts Across the Country
This blog reviews new data on the share of children with Medicaid/CHIP coverage of more than 7,000 school districts nationwide and the importance these coverage programs have to students.
New Rule Opens the Affordable Care Act Marketplaces to DACA Recipients
This commentary summarizes the provisions of the new Department of Health and Human Services regulation and discusses the implications for states.
States of Innovation: March & April 2024
This inaugural post highlights state activity from March and April 2024.
CMS Final Rules Part 1: Access, Enrollee Engagement, and Provider Payment Transparency
During this webinar, experts from Manatt Health provided an overview of the provisions in both rules regarding access monitoring, enrollee engagement, provider payment transparency, and HCBS.
Marketplace Enrollment Among Those Losing Medicaid Coverage During Unwinding Slowed in Last Month of Open Enrollment
This blog examines new data for January 2024, which was the last month of the 2024 Open Enrollment Period in nearly all states.
What to Know About Nursing Home Staffing Minimums: Implications of New Federal Rules
This blog post reviews existing regulations on nursing home staffing and breaks down CMS’ new staffing requirements, including how states will need to respond.
The Impact of Medicaid on the Rural Health Care Landscape
This first episode in a new season of the podcast highlights the importance of Medicaid to the millions of people living in rural communities across the country.
Final Medicaid Managed Care Rule Explained
This blog provides a high-level summary of the Managed Care Rule.
Compendium of Medicaid Managed Care Contracting Strategies to Promote Health Equity
This latest update to the resource includes descriptions of the approaches 26 states are taking within MMC to promote health equity, examples of what states are doing examples, and excerpts from state contracts and procurement documents.
Child Medicaid Disenrollment Data Shows Wide Variation in State Performance
This paper uses administrative data reported by states to CMS to examine how the unwinding impacted children’s enrollment in Medicaid and CHIP in 2023.
Tracking Health Insurance Coverage During the Unwinding: Monthly Data from the Household Pulse Survey
This blog uses data from the U.S. Census Bureau’s Household Pulse Survey to track trends in adult health insurance coverage rates as states “unwind” Medicaid continuous coverage and restart standard redetermination procedures.
The Links Between Postpartum Medicaid Coverage and Mental Health
This blog examines research on continuous Medicaid coverage and mental health among mothers and infants in the postpartum year.
State Momentum on Medicaid Doula Coverage, Rate Increases
This blog examines which states nationwide have taken steps toward Medicaid coverage for doula care.
Medicaid Eligibility and Enrollment Rule Explainer
This report summarizes and examines the content of the most recent final rule from CMS.
Fact Sheet Highlights MCOs’ Strategies to Address Redeterminations
The survey series provides an in-depth view of health plans’ responses regarding risk mitigation, disenrollment, and outreach.
CMS Final Rule on Medicaid and CHIP Eligibility, Enrollment, and Renewal
During this webinar, experts from Manatt Health reviewed key Medicaid and CHIP provisions in the final rule and discussed considerations for state policymakers.
The Final 2025 Notice of Benefit and Payment Parameters: Implications for States
On April 2, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final Notice of Benefit and Payment Parameters (NBPP) for 2025. This annual rule governs core provisions of the Affordable Care Act (ACA), including operation of the health insurance Marketplaces, standards for health plans, insurance brokers (including web-brokers), and the risk adjustment program. This blog focuses on provisions of the final rule of interest to state officials.
Marketplace Enrollment Update
This blog examines increases in Marketplace enrollment among people losing Medicaid coverage during the unwinding.
Tracking Health Insurance Coverage During the Unwinding
This blog tracks trends in adult health insurance coverage rates as states “unwind” the Medicaid continuous coverage requirement.
Call Center Data Shows Trends Across States, But May Not Provide Full Picture
This blog examines the first batch of call center data provided by CMS from March and its shortcomings.
Surveys Show Unwinding Awareness Lags, Highlighting Need for Outreach
In this blog, the Georgetown University Center for Children and Families analyzes recent survey findings regarding the impact of Medicaid unwinding and enrollees' experiences.
10 “Do Nots” in Conducting Medicaid Renewals
In this blog, The Georgetown University Center for Children and Families outlines and expands on the 10 "Do Nots" outlined in the bulletin.
Using Health Literacy Strategies to Advance Equity in Medicaid
In this blog, the Center for Health Care Strategies examines how state agencies employ health literacy strategies to improve health equity.
State Shares of Medicaid/CHIP MAGI Applications Exceeding 45-Day Processing Standard
The Center for Children and Families (CCF) at Georgetown University analyzed data on which states are taking longer than the federally regulated 45 days to process Medicaid applications for low-income children, families, and adults. This blog takes a look at some of the states taking longer than their allotted 45 days and the possible reasons behind it.
Marketplace Enrollment Among Those Losing Medicaid Coverage During Unwinding More than Doubled in November with Start of Open Enrollment Period
In this blog CCF analyzes CMS data on marketplace enrollment from November, 2023.
Sexual Orientation and Gender Identity Data: New and Updated Information on Federal Guidance and Medicaid Data Collection Practices
CMS recently added new questions on the topic of sexual orientation and gender identity (SOGI) to the application used by HealthCare.gov and released guidance for states that want to add the same questions to their Medicaid and Children’s Health Insurance Program applications. This brief summarizes the guidance and presents several considerations for states as they look to improve their collection of sexual orientation and gender identity data.
Monthly Health Coverage Data from the Household Pulse Survey
This blog tracks trends in adult health insurance coverage rates as states unwind the Medicaid continuous coverage requirement and continue redetermination procedures.
Updated Medicaid & CHIP Telehealth Toolkit
CMS released an updated State Medicaid and CHIP Telehealth Toolkit on issues from billing best practices to strategies for using telehealth in schools. This blog shares a toolkit that includes state best practices and strategies, information such as a state checklist, a Medicaid telehealth assessment plan, and telehealth communication strategies.
Medicaid Churn Toolkit
This blog shares a “Medicaid Churn Toolkit” to guide Medicaid agencies and their partners in the design and implementation of efforts to reduce churn.
Marketplace Enrollment Surges Among Those Losing Medicaid Coverage
This blog discusses the surge in Marketplace enrollment among individuals losing coverage during the unwinding.
A Lifeline for Families of Children With Special Health Care Needs
This blog examines how gaps in coverage are affecting California families, particularly those that have children with special healthcare needs, and steps the state can take to renew coverage for more families.
Ensuring Continuity in Healthcare Coverage While Medicaid Unwinds
This blog examines state and territorial health agencies strategies, and state approaches during the unwinding of continuous coverage.
Most States Show Improvement in Automated Medicaid Renewals
This blog compared states' ex parte rates from their first month of unwinding to the most recent to identify whether progress has been made.
Q&A: Preparing to Implement the 12-Month Continuous Enrollment Requirement for Children
This blog examines a Q&A, which is intended to serve as an added resource for states implementing continuous eligibility.
Insights to Inform 2024 Medicaid Renewal Messaging
This blog highlights findings from a rapid message test conducted to gauge the persuasiveness of Medicaid renewal message themes.
Bridging Public Health and Clinical Healthcare
This blog discusses how policymakers are addressing access to care through telehealth, safety net and emergency services, and adjusted reimbursement rates to Medicaid-enrolled providers.
Navigator Guide FAQs of the Week: Wrapping Up Open Enrollment
This blog reviews FAQs from the Georgetown Center on Health Insurance Reforms' Navigator Resource Guide related to the conclusion of the annual open enrollment period.
HHS and CMS Take Action to Preserve Coverage for Eligible Children
On December 18, 2023, the Centers for Medicare & Medicaid Services (CMS) released a suite of Medicaid unwinding-related guidance and enrollment data that includes a focus on ensuring eligible children maintain Medicaid and Children’s Health Insurance Program (CHIP) coverage. In conjunction with CMS’ release, the United States Department of Health and Human Services (HHS) sent letters to the governors of nine states with the highest child disenrollment rates.
This blog from State Health & Value Strategies reviews the HHS letters and discusses specific resources available to states as the unwinding continues.
State Approaches to Addressing Health-Related Social Needs in Medicaid Managed Care
This blog from State Health & Value Strategies (SHVS) examines new HRSN highlights from states across the country and reviews recent updates to SHVS' HRSN Toolkit.
State Reporting to Monitor Medicaid’s Unwinding
This blog examines states' unwinding data, variation in reporting of indicators, and data dashboards.
Improving Data Sharing Across SNAP and Medicaid Agencies: Key Factors for Success During Unwinding and Beyond
This webinar explored successful practices for data coordination between SNAP and Medicaid agencies gleaned from a 50-state survey and three state case studies.
Expanding the Menu: How Medicaid Can Address Food Insecurity
This brief outlines strategies for state Medicaid agencies to help people experiencing food insecurity obtain continuous access to nourishing food.
What States Can Do to Keep People Covered as Unwinding Continues
This blog highlights a new Commonwealth Fund post, which assesses the status of state efforts to smooth coverage transitions during the unwinding and discusses the need for more timely and accurate data.
State-Based Marketplace Transition Data During the Unwinding
This blog reviews SBMs reporting of Marketplace transition outcome data, state variations in reporting, and considerations for presenting outcomes data.
State-Based Marketplaces: Continuing Innovations for Open Enrollment 2024
This blog highlights new and innovative initiatives being implemented during the plan year 2024 OEP.
Improving Data Sharing Across SNAP and Medicaid Agencies: Key Factors for Success During Unwinding and Beyond
This webinar explores successful practices for data coordination between SNAP and Medicaid.
Lessons in Leadership: Navigating Change in Public Sector Agencies
This blog shares stories from public sector leaders across the country as they navigate day-to-day operations.
Tracking Health Insurance Coverage During the Unwinding: Monthly Data from the Household Pulse Survey
This blog uses data from the U.S. Census Bureau’s Household Pulse Survey to track trends in adult health insurance coverage rates during the unwinding.
State-Based Marketplace Transition Data During the Unwinding
This blog examines CMS' fourth release of state data reporting metrics, which includes information on Marketplace enrollment transitions.
State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
Using state data, this continually-updated blog analyzes the current state of the unwinding and identifies state-based based best practices and trends.
What’s New for 2024 Marketplace Enrollment?
This blog summarizes a number of new and ongoing policy changes that will impact the Marketplace as the annual open enrollment period for Affordable Care Act Marketplace coverage kicks off November 1 in most states.
Tracking Health Insurance Coverage During the Unwinding: Monthly Data from the Household Pulse Survey
This blog uses data from the U.S. Census Bureau’s Household Pulse Survey to track trends in adult health insurance coverage rates amid the unwinding.
CMS Releases Third Batch of State-Reported Unwinding Data
This blog shares new CMS data on Marketplace enrollment and transitions, and separate CHIP enrollment.
State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog examines variations in states' reporting of indicators and data highlights.
How Medicaid Agencies Can Leverage Multi-Payer Aligned Measure Sets
This blog reviews how Medicaid programs in Connecticut, Massachusetts and Rhode Island have engaged with commercial payers, providers, patients, advocates and other parties to create and adhere to multi-payer aligned measure sets.
CMS Finalizes Medicaid Rule to Streamline Enrollment into Medicare Savings Programs
This blog provides a high-level overview of key provisions included in the final rule that will facilitate enrollment and retention of Medicare Savings Program coverage.
Tracking Health Insurance Coverage During the Unwinding: Monthly Data from the Household Pulse Survey
This blog uses data from the U.S. Census Bureau’s Household Pulse Survey to track trends in adult health insurance coverage rates as states “unwind” the Medicaid continuous coverage requirement.
States of Unwinding: How State Officials Are Innovating to Support Coverage
This blog discusses states' approaches to support coverage through the unwinding period.
New Mothers Gained Health Coverage During Pandemic-Era Coverage Protections
This blog shares a new report that offers policy recommendations to ensure new mothers are able to access coverage and high-quality care during the postpartum period.
Declining Uninsured Rates Supported by Private and Public Coverage Increases
This blog highlights national and state-level changes that took place between 2021 and 2022 in the broadest categories of insurance.
Exploring Cost and Coverage Rates in Employer-Sponsored Insurance (Infographic)
In this blog and infographic, SHADAC researchers use recently released data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to analyze private-sector ESI and provide an initial snapshot of estimates for 2022 on a national level and within the states.
Medicaid-Eligible Adults Who Lack Private Coverage and Are Not Enrolled
This report shares findings with policy implications for how counts of the uninsured should be interpreted while highlighting the importance of policies that promote Medicaid enrollment and retention.
Strategies for States to Improve Ex Parte Renewals During – and Beyond – the Medicaid Unwinding
This blog discusses available options states can adopt to improve ex parte rates.
State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog shares data on how states are monitoring the impacts of the resumption of eligibility redeterminations and disenrollments.
Tracking Health Insurance Coverage During the Unwinding: Monthly Data from the Household Pulse Survey
This blog tracks trends in adult health insurance coverage rates as states “unwind” the Medicaid continuous coverage requirement.
Neighborhood Resource Access and Health Risks for Children Covered by Medicaid and CHIP
This brief examines whether neighborhood conditions vary with children who rely on Medicaid or CHIP for coverage.
Developing Financially Sustainable Child Health Transformation: Lessons from Primary Care Innovators
This brief describes existing payment barriers and opportunities for primary care providers serving children to work toward financially sustaining care transformation.
Early Rate Filings Show Premium Increases, Rising Costs of Care
This blog shares the findings of CHIR's research into the rate requests from select states with early rate filing deadlines to see what’s behind the premiums consumers could be facing in 2024, both on- and off-Marketplace.
Using Surveys to Monitor Coverage Transitions During the Unwinding of the Medicaid Continuous Coverage Requirement
This blog shares individual-level surveys of people who were enrolled in Medicaid during the continuous coverage requirement to help answer whether people are gaining employer-sponsored insurance (ESI) upon leaving Medicaid coverage and why some successfully renewed while others could not.
Call Center Strategies to Support Unwinding: State Toolkit
This toolkit identifies opportunities and explores strategies to improve call center functionality.
The Perfect Storm: Misleading Marketing of Limited Benefit Products Continues as Millions Losing Medicaid Search for New Coverage
This publication explores how Medicaid enrollees searching for new health plans on the private market are facing aggressive and misleading marketing of limited benefit products that often fail to protect consumers from the steep cost of healthcare.
The Intersection of Housing and Health
In this podcast, public officials from Wisconsin and Arizona share how their state’s Medicaid programs are partnering with the housing sector to tackle the challenges faced by people experiencing homelessness.
The Medicaid Unwind’s Impact on Children: Are They Moving to CHIP?
This blog reviews state processes that are underway to ensure eligible children who are losing Medicaid coverage are transitioning to CHIP.
Medicaid Managed Care Strategies to Reduce Racial and Ethnic Health Disparities in Mental Healthcare for Adults
This brief identifies ways in which states can leverage their Medicaid managed care programs to advance their health equity goals.
Tracking Health Insurance Coverage During the Unwinding
This blog examines trends in adult health insurance coverage rates as states “unwind” the Medicaid continuous coverage requirement and restart standard redetermination procedures.
State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog examines states' use of data dashboards to monitor progress on coverage transitions during the unwinding.
State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog discusses how data dashboards allow states to make proactive decisions about what data to release and on what schedule.
Community and Uninsured Profile In Action: Local Case Studies
This blog examines two case studies that highlight how the profile can support the enrollment efforts of local organizations and departments.
Community and Uninsured Profile In Action: Local Case Studies
This blog discusses how states are approaching helping their residents secure coverage.
State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog discusses how data dashboards can be useful for states to make proactive decisions about what data to release and on what schedule and then organize that data in an easy-to-digest visual format that facilitates the interpretation of key coverage trends.
Addressing Health-Related Social Needs through 1115 Demonstrations
Addressing Health Related Social Needs (HRSN) in 1115 demonstrations can help states improve coverage, access, and equity. This blog examines innovative state demonstrations and implications for cross agency partnerships.
State Dashboards to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog examines and maps states that are using publicly available dashboards to share key data points as they monitor enrollment transitions throughout the unwinding.
State Dashboards to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog examines states' plans to publish a data dashboard to monitor progress.
States Support Postpartum Health with Medicaid Expansions
This blog discusses federal support for states looking to expand postpartum coverage through Medicaid.
Data Coordination at SNAP and Medicaid Agencies: A National Landscape Analysis
This report examines how states coordinate across Medicaid and the Supplemental Nutrition Assistance Program.
Searching for a New Normal: How Expiration of the Federal Public Health Emergency Impacts Access to Health Care Services
This blog reviews selected policies tied to the PHE and evaluates how their expiration will impact consumers’ access to services.
CMS Proposes Significant Medicaid Policy Changes for Access Monitoring, Managed Care, and HCBS
This blog examines how two newly-released proposed rules from CMS could reshape the federal regulatory landscape for Medicaid and the Children’s Health Insurance Program.
The Health Coverage of Noncitizens in the United States (2024)
This report analyzes healthcare coverage and eligibility of nonelderly noncitizens compared with the entire nonelderly population of the US.
Final 2024 Payment Rule, Part 1: Insurance Market Rules And Consumer Assistance
This blog focuses on market reforms and consumer assistance within the 2024 Notice of Benefit & Payment Parameters.
A Closer Look at CMS’s Proposed Rule to Improve Access to Care in Medicaid and CHIP
This blog aims to summarize the access rule which includes changes to Payment for Services, Medicaid Advisory Committees, and Home and Community-Based Services.
Effective Medicaid Renewal Notices Are Key to Getting it Right During Unwinding
This blog discusses that, while there are many factors that may affect the scale of coverage losses from procedural disenrollments, one of the significant concern is notices.
Expedited CMS Approvals in Washington and Oregon Can Further Minimize Coverage Disruptions, Aid Unwinding
This blog discusses how new CMS approvals in Oregon and Washington will protect health coverage for children and families during this Medicaid unwinding, minimizing coverage disruptions and easing transitions to new sources of health coverage.
The Final 2024 Notice of Benefit & Payment Parameters: Implications for States
This blog focuses on provisions of the final rule most of interest to State-Based Marketplaces and state insurance regulators.
Georgia Extends Medicaid Postpartum Coverage for Pregnant Women
This blog examines Georgia’s efforts to address maternal mortality, partly through Medicaid postpartum coverage extension.
Final 2024 Payment Rule, Part 1: Insurance Market Rules And Consumer Assistance
This blog discusses key themes underlying many of the 2024 rules including the administration's commitments to advancing health equity, improving the costumer experience, and expanding marketplace enrollment.
CMS Issues Guidance on Section 1115 Demonstration Opportunity to Support Reentry for Justice-Involved Populations
The blog discusses parameters for reentry 1115 demonstrations.
IMI Releases Updated Risk Adjustment Model for Medicaid
This blog explores the updated model and its' three primary goals to risk adjustment.
Stakeholder Perspectives on CMS’s 2024 Notice of Benefits and Payment Parameters: Consumer Advocates
This blog examines issues including network adequacy, door-to-door enrollment assistance, re-enrollment decision hierarchies, and standardized plans.
CMS Opens Door for Pre-Release Services for Justice-Involved Populations: Health Care and Justice System Implications
This webinar explores a new opportunity to improve access to care and services for people returning to the community from state prisons, county jails, and youth correctional facilities.
State Dashboards to Monitor the Unwinding of the Medicaid Continuous Coverage
This blog discusses how states have initiated plans to publish a data dashboard to monitor unwinding progress.
Leveraging Data to Drive Results for Medicaid and Marketplace Enrollment
This blog discusses opportunities and considerations to utilize strategies to minimize coverage loss as states reinstate Medicaid redeterminations.
The State of State Protections: Maintaining Access to Services after Transitioning from Medicaid
This blog discusses actions government officials have been taking to promote continuity of coverage to minimize the number of people who become uninsured or face a gap in coverage.
State Dashboards to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement
This blog discusses how some states have initiated plans to publish a data dashboard to monitor progress given the intense focus on coverage transitions during the unwinding.
Key Strategies to Help States Prevent a Potentially Historic Loss in Health Insurance Coverage Nationwide
This blog examines three key strategies Benefits Data Trust believes will help streamline the transition for government staff and Medicaid recipients.
Secrets to a Successful Unwinding: Actions State-Based Marketplaces and Insurance Departments Can Take to Improve Coverage Transitions
This blog provides a checklist of actions state-based Marketplaces and state departments of insurance can take to reduce gaps in coverage and minimize disruptions in care.
Updates to the Navigator Resource Guide Provide Information for People Transitioning from Medicaid to Private Health Insurance
This blog highlights updates to the Center On Health Insurance Reforms' Navigator Resource Guide to help consumers and enrollment assisters during the unwinding.
Unwinding Medicaid Continuous Coverage: Checklist for Redeterminations
This publication presents a checklist that provides an overview of the minimum redetermination requirements states must follow, and identifies some common red flags that may indicate failures by the Medicaid agency to meet those requirements.
States Should Streamline Medicaid Enrollment and Renewal for Older Adults and People With Disabilities Ahead of Unwinding
As states prepare to unwind the COVID-19 pandemic-related Medicaid continuous coverage requirement and resume terminations of coverage as soon as April 1, this blog examines how they could streamline eligibility determinations for older adults and people with disabilities, who face unique challenges with the Medicaid enrollment and renewal process.
States Should Use Federal Matching Funds to Ensure Adequate Staffing During “Unwinding” of Medicaid Continuous Coverage
This blog highlights the benefits of using federal matching funds to help states hire more people, raise wages, and temporarily bring back retired workers, and pay overtime.
Pediatricians Urge State Leaders to Shield Children from Losing Medicaid Coverage
This blog reviews a new report that explores the high stakes for children when the continuous coverage protection expires.
Reporting Requirements Related to Unwinding Medicaid Continuous Coverage: Considerations for Medicaid and the Marketplace
This blog outlines the relevant reporting requirements that were included in the CAA and the corresponding reporting guidance provided by CMS.
CMS Announces Important Consumer Protection for People Losing Medicaid/CHIP
This blog covers key considerations to account for as the unwinding begins, including a newly announced special enrollment period (SEP).
Race/Ethnicity Data in CMS Medicaid (T-MSIS) Analytic Files: 2020 Data Assessment
This blog shares how CMS guides researchers and other consumers in their use of T-MSIS data through production of data quality assessments of the race and ethnicity data along with other data such as enrollment, claims, expenditures, and service use.
Supporting Continuity of Coverage from Medicaid into the Marketplace: Post-PHE Considerations for States
This blog highlights state strategies to maximize continuity of coverage for consumers coming off Medicaid and needing to transition to the marketplace.
Implementing Changes to Medicaid Coverage for Former Foster Youth Could Be a Long, Bumpy Path but States Have Easier Option Available
This blog discusses that, though the law intended to cover ALL FFY and the provision seems straightforward, the way the law was constructed has many barriers and administrative burdens.
Funding for Community Health Workers Authorized in Consolidated Appropriations Act – How could this help children and families?
This blog examines how the Consolidated Appropriations Act of 2023 will strengthen the CHW workforce and improve patient care.
Improving Ex Parte Renewal Rates to Support Unwinding: Questions and Answers
This Q&A style blog discusses ex parte redeterminations in which Medicaid officials attempt to make a redetermination of an individual’s eligibility based on available data, without requiring additional information from the individual.
The Proposed 2024 Notice of Benefit & Payment Parameters: Implications for States
On December 12, 2022, the Centers for Medicare & Medicaid Services released its proposed Notice of Benefit & Payment Parameters for plan year 2024. This blog assess provisions of the proposed rule that are of interest to state-based marketplaces regulators.
Supporting Continuity of Coverage from Medicaid into the Marketplace: Post-PHE Considerations for States
This blog delves into specific actions states can take to minimize gaps in coverage for consumers who become ineligible for Medicaid.
The Impact of the COVID-19 Public Health Emergency Expiration on All Types of Health Coverage
This report breaks down the estimate that if the PHE expires in April 2023, 18.0 million people will lose Medicaid coverage in the following 14 months.
Creating Robust Provider Networks to Support Older Adults and People with Disabilities: Considerations for Medicaid Health Plans in California and Nationwide
This blog reviews considerations for California's Medi-Cal managed care plans as they fortify provider networks to ensure that older adults and people with disabilities have their health and social needs met.
Medicaid Population-Based Payment: The Current Landscape, Early Insights, and Considerations for Policymakers
This report can help states design and implement effective Medicaid PBP models.
How States are Leveraging Medicaid Managed Care to Address Health-Related Social Needs
In this webinar, experts from Bailit Health reviewed a new resource, Addressing Health-Related Social Needs Through Medicaid Managed Care, which describes approaches to require and/or incentivize Medicaid plans to address health-related social needs.
Supporting Continuity of Coverage from Medicaid into the Marketplace: Post-PHE Considerations for States
This blog is part of a series on unwinding strategies for states and highlights ideas from earlier works on issues like continuity of care, health equity implications, etc., and offers new ones for states to consider to support continuity of coverage.
Survey: Medicaid Health Plans Share Successes During COVID-19 Response, Identify Challenges in Data Collection and Sharing
This survey offers findings and insights that can help inform efforts led by Medicaid health plans and state agencies to meet enrollees' needs post-COVID.
That’s Medicaid: When You Care for a Family
This commentary shares the story of Natalie and her family. Natalie was born with a disability but access to Medicaid has allowed her to live her best life possible, at home with her parents.
Developing a Payment and Spending Strategy to Advance Health Equity: Checklist for Medicaid Decision-Makers
This brief includes a checklist of eight key questions that can help state purchasers and other payers develop a robust payment and spending strategy focused on advancing health equity.
Promoting Equity and Dignity in Benefits Access: Supporting North Carolina and Washington in Advancing Statewide Change
This blog discusses how Benefits Data Trust is supporting North Carolina and Washington over the next two years in achieving the ambitious goals they have set to increase access to Medicaid and social service benefits.
Strengthening Oral Health in the U.S. through Integration and Workforce Development: Lessons from State and Federal Health Officials
This blog discusses how, given gaps in access to dental insurance and providers, state health policy is an important area for achieving oral health equity.
When a Life Is Saved
This commentary discusses how Medicaid supported Susie when she learned her young daughter Tymia was diagnosed with sickle cell disease.
CMS Proposed Rule on Medicaid and CHIP Eligibility, Enrollment, and Renewal
This blog analyzes the new rule's ability to close gaps and extend best practices identified by CMS and states in the course of preparing for the end of the Medicaid continuous coverage requirement under the federal public health emergency (PHE).
Overview of the Public Charge Final Rule
This blog discusses the contents of the Public Charge Final Rule.
Protecting Coverage for Postpartum Individuals at the End of the Public Health Emergency
This issue brief reviews proactive strategies that states can deploy to support postpartum individuals in maintaining health coverage and access to care when the Medicaid continuous coverage guarantee ends and beyond.
When Support Helps Find Your Passion
This commentary tells the story of how Medicaid guided Alicia through her pregnancy and the birth of her son while incarcerated.
Emerging State Innovations in Developing a Medicaid Community-Based Palliative Care Benefit
The blog analyzes Medicaid community-based palliative care benefits that several states are developing to advance palliative care.
Ensuring Continuity of Care for Individuals Transitioning from Medicaid to Marketplace: Post-PHE Considerations for States
This blog identifies strategies for state-based Marketplaces, in partnership with Medicaid agencies, departments of insurance, consumer assisters, and participating insurers, to help maintain continuity of care.
State Strategies for Sequencing Enrollee Communications When Medicaid Continuous Coverage Ends
This blog explores how states can coordinate and prepare communications related to the end of the Medicaid continuous coverage requirement with clear messaging to inform enrollees, help to reduce churn, and maximize coverage renewal, retention, and transition.
Medicaid Managed Care Contract Language: Health Disparities and Health Equity
This report provides excerpts of health disparities and health equity language from Medicaid managed care (MMC) contracts and requests for proposals (RFPs) from 17 states and the District of Columbia. The criteria for inclusion in this compendium are contracts and RFPs that explicitly address health disparities and/or health equity.
Leveraging Technology to Improve Quality within Medicaid Managed Care: Early Lessons
This blog reviews ways states can support the identification and implementation of tech-enabled innovations to Medicaid systems.
How California’s Medi-Cal Program Aims to Advance Health Equity for Pregnant People
With new budget initiatives, a California Momnibus Act, and a new Medicaid transformation initiative, the state is seeking to advance more whole-person care for pregnant and birthing people, and to ensure and expand access to reproductive health care, including abortion services.
Inside Medicaid’s Workforce Recovery
This new episode of the Medicaid Leadership Exchange podcast explores the inner workings of Medicaid’s workforce recovery and the opportunity to build a more diverse, equitable, and inclusive work culture.
Medicaid’s Ongoing Equity Commitment
The podcast episode features Medicaid leaders discussing the need for agency leadership to engage in self-observation and recognize bias when committing to advance equity within their agencies and for enrollees.
Experience Implementing Social Risk Factor Screening Measures in Medicaid
The webinar aimed to bring together those in states who have implemented social risk factor screening measures for incentive use in managed care contracts.
Using Medicaid Datasets to Measure Tobacco Use: A Review
This blog explores how states can use Medicaid data to quantify tobacco use within this population, identify related best practices, and make recommendations for scaling.
Leveraging Section 1902(e)(14) Waiver Authority Amid Unwinding
This blog explores the 1902(e)(14) waiver to help support states in their efforts to successfully “unwind” from the Medicaid continuous coverage requirement.
What Will Happen to Health Care Spending If the American Rescue Plan Act Premium Tax Credits Expire?
In this brief, researchers explore what will happen to healthcare spending if the American Rescue Plan Act Premium Tax Credits expire.
Improving Ex Parte Renewal Rates: State Diagnostic Assessment Tool
This toolkit contains a table that can be used by a state to examine current ex parte processes and identify and deploy additional strategies that could increase their ex parte rates.
Ensuring Continuity of Coverage and Care for High Need Enrollees When the Medicaid Continuous Coverage Ends: Medicaid Strategies
This blog, the first in a two-part series, outlines strategies state Medicaid agencies can take to identify people with high health needs and provide them with additional support to retain or transition their health coverage in order to maintain access to essential healthcare services.
Standards for Provider Network Adequacy in Medicaid and the Marketplaces
This blog analyzes the Centers for Medicare & Medicaid Services' final rules for provider network adequacy standards in the federal healthcare marketplaces and Medicaid.
Standards for Provider Network Adequacy in Medicaid and the Marketplaces
This blog compares the standards for network adequacy in Medicaid with those in the marketplaces.
That’s Medicaid: A Financial and Personal Lifeline
This commentary tells the story of Theresa. At an early age, she was diagnosed with Spastic Quadriplegia Cerebral Palsy, a disorder that affects a person’s ability to maintain balance and posture. Now in her 40s, Medicaid allows her to work and live independently. It also provides her with speech, physical and occupational therapies, a wheelchair and the help of personal care attendants who assist with basic needs such as meal preparation, cleaning, dressing, and laundry.
Leading Medicaid Out of Emergency and Into Its Future
In this podcast, Medicaid Leadership Exchange, former Medicaid directors explore what they would prioritize now and into the future when the Medicaid public health emergency unwinds — and where blind spots may lie.
States Want to Integrate Medicare and Medicaid, But They Need Federal Resources and Flexibilities
In this Health Affairs blog post, Nancy Archibald, MHA, MBA, CHCS’ Associate Director for Federal Integrated Care Programs, outlines perspectives from state Medicaid officials on the federal policies that have advanced Medicare-Medicaid integration, and areas where they believe additional federal policy actions are needed.
Estimating Health Coverage in 2023
This update to the methodology documentation for the Urban Institute’s Health Insurance Policy Simulation Model explains how they estimated health coverage in 2023, taking into account major uncertain issues such as Medicaid enrollment after the HHS public health emergency and the potential expiration of enhanced premium tax credits for Marketplace coverage in 2023.
Planning for the End of the Continuous Coverage Requirement: Communications Resources for States
This page provides communications resources designed to support states as they prepare for the various stages of work needed to inform stakeholders and consumers about the upcoming end of the Medicaid continuous coverage requirement. The end of the Medicaid continuous coverage requirement presents states with tremendous opportunities to keep individuals enrolled in Medicaid or transition to another form of health coverage.
View Each State’s Efforts to Extend Medicaid Postpartum Coverage
This interactive map and chart summarize proposed and approved legislation since 2018, Medicaid waivers, financial estimates, and other initiatives designed to extend coverage during the postpartum period. (Under the Families First Coronavirus Response Act, Medicaid enrollees who typically lose coverage after 60 days postpartum cannot be disenrolled until the end of the month in which the public emergency period ends.)
Toolkit: Increasing WIC Coverage Through Cross-Program Data Matching and Targeted Outreach
This toolkit is designed to help state and local WIC agencies leverage data from Medicaid and SNAP to measure enrollment gaps and increase enrollment using tools to plan, launch, and/or strengthen data matching and targeted outreach to eligible families who are not receiving WIC benefits.
Broker Commissions for Mid-Year Enrollment in the Marketplaces: Options for State Marketplaces and Insurance Regulators to Prevent Discrimination
At the end of the Pubic Health Emergency, more than 15 million people may become uninsured if they cannot secure alternate sources of health coverage. This blog provides actions states should carefully consider to ensure that stakeholders, including insurers, are facilitating these critical transitions.
Mitigating Coverage Loss When the Public Health Emergency Ends: The Role of the Affordable Care Act Marketplaces
This blog discuss the important role that ACA marketplaces will play in mitigating coverage losses as they prepare for the end of the Public Health Emergency and identifies basic as well as more innovative strategies marketplaces can adopt to help consumers make a smooth transition to affordable, comprehensive coverage.
Leveraging Managed Care Plans to Support Medicaid Continuous Coverage Unwinding Toolkit
This toolkit highlights opportunities for states to leverage managed care plans to support unwinding the Medicaid continuous coverage requirement.
Making Medicaid Estate Recovery Policies More Equitable: State Toolkit
This toolkit is intended to assist state officials in evaluating their current estate recovery policies and understanding where they may have flexibility to make the policies less burdensome for affected low-income families.
Overview of States’ Health Care Cost-Growth Benchmark Programs
A cost-growth benchmark program is a cost-containment strategy that limits how much a state’s health care spending can grow each year. This chart provides a snapshot of programs across the country including state efforts to improve care quality and outcomes in the program.
Engaging Consumers to Inform Medicaid Decisions: Lessons from Iowa’s Town Halls
This blog explores how Iowa Medicaid program implemented a town hall program that successfully integrates member and stakeholder perspectives into it's program and policy design.
CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports
This report summarizes the different elements of California’s initiative, which provides a model for other states seeking to expand housing services and whole person care through Medicaid.
Midwife Medicaid Reimbursement Policies by State
This interactive map summarizes state Medicaid reimbursement policies for all types of midwives including certified nurse-midwives and midwives who pursue alternative pathways to licensure, often referred to as certified professional midwives, certified midwives, or direct entry midwives depending on state regulations.
Assessing Federal and State Network Adequacy Standards for Medicaid and the Marketplace
This brief reviews the regulatory framework for network adequacy for Medicaid Managed Care Organizations and Marketplace qualified health plans and identifies policies and practices to ensure their networks include the number and mix of providers that enrollees need.
Leadership Tips from a Life-Long Public Servant
This blog explores strategies on how to invest in the development of Medicaid leaders to help states and territories improve the health and well-being of people served by publicly financed care.
Key tips include:
Always have a plan b, plan c, and plan d.
Build relationships and find a common thread.
Fill the void.
And more.
The Doctor Will Hear You Now: Audio-Only Telehealth and the Promise of Access, Equity, and Engagement in Medicaid
This blog explores how telehealth can support services like telematernity and behavioral health visits and its potential to meet health needs and improve health equity.
Effects of Medicaid Expansion on Physician Participation
This brief summarizes key findings from a new study led by Dr. Hannah Neprash which provides direct answers about how clinicians responded to the Medicaid expansion.
New CMS Guidance on Expectations for Unwinding Federal Medicaid Continuous Coverage
This blog summarizes key takeaways laid out in the new CMS guidance related to timelines and operational strategies states can leverage to mitigate churn when the federal Medicaid continuous coverage requirement ends.
Tracking Medicaid Enrollment Growth During COVID-19 Databook
This Databook provides a comprehensive, detailed look at Medicaid enrollment trends from the beginning of the COVID-19 pandemic through November 2021 and enrollment detail by state across four eligibility categories:
Expansion adults
Children (including those enrolled in CHIP)
Non-expansion adults
Aged, blind, and disabled individuals
What Will Happen to Medicaid Enrollees’ Health Coverage after the Public Health Emergency?
This brief projects Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and 2023, assuming the PHE is extended through the first, second, or third quarters of 2022.
Harnessing Payment to Advance Health Equity: How Medicaid Agencies Can Incorporate LAN Guidance into Payment Strategies
This blog summarizes practical steps and recommendations for alternative payment models to help state Medicaid agencies make care more accessible and equitable, and drive better health outcomes.
Investing in Integration: Indiana’s Long-Term Care System Redesign Focuses on Dual-Eligible Populations
This blog profiles Indiana’s plans to launch Medicaid managed long-term services and supports in 2024, under which a majority of participants are expected to be dually eligible individuals.
Adoption of Value-Based, Alternative Payment Models: Where Are We Today and Where Do We Go from Here?
This blog explores value-based, alternative payment models as employer-sponsored health insurance costs have increased by 6.3 percent in the United States since 2010, with additional increases projected.
Tracking Medicaid Coverage Post the Continuous Coverage Requirement: Using Data Dashboards to Monitor Trends
This issue brief examines the current status of data collection to assess Medicaid enrollment and retention, summarizes potential forthcoming reporting requirements, and describes some of the best practices states should consider when developing a data dashboard to display this type of information.
Stratifying Data and Implementing Financial Incentives: How States Are Leveraging Medicaid Managed Care to Further Health Equity
This blog provides Medicaid agencies with examples of how different states are leveraging their managed care programs, inclusive of contracts, quality initiatives, and procurement processes, to promote health equity and address health disparities.
Text Messaging: An Important Communication and Outreach Strategy as States Unwind the Federal Medicaid Continuous Coverage Requirement
This blog explores text messaging as a mechanism for outreach for state Medicaid and Children’s Health Insurance Program (CHIP) agencies to directly contact Medicaid and CHIP enrollees and communicate important information.
Mobile Crisis: Maximizing New Medicaid Opportunities
This blog examines some of the key factors and decision points states may want to consider as they build out mobile mental health crisis services and systems that qualify for enhanced federal medical assistance percentage funding; engaging a cross-agency team and a broad range of external stakeholders can help ensure full consideration of diverse state crisis needs.
Marketplace Pulse: Participation in 2022
This blog examines recent happenings with insurer participation in the Affordable Care Act marketplace.
Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates
This chart summarizes temporary Medicaid and CHIP flexibilities enacted by the federal government to help states respond to the ongoing COVID-19 pandemic. The chart includes effective dates and expiration dates as dictated by law or agency guidance.
Leveraging Managed Care Plans to Support Medicaid Continuous Coverage Unwinding Toolkit
This toolkit highlights opportunities for states to leverage managed care plans to support unwinding the Medicaid continuous coverage requirement.
The Proposed 2023 Notice of Benefit & Payment Parameters: Implications for States
This brief examines provisions of the Notice of Benefit and Payment Parameters for the plan year 2023 related to the state-based marketplaces and state insurance regulators.
Reducing Bias in Algorithms: Spotlight on Pennsylvania
This blog post sheds light on how Pennsylvania has taken steps to better understand how to mitigate the racial bias by collecting information on how Medicaid Managed Care Organizations are using algorithms, the types of proxies being used, and the outcomes as a method to develop their health equity strategies.
State Medicaid Approaches to Doula Service Benefits
This informative chart details key components and features of states’ Medicaid doula benefits.
Planning for the End of the Continuous Coverage Requirement: A Communications Toolkit for States
This extensive report provides a communications planning guide and template communications resources designed to support state Medicaid agencies as they prepare for the upcoming end of the continuous coverage requirement.
When Support Helps Find Your Passion (Oregon)
This commentary tells the story of Alicia, whose Medicaid-assigned doula guided her through pregnancy while in incarceration and the birth of her son.
SHADAC at the 2021 Virtual AcademyHealth Annual Research Meeting (ARM)
This blog post describes how the COVID-19 pandemic has created historically large disruptions to the economy and health insurance coverage at a time when having access to health care is especially important.
Three in 10 Adults in California Immigrant Families with Low Incomes Avoided Safety Net Programs in 2020
This report examines how many immigrant families have avoided safety net and pandemic relief programs in recent years over concerns that their participation would have adverse immigration consequences.
Promising Approaches to Reducing Disparities in Birth-Related Health Outcomes in Medicaid
The brief focuses on actions Medicaid agencies can pursue through their managed care programs or directly with provider organizations and highlights state interventions and collaborations that demonstrate promise in reducing disparities and begin to center equity in birth-related health policies.
Overview of States’ Hospital Reference-Based Pricing to Medicare Initiatives
This chart presents efforts by state insurance purchasers using reimbursement rates paid by Medicare as a reference-point to inform their programs’ hospital payments.
A Hybrid Funding and Coverage Model to Ensure Universal Access to Mobile Crisis Services
This issue brief presents a sustainable, hybrid coverage and funding approach for mobile crisis services in light of the new federal funding opportunities for states to improve access to behavioral health crisis services.
States Use American Rescue Plan Act Funds to Strengthen Home and Community-Based Service Workforce
This brief explores how states propose using American Rescue Plan Act funds to bolster the workforce that provides home- and community-based services, including increasing reimbursement rates, providing new opportunities for professional advancement, and offering recruitment and retention incentives.
ACA Marketplaces Well-Positioned for Strong 2022 Open Enrollment Season
This expert perspective highlights observations about the factors impacting rate changes in the Affordable Care Act Marketplaces this year and the kind of variations that exist among states.
What Will Happen to Unprecedented High Medicaid Enrollment after the Public Health Emergency?
This report aims to estimate the Medicaid enrollment trends once the COVID-19 public emergency ends and policies prohibiting disenrolling beneficiaries are nullified.
Strengthening Long-Term Services and Supports
This report finds that generous funding to support policies related to home- and community-based services (HCBS) eligibility, caregiver wages, and services could drastically improve the lives of people in need and the workers who serve them.
How State-Based Marketplaces Can Maximize Consumer Outreach during Open Enrollment
This commentary presents strategies for state-based marketplaces to improve consumer outreach, provide enrollment assistant and clearly communicate with consumers with what health coverage options are available for them in 2022.
Building State Capacity To Facilitate Equitable Access To Testing And Treatment For HIV, Viral Hepatitis, STDs And TB
This paper includes considerations and approaches to promote equity and improve public health capacity to prevent, detect and respond to HIV, viral hepatitis, STDs and TB during the public health emergency and beyond.
Medicaid Managed Care Contract Language: Health Disparities and Health Equity
This report provides updated excerpts of health disparities and health equity language from Medicaid managed care contracts and requests for proposals from 15 states and the District of Columbia as well as the contract for California’s state-based marketplace, Covered California.
Promoting Health Equity in Medicaid Managed Care: A Guide for States
This guide describes recommended process steps for states to integrate a focus on health equity in their Medicaid managed care programs.
Strategies for Working with Managed Care Organizations to Increase COVID-19 Vaccination Rates
This expert perspective explores how state Medicaid managed care programs and health plans can work collaboratively to increase COVID-19 vaccination rates for the more than 55 million Medicaid enrollees in comprehensive managed care plans.
State Medicaid Coverage of Dental Services for General Adult and Pregnant Populations
This map and chart highlight dental benefits for general adults and pregnant populations enrolled in Medicaid.
Engaging Families in Program and Policy Development to Ensure Equitable Health Outcomes for Children
This blog post explores seven key considerations for health care organizations, Medicaid programs, and advocacy organizations to facilitate family engagement in program and policy design and implementation.
States Can Again Weigh in on TennCare Demonstration with Closed Formulary
This blog examines how states and other stakeholders have another chance to weigh in on Tennessee’s 10-year Medicaid funding demonstration which was approved by the Centers for Medicare & Medicaid Services in early January during the final days of the Trump administration.
Each State’s Efforts to Extend Medicaid Coverage to Postpartum Women
This interactive map and chart summarize proposed and approved legislation since 2018, Medicaid waivers, financial estimates, and other initiatives designed to extend coverage during the postpartum period.
Op-Ed: Medical Professionals: Who benefits from Medicaid expansion? Everyone.
This op-ed provides arguments for Medicaid expansion in Wyoming from the perspective of provider organizations.
Op-Ed: N.C. could benefit from Virginia’s deal
This op-ed argues for Medicaid Expansion in the North Carolina, highlighting the success Virginia had in extending access to health care through its expansion.
Op-Ed: Kansas legislators should follow the will of their constituents. It’s time to pass Medicaid expansion.
This op-ed argues the need for Kansas to expand its Medicaid program to close the "coverage gap".
That’s Medicaid: Down Syndrome Coverage
This brief highlights the stories of people with Down syndrome who have benefited from Medicaid coverage.
States Are Leveraging Medicaid Managed Care to Further Health Equity
The blog highlights updates to a compendium providing Medicaid agencies with examples of how different states are leveraging their managed care programs, inclusive of contracts, quality programs, and procurement processes, to promote health equity and address health disparities.
States Use Appendix K and Emergency Waivers to Support Home- and Community-Based Services in Response to COVID-19
This National Academy for State Health Policy’s Appendix K interactive map, supported by The John A. Hartford Foundation, tracks each state’s new flexibilities in modified 1915 (c) and 1115 waivers and includes information about flexibilities in COVID-19 Public Health Emergency Demonstration 1115 waivers.
Explore Physician Acceptance of New Medicaid Patients through Two New Measures on SHADAC’s State Health Compare and in a New MACPAC Factsheet
These digital tools examine and compare physician acceptance of new Medicaid patients at the state level and by physician and practice characteristics.
Health Equity Language Guide for State Officials
This guide is comprised of three tools to help state officials with the language they use to discuss and write about race and health equity.
Exploring the Pathways to Medicaid Leadership
This report highlights key findings from a survey, interviews, and literature scan to identify pathways to Medicaid leadership positions, challenges, and opportunities for developing a more diverse pool of future Medicaid executives, and the skills necessary to succeed in these roles.
Minnesota Medicaid Enrollment Grew More than the U.S. Average during COVID-19
This blog examines how Minnesota’s Medicaid expansion was a crucial resource during the COVID-19 pandemic for those who lost their jobs and/or their employer-sponsored health insurance coverage. It is estimated that approximately 29,500 Minnesotans lost their private health insurance coverage between April 2020-July 2020.
Building Health Equity into Medicaid Budgeting
This podcast talks about the COVID-19 pandemic, ensuing recession, and amplification of issues related to health equity that have forced state Medicaid agencies to evaluate their budgets and investments to better serve Medicaid enrollees.
Implementing Diversity, Equity, and Inclusion Efforts to Better Support Staff of Color
This podcast describes how the past year has seen many sectors of health care increasingly pursue diversity, equity, and inclusion efforts as health equity becomes a more prominent topic.
Talking about Anti-Racism and Health Equity: A Conversation with Tekisha Everette, Jim Jones, and Lisa Lee
This podcast describes how critical conversations about health equity can be productive when there is a shared and agreed-upon language amongst Medicaid agencies.
Medicaid Enrollment and Health Equity
This presentation examines the affect of the COVID-19 pandemic on historically under-served populations and strategies to increase Medicaid outreach and enrollment within these communities.
New Proposed Insurance Rule Opens Enrollment Options; Rescinds Trump Policies
This commentary examines how in late June, the U.S. Department of Health and Human Services (HHS) issued its first proposed rule governing the health insurance markets and marketplaces.
Filling the Medicaid Gap with a Public Option
This report examines how a public option that typically pays Medicare rates would considerably reduce the cost of increasing coverage in the Medicaid gap.
Do Black and White Patients Experience Similar Rates of Adverse Safety Events at the Same Hospital?
This report assesses racial disparities in the quality of inpatient care using 11 patient safety indicators that measure rates of adverse patient safety events of hospital-acquired illnesses or injuries.
Using Data to Empower Medicaid to Support Health Equity
This podcast covers how effective data measurement is critical for Medicaid programs seeking to advance health equity and better understand different experiences of populations served by the program.
State Strategies for Costly Drugs with Unconfirmed Clinical Benefits
This commentary examines how recent approval of the Alzheimer’s drug Aduhelm under the U.S. Food & Drug Administration’s Accelerated Approval Program is controversial for a range of reasons, including its projected impact on state Medicaid budgets which will be required to cover the drug, priced at $56,000 a year, despite inconclusive evidence of its clinical effectiveness.
Round III of the 2022 Notice of Benefit & Payment Parameters: Implications for States
This commentary analyzes how the U.S. Departments of Health & Human Services and Treasury have released a proposed rule governing the Affordable Care Act health insurance marketplaces and insurance standards for the plan year 2022.
The No Surprises Act Interim Final Rule: Implications for States
This expert perspective summarizes the Interim Final Rule (IFR) of the No Surprises Act, the comprehensive federal law banning balance bills in emergency and certain non-emergency settings.
COVID-19 Federal Funding Earmarked for Hospitals, Providers, and States
This chart details the amounts and required oversight of COVID-19 federal funds allocated to hospitals, providers, and states by the Families First Coronavirus Response Act (Families First Act), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the Paycheck Protection Program and Health Care Enhancement Act (HR 266), the Consolidated Appropriations Act, 2021, and the American Rescue Plan Act of 2021.
State Medicaid Approaches to Doula Service Benefits
This chart demonstrates how states are using a variety of approaches to provide doula services within their Medicaid programs to address inequities.
Opportunities to Maximize Delegation within Medicaid Agencies
This commentary explains how Medicaid leaders have significant opportunities to impact the health and well-being of millions but must balance a myriad of federal and state priorities related to fiscal stewardship, quality assurance, program integrity, and more.
Nevada Enacts a Public Option
This brief describes Nevada's new public option that is intended to provide consumers with comprehensive, but lower cost health insurance.
Building a Culture of Health Equity from Within: Spotlight on Virginia Medicaid
This blog post highlight's the Virginia Department of Medicaid Services' efforts, successes, and challenges in building a culture of equity.
That’s Medicaid: Heart Health
This brief highlights the stories of people with heart conditions who have benefited from Medicaid coverage.
Leveraging Accountable Care Organizations to Address Health Equity: Examples from States
This report outlines promising state examples of accountable care organizations’ incentives or requirements that can be used to advance health equity.
Fostering Health Equity: Perspectives from a Medicaid Medical Director
This blog outlines the Center for Health Care Strategies' recent interview with internist and pediatrician Nathan Chomilo, MD, Medical Director of Minnesota Medicaid and MinnesotaCare to get his perspectives on priority opportunities for addressing health equity for people served by the state’s Medicaid program.
Assessing Enhanced Federal Funding for HCBS Under the American Rescue Plan
This updated brief describes the American Rescue Plan Act’s home and community-based services enhanced federal medical assistance percentage (FMAP) provision, CMS’s recent implementation guidance, and considerations and next steps for state policymakers.
Collection of Race, Ethnicity, Language (REL) Data in Medicaid Applications: A 50-state Review of the Current Landscape
This issue brief documents how states are collecting information about race, ethnicity, and language on their Medicaid applications.
Vaccine Equity Strategies: Perspectives from Georgia and West Virginia
This podcast features Lynnette Rhodes, executive director of medical assistance plans at the Georgia Department of Community Health, and Cindy Beane, commissioner at the West Virginia Bureau for Medical Services, discussing leadership challenges and successes they have faced in developing equitable vaccine distribution strategies and the status of their respective states’ vaccine rollout.
Supporting Early Development and Learning Amid the COVID-19 Pandemic: Early Childhood and Medicaid Panel Discussion
This webinar features early childhood and Medicaid experts highlighting efforts used to support young children with development and learning needs throughout the COVID-19 pandemic.
How Might State Responses to the Pandemic Affect the Safety Net?
This report examines how the pandemic and related economic downturn affected the need for safety net supports; actions states are taking to mitigate the immense hardship the pandemic has caused; implications for racial equity; and challenges, opportunities, and questions facing state leaders.
How Might State Medicaid and Other Health Programs Be Affected in the Pandemic’s Aftermath?
This report examines how state Medicaid and other health programs responded to the COVID-19 pandemic and its related economic downturn.
That’s Medicaid: Critical Coverage During COVID-19
This brief highlights the stories of people who have benefited from Medicaid coverage during the COVID-19 pandemic.
Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates
This brief summarizes the time frames for emergency measures for Medicaid and Children's Health Insurance Program flexibilities during the COVID-19 pandemic.
Leveraging Medicaid to Support Early Childhood and Parental Mental Health Amid the COVID-19 Pandemic and Beyond
This commentary draws from examples of states participating in the Aligning Early Childhood and Medicaid program and additional states to explore strategies for leveraging cross-agency collaborations and strengthening Medicaid to support early childhood and parental mental health during the COVID-19 pandemic crisis and beyond.
Medicaid Explained
This presentation outlines the key provisions of the Medicaid program.
Medicaid Research Roundup From Research, Evaluation, and Learning
This report includes a collection of summarized evidence on how Medicaid can improve the health of states' residents and communities.
Assessing the Fiscal Impact of Medicaid Expansion Following the Enactment of the American Rescue Plan Act of 2021
This report describes the American Rescue Plan Act's (ARPA) Medicaid matching rate provision and also assesses its fiscal impact for each of the states that have not yet expanded Medicaid, while comparing the available new federal dollars to the cost of expansion.
Assessing Enhanced Federal Funding for HCBS Under the American Rescue Plan Act
This brief describes the American Rescue Plan Act's home- and community-based services federal medical assistance percentage increase provision, the requirements for states receiving the enhanced federal funding, and considerations and next steps for state policymakers.
Medicaid Agencies Cultivate Partnerships and Deploy Data to Bolster COVID-19 Vaccination Efforts
This commentary features discussions with several state Medicaid officials to learn more about how their agencies—and specifically their Medicaid managed care organizations—are leveraging partnerships and data to advance their vaccination efforts.
Balancing Medicaid Budgets and Serving State Residents During a Pandemic
This report outlines key factors for governors and state leaders to consider when balancing state budgets and making difficult decisions about funding Medicaid during the COVID-19 crisis and subsequent economic downturn.
Taking the Disputes out of Dispute Resolution
This report analyzes states’ experiences trying to resolve surprise medical payment disputes between health care providers and insurers.
Federal Policy Recommendations to Advance Health Equity
This series of policy briefs include evidence-based recommendations to help people through the immediate health and economic crises and longer-term recommendations to ensure a fair and just opportunity for health.
Tracking Medicaid Enrollment Growth During COVID-19 Databook
This toolkit looks at Medicaid enrollment trends from the beginning of the COVID-19 pandemic through January 2021.
Analyzing Health Disparities in Medicaid Managed Care
This webinar features discussions on how states can use performance rates and disparities analyses from Medicaid managed care programs in other states to determine where disparities are likely to exist in their own state and develop interventions.
Medicaid Managed Care Contract Language: Health Disparities and Health Equity
This report provides excerpts of health disparities and health equity contract language from Medicaid managed care contracts and requests for proposals from 12 states and the District of Columbia as well as the contract for California’s state-based marketplace, Covered California.
MCO Strategies to Promote COVID-19 Vaccine Uptake
This commentary outlines four recommendations for states to engage their managed care plans to assist in efforts to successfully and rapidly vaccinate the Medicaid population for COVID-19.
A Better Way to Manage Medicaid Costs
This toolkit outlines state options to address Medicaid spending without harming enrollee health and provider stability and access to care.
That’s Medicaid: When You Provide for a Family (Pennsylvania)
This commentary tells the story of Michael, who supported his family with Medicaid coverage after 26 years as an educator with employer-sponsored insurance.
Many Uninsured Adults Have Not Tried to Enroll in Medicaid or Marketplace Coverage
This report assesses awareness of and experiences with publicly subsidized coverage options among adults who were uninsured in September 2020.
CMS Guidance to States on Resuming Public Health Program Operations Post the COVID-19 Public Health Emergency
This brief provides a high-level summary of the Center for Medicare and Medicaid Services guidance related to: (1) conducting redeterminations for Medicaid enrollees who were continuously enrolled; (2) terminating, or extending where appropriate, temporary flexibilities; and (3) developing a consumer and provider communication strategy.
StateNetwork.org’s Top Ten Resources of 2020
The ten most-visited resources on StateNetwork.org during 2020.
Utah: A Business Case for an Asthma Home Visiting Program
This commentary explores Utah’s Medicaid and public health partnership and its efforts to expand Medicaid coverage of the state’s asthma home visiting program.
Michigan: Improving Access to Asthma Control Benefits in Medicaid
This commentary explores Michigan’s efforts in improving access and adherence to asthma medications and devices, as well as promoting the use of evidence-based interventions to improve access to important asthma devices and services.
Increasing Consumer Engagement in Medicaid: Learnings from States
This brief summarizes key learnings from conversations with 50 leaders of state Medicaid programs across 14 states about implementing strategies to improve consumer engagement in policy and program planning.
Audio-Only Medicaid Telehealth Policies
This commentary describes the legal authority that permits states to continue to authorize Medicaid reimbursement for audio-only telehealth after the public health emergency ends.
Understanding The Effects Of Medicaid Innovation
This report explores key considerations and outlines promising tactics for states to use in evaluating new Medicaid policies.
Driving and Delivering Results
This podcast explores strategies public-sector leaders have implemented in response to the COVID-19 pandemic.
More States Looking to Section 1332 Waivers
This map current state activity related the Affordable Care Act’s Section 1332 waivers.
Practicing Good Public Administration During Challenging Times
This podcast episode examines how good public administration works applies in practice, featuring the experiences of two Medicaid directors.
Minnesota: Improving Access to Medicaid Tobacco Cessation Benefits
This brief explores the ways in which various organizations worked together to improve access to and use of tobacco cessation benefits among Minnesota's Medicaid population with the goal of reducing commercial tobacco use in this population.
Redistribution of Federal Funding Across States Due to the Financing of Medicaid and CHIP
This report explores the ways in which Medicaid and CHIP largely transfer funding from higher-income states to lower-income states.
Quick-Takes For Medicaid Leaders Amid COVID-19: What’s Next?
This brief explores the response to the COVID-19 crisis, taking stock of what we have learned and how we have changed.
Ensuring Access To The COVID-19 Vaccine For Adult Medicaid Enrollees: A Roadmap For States
This commentary explores the complex question of which health care payers will cover the costs of COVID-19 vaccine administration.
Social Risk Factor Screening in Medicaid Managed Care
This brief provides an introduction to screening for social risk factors, the first step most states are taking through their Medicaid managed care programs to address how social determinants of health influence enrollees' health status and spending.
Recession and Medicaid Budgets: What Are The Options?
This blog describes some of the limited actions states may take to alleviate fiscal pressure due to the COVID-19 pandemic through the management of their contracts with Medicaid managed care organizations.
Analyzing Medicaid Managed Care Organizations: State Practices for Contracting with Managed Care Organizations and Oversight of Contractors
This report examines how Medicaid agencies in 40 states select managed care organizations to contract with, how contract terms are set, and how performance is evaluated.
Exploring Strategies to Fill Gaps in Medicaid Race, Ethnicity, and Language Data
This commentary provides suggestions states can use to improve the completeness of Medicaid data on enrollee race, ethnicity, and language.
Medicaid Agencies Implement Innovative Outreach Strategies: Lessons from Kentucky and Virginia
This report examines Kentucky and Virginia's adapted outreach efforts to help make enrollment as easy as possible to ensure access to critical coverage and care.
Maintaining Medicaid and CHIP Coverage Amid Postal Delays and Housing Displacements
This commentary examines the impact that recent postal delays, COVID-19-related housing and economic crises, and natural disasters have had on state Medicaid and Children’s Health Insurance Program agencies.
Medicaid and Early Childhood Services: Potential Fiscal Impacts from the COVID-19 Pandemic
This commentary explores the potential fiscal impact of the COVID-19 pandemic on Medicaid and early childhood services and offers opportunities to sustain critical services.
Revisiting Medicaid Provider Payment Strategies During the COVID-19 Crisis
This webinar features experts reviewing examples of specific strategies states implemented between April and August 2020 to increase payments to providers in financial distress as a result of decreased health care utilization.
Modifying the Focus of Medicaid Value-Based Payment in the Context of COVID-19
This commentary explores the key role Medicaid programs play in helping the health care system make the transition to the new normal of the COVID-19 crisis.
Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis
This webinar walks through tools states can use to increase payments to providers through both fee-for-service and Medicaid managed care, despite COVID-19 driven changes to utilization.
Risk Adjustment Based on Social Factors: State Approaches to Filling Data Gaps
This report examines examples from two state Medicaid programs and a nonprofit quality measurement and reporting organization of the data sources used to identify patients’ social risk factors when risk-adjusting payments or measuring quality.
Considerations for State Medicaid and CHIP Agencies As They Prepare to Unwind COVID-19 Eligibility and Enrollment Flexibilities
This commentary explores how states have been required to make numerous changes to their eligibility and enrollment systems, operations, and policies, in order to comply with the enhanced Federal Medicaid Assistance Percentages.
State Budget Actions in Response to COVID-19 and the Impact on State Health Programs
This commentary provides an overview of how COVID-19 is affecting state budgets and state health programs.
Ensuring Medicaid MCO Enrollees Receive Necessary Care During COVID-19
This commentary recommends specific steps for state Medicaid programs to ensure state residents receive needed services during the COVID-19 pandemic, with a specific focus on Medicaid managed care organization (MCO) enrollees.
States Confront Current and Future Insurance Coverage Challenges as Pandemic Persists
This commentary discusses how state Medicaid, children’s health insurance programs, and health insurance marketplaces prepare for an expected increase in demand due to COVID-19, an economic downturn and ensuing budget crises, and unpredictable federal relief efforts.
Addressing VUCA as a Leader
In this podcast, Medicaid experts share five tips for leaders to address today’s VUCA (volatility, uncertainty, complexity, and ambiguity) challenges within their organizations.
Nebraska: Encouraging Appropriate Antibiotic Prescribing in the Outpatient Setting
This brief highlights how Nebraska’s Medicaid agency and its Division of Public Health partnered to share antibiotic prescribing information between Medicaid claims and evaluation and management codes to determine where targeted education and outreach efforts were needed.
Using Vision as Coherence During Unsettling Times
In this podcast, Medicaid experts discuss how vision coherence is important for effective leadership.
Ensuring Access to LTSS During COVID-19: Exploring a State Resource Guide Produced by Manatt Health and The SCAN Foundation
In this webinar, experts present key findings from a new COVID-19 state resource guide on federal and state Medicaid flexibilities and how they are being deployed to help ensure access to long-term services and supports.
An Early Look at State Budget Actions in Response to COVID-19 and the Impact on State Health Programs
This commentary provides a snapshot of how states are navigating fiscal challenges of the COVID-19 pandemic, given declining revenues and rising spending demands.
Analyzing the Fiscal Impact of COVID-19, the Economic Downturn, and Recent Policy Changes: 50-State Databook
This dataset examines projected changes in federal and state Medicaid and CHIP expenditures for scenarios during the COVID-19 pandemic.
Medicaid Managed Care Contract Language: Health Disparities and Health Equity
This report provides excerpts of health disparities and health equity contract language from Medicaid Managed Care contracts from five states, Washington, D.C., and the contract for California’s Health Exchange, Covered California.
Effects of Medicaid Health Plan Dominance in Health Insurance Marketplaces
Stakeholders in six states assess the impact of Medicaid insurers increasing dominance in the ACA marketplaces.
New Hampshire COVID-19 Directed Payment
This brief provides an overview of New Hampshire’s recent directed payment to six types of essential Medicaid providers in order to help them keep their doors open during the COVID-19 pandemic.
Federal and State Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and Expiration Dates
This brief provides a chart describing the effective dates of various federal provisions to allow for temporary flexibilities in the Medicaid and Children's Health Insurance Program programs.
Coronavirus (COVID-19) Unwinding Federal Medicaid Flexibilities: Issues and Considerations for States
This toolkit is intended to serve as a resource for states as they begin to strategize about reopening and plan for the next phase of the COVID-19 pandemic.
COVID-19 Catalyzing Health Center Payment Reform: Addressing the Financial Stability of the Primary Care Safety Net in Crisis and Beyond
This commentary outlines three key policy steps to help health centers survive in the short term and thrive beyond the COVID-19 crisis.
Marketplace Pulse: The Medicaid Map May Shape Marketplace Entry
This commentary outlines how continuity between Medicaid and the marketplace is more important than ever.
Virtual Care Post-Apex: Rethinking Telehealth Policy After the COVID-19 Surge
In this webinar, experts reviewed the current telehealth policy landscape and considerations for states as they design their post-apex telehealth policies.
Which Types of Insurance Are Marketplace Enrollees Choosing
This report uses new enrollment data to examine insurer type enrollment trends from 2016-2018.
States Factor in COVID-19’s Impact on Immunizations and VBP Incentives
This commentary provides an overview of CMS relief guidance and flexibility to state hospitals, facilities, and providers on reporting measures for value-based purchasing and quality reporting programs.
Early Evidence Suggests Increased Medicaid Enrollment Due to COVID-19
This commentary explains how, due to the loss of employer-sponsored insurance from the economic fallout of COVID-19, states may continue to see an increase in Medicaid enrollment.
Understanding the Fiscal Impact of COVID-19, the Economic Downturn, and Recent Policy Changes
This webinar presented results from a financial model examining the Medicaid fiscal implications of the interaction between the COVID-19 pandemic, the emerging economic downturn, and recent policy changes.
COVID-19, Unemployment Compensation, and State Medicaid Expansion Decisions
This report shows how the additional levels of unemployment insurance provided through the Federal Pandemic Unemployment Compensation program affects eligibility for subsidized coverage in expansion and nonexpansion states.
Developing Others When No One is Around
In this podcast episode, Ed O’Neil, PhD, MPA, a leadership development expert, speaks with Hilary Kennedy, program director for Medicaid leadership at the National Association of Medicaid Directors, about strategies Medicaid leaders can use to continue developing their staff at a distance.
Impact of COVID-19 on Medicaid Managed Care Performance Incentives: Policy Options for States
This commentary identifies actions federal and state policymakers have taken to address the impact of COVID-19 on their managed care performance incentive programs.
Strategies for Supporting and Strengthening Medicaid Information Technology During the COVID-19 Crisis
This report outlines potential IT investments in responding to COVID-19 and strategies for states to support these investments, and to secure current and future IT investments that enable ongoing Medicaid program operations and advance health information exchange.
Medicaid IT: Investing in Needed Infrastructure to Address COVID-19
This webinar reviews potential information technology (IT) investments in responding to COVID-19 and strategies for states to support these investments to secure current and potential IT investments that enable ongoing Medicaid program operations and advance health information exchange.
Medicaid/CHIP and Marketplace Interactions in COVID-19
This commentary provides an overview of strategies that states can consider to help address gaps in coverage to ensure as many people as possible get access to comprehensive care as the country continues to respond and recover from the COVID-19 health and economic crisis.
Changes in Coverage: Managing the Loss of ESI in the Midst of COVID-19
This webinar discussed the models that have been published of where individuals are expected to gain Medicaid and Marketplace coverage over the next 18 months.
State Strategies to Support Medicaid/CHIP Eligibility & Enrollment in Response to COVID-19
In this webinar, experts review strategies states can use to manage and process an increased number of Medicaid applications, and the federal authorities that permit states to do so.
Medicaid COVID-19 Messaging
This document provides examples of potential Medicaid messaging states can use during the COVID-19 pandemic.
How State Medicaid Programs Can Use Telehealth to Serve Pregnant Women during COVID-19
This infographic highlights what states need to consider when providing pregnancy-related services to Medicaid enrollees through telehealth during the pandemic.
Leveraging CHIP HSIs to Respond to COVID-19
This brief provides an overview of Children Health Insurance Program (CHIP) Health Services Initiatives (HSIs) and identifies ways that states can leverage them as part of their targeted response to the COVID-19 pandemic.
States’ Recent 1115 Waiver Applications Include Provisions to Support Children during the Pandemic
This commentary discusses the 1115 waiver applications submitted by states that have the potential to safeguard access to care and increase support for children during the COVID-19 pandemic.
Medicaid Enhanced Provider Payment Strategies and COVID-19: Questions and Answers
This Q&A responds to questions received regarding the April 9 Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis Webinar and corresponding Toolkit.
Increasing Federal Medicaid Matching Rates to Provide Fiscal Relief to States during the COVID-19 Pandemic
In this report, researchers estimate the fiscal impacts of several approaches for increasing federal Medicaid matching rates, providing state-level estimates for each approach.
The Federal Government’s Response to the Coronavirus (COVID-19) Pandemic: Questions & Answers
This Q&A provides a moment-in-time update in response to questions about the federal government’s response to the COVID-19 pandemic.
Impact of COVID-19 on Medicaid Managed Care Performance Incentives
This webinar discuses the impact of COVID-19 on Medicaid Managed Care Performance Incentives.
States Race to Secure Home- and Community-Based Services during COVID-19
This commentary discusses the states that have rapidly amended their Medicaid home- and community-based services for older adults and their family caregivers to ensure access to long-term services and supports during the COVID-19 crisis.
States Implement Strategies to Safeguard Pregnant Women during the COVID-19 Pandemic
This commentary discusses the steps states are taking during the COVID-19 pandemic to protect pregnant women and their infants during delivery.
Medicaid Managed Care Response to COVID-19
This brief addresses how Medicaid Managed Care Organizations (MCOs) and states can individually and collectively play a role in responding to the COVID-19 pandemic.
States Act to Increase Medicaid/Marketplace Coverage to Insulate Consumers from COVID-19 Care Costs
This commentary discusses new federal and state laws that are making significant steps to eliminate consumer cost-sharing for coronavirus (COVID-19) testing, diagnosis, and prevention.
States Modify Medicaid Home- and Community-Based Waivers to Respond to COVID-19
This commentary includes some of the options available to states to ensure that individuals with complex medical conditions and their families have access to necessary home- and community-based services during the coronavirus (COVID-19) crisis through waiver and state plan amendment applications.
Addressing the Needs of Medicaid Populations During the COVID-19 Pandemic
This resource library provides key guidance, reference materials, and tools for states as they try to lessen the impact of COVID-19 on Medicaid populations.
Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis
This webinar walks through tools states can use to increase payments to providers through both fee-for-service and Medicaid managed care, despite COVID-19 driven changes to utilization. An accompanying toolkit is included that identifies the immediately available tools for states.
With New Marketplaces Created by the Affordable Care Act, Is It Still Less Expensive to Serve Low-Income People in Medicaid Than in Private Insurance?
This report assesses the cost of Medicaid relative to private insurance in the health insurance landscape under the Affordable Care Act (ACA).
State Medicaid and CHIP Strategies to Respond to the COVID-19 Public Health Crisis
This perspective discusses strategies state Medicaid and CHIP agencies can pursue as part of their emergency preparedness planning for, and response to, COVID-19.
Implications of Health Care Provisions for States in the Second COVID Stimulus Bill
In this webinar, experts explore the key health care provisions in the Families First Coronavirus Response Act and the implications for states.
How the Families First Coronavirus Response Act Affects State Medicaid Programs
This brief examines the Families First Coronavirus Response Act that was signed into law to provide resources to help states address the effects of COVID-19.
Q&A: What States Should Know about the Medicaid FMAP Increase
This Q&A examines what the Families First Coronavirus Response Act is doing to help states address the COVID-19 pandemic.
State COVID-19 Communication Examples
This brief is a compilation of communication examples from state departments and agencies during the COVID-19 pandemic.
Unemployment, Health Insurance, and the COVID-19 Recession
This report examines the kinds of health insurance unemployed workers have and how coverage patterns have shifted under the Affordable Care Act (ACA).
COVID-19: CMS Issues Guidance for States About New Increased Medicaid and CHIP Matching Rate
This commentary reviews key information for states about the recent federal medical assistance percentage (FMAP) increase and conditions states must meet to qualify for it.
States Use Federal Waivers to Expand Health Care Resources to Confront COVID-19
The federal government has offered Medicaid waivers to give states flexibility to quickly increase their health care workforces in response to the COVID-19 pandemic.
Medicaid Block Grants and per Capita Caps: The Coronavirus Highlights Risks to States
This brief examines the effect of a recently announced federal program allowing states to apply for Medicaid block grants or per capita caps in exchange for new flexibility to limit enrollment and benefits.
Families First Coronavirus Response Act Medicaid and CHIP Provisions Explained
This report examines the Families First Coronavirus Response Act and its implications for Medicaid and the Children's Health Insurance Program (CHIP).
Moving the Needle on Maternal and Infant Mortality: A Conversation with New Jersey, Ohio, and Virginia
This podcast discusses the many ways that states are working to address the challenges surrounding maternal and infant mortality, specifically the significant disparity experienced by black women,
Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis
This report describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities in five areas: coverage, enrollment, benefits, models of care, and quality improvement.
Creating Meaningful Consumer Engagement in Medicaid: Perspectives from Colorado and Washington State
This podcast discusses the strategies and challenges faced while developing meaningful consumer engagement strategies for Colorado and Washington State Medicaid.
Leveraging American Community Survey (ACS) Data to Address Social Determinants of Health and Advance Health Equity
This report focuses on how Medicaid programs can use data from the American Community Survey (ACS), to inform and target interventions that seek to address social determinants of health and advance health equity.
New Hampshire’s Experiences with Medicaid Work Requirements: New Strategies, Similar Results
This report studies New Hampshire’s Medicaid work requirement program to understand how it was implemented and why it appears to fail to protect coverage and promote work.
CMS Guidance Authorizes Medicaid Demonstration Applications That Cap Federal Funding: Implications for States
This report reviews the key features of the proposed capped funding demonstrations and highlights the considerations for states. On January 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) inviting states to apply for Section 1115 demonstration projects that would impose caps on federal Medicaid funding for the adult expansion and some other adult populations in exchange for new programmatic flexibility.
Staying on Mission in Wisconsin Medicaid: Strategies for Engaging Staff
In this podcast, three individuals from the Wisconsin Department of Health Services discuss how they have created an environment that values transparency and staff well-being.
State Investments in Supportive Housing
This report gives an overview of the federal authorities under which states are able to cover nonclinical housing-related services for high-need Medicaid enrollees, and also details how states are using these authorities to invest in supportive housing for diverse high-need Medicaid populations.
Ensuring Strategic Program Sustainability in Medicaid
In this podcast, Connecticut’s Medicaid director Kate McEvoy and chief financial officer Mike Gilbert discuss their experiences working with partners in the executive and legislative branches to build trust and a shared vision for sustaining critical programs.
StateNetwork.org’s Top Ten Resources of 2019
These were the ten most-visited resources on StateNetwork.org during 2019
Medicaid Managed Care Plan and Health Centers Advancing Value-Based Payment and Care
This blog from the Delta Center illustrates five key insights related to program design and evaluation from the productive partnership between the Partnership HealthPlan of California (PHC) and local community health centers (CHCs) to create a care coordination (CCM) program.
Implementing the ASAM Criteria for SUD Treatment through Medicaid Managed Care
This issue brief draws from the experiences of states that were among the first to implement their substance use disorder waivers to profile how the American Society for Addiction Medicine (ASAM) Criteria is used within the context of managed care and utilization review, and the challenges and best practices associated with its use.
Is There Potential for Public Plans to Reduce Premiums of Competing Insurers?
This report analyzes commercial insurers’ experiences competing in marketplaces with managed care organizations, which only offered coverage within public programs prior to ACA implementation.
Keeping Medicaid’s Promise: Strengthening Access to Services for Children With Special Healthcare Needs
This issue brief examines how state Medicaid agencies, families, advocates, providers and other stakeholders can partner to improve access to services for Medicaid-enrolled children with special health care needs.
Behavioral Health Provider Participation in Medicaid Value-Based Payment Models: An Environmental Scan and Policy Considerations
This report provides an overview of the behavioral health system’s engagement in Medicaid value-based payment (VBP) models and provides policy recommendations to support VBP adoption.
Medicaid Demonstration Waivers with Housing Supports: An Interim Assessment
This report describes preliminary observations regarding implementation of Medicaid housing support demonstrations in California, Maryland, and Washington.
That’s Medicaid: When Tragedy Strikes
This commentary shares how Medicaid helped Tom gain access to mental health and kidney cancer treatment, enabling him to get back on his feet after a personal tragedy resulted in him losing his career.
What’s the Difference Between Medicaid and Medicare?
This short video explains the difference between Medicaid and Medicare.
An In-Depth Look at the Citizens Who Rely on Medicaid
This short video explains how Medicaid has expanded its coverage to cover roughly 1 in 5 Americans.
The Profound Effect of Medicaid on Children’s Health
This short video explains the effect of Medicaid on children's health.
Leadership Tips for State Agency Directors
These tip sheets provide general guidance to help state agency leadership develop and refine the necessary skills and expertise to successfully lead their state programs.
Understanding the Roles of Medicaid and Public Health in CDC’s 6|18 Initiative: Primers and FAQs
These resources describe the core roles of state Medicaid and public health agency staff when partnering to implement evidence-based prevention interventions.
The Critical Role of Medicaid Leadership
This blog reflects on the value of Medicaid and the critical role of Medicaid directors since the program's inception more than 50 years ago.
A Marriage between Medicaid and Public Health: A Q&A on Partnering for Prevention
In this blog, two former state medicaid directors demystify the distinct yet complementary roles of public health and health care — and how these state agencies can align efforts around prevention strategies to impact health and costs.
How States Can Use Measurement as a Foundation for Tackling Health Disparities in Medicaid Managed Care
This issue brief provides examples from a handful of states that have begun the work of identifying, evaluating, and reducing health disparities within their Medicaid managed care programs.
Many Adults Targeted by Medicaid Work Requirements Face Barriers to Sustained Employment
This study assesses potential barriers facing Medicaid enrollees in meeting work requirements through employment on a sustained basis, using pooled data from the September 2018 and March 2019 Health Reform Monitoring Survey.
Medicaid Leadership Exchange: A Candid Dialogue on What Works — and What Doesn’t — in Leading Today’s State Programs
A new podcast series, Medicaid Leadership Exchange, is launching to help Medicaid directors and their senior management teams steer the course.
Resources to Help States Fund Health-Related Social and Economic Needs
This table highlights new programs and federal initiatives to combat the opioid crisis.
Why Don’t More Medicaid Insurers Sell Plans in ACA Marketplaces?
This report examines ACA marketplace participation by insurers that participated in Medicaid but not in private insurance markets prior to the ACA.
Webinar: State Medicaid Buy-Ins
The webinar highlights six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program.
State Medicaid Buy-Ins: Key Questions to Consider
The issue brief identifies the key questions for states pursuing Medicaid buy-in programs to consider as they seek to design and implement their proposals.
Addressing Social Factors that Affect Health: Trends and Leading Edge Practices in Medicaid
This issue brief explores the “next generation” practices that states are deploying to address social factors using Medicaid 1115 waivers and managed care contracts.
Monitoring and Evaluating Medicaid Work and Community Engagement Requirements
This report examines monitoring and evaluation of work/CE demonstrations and reviews the data assets and infrastructure necessary to support states and their researcher partners in robust monitoring and evaluation efforts.
Using Medicaid Levers to Improve Health Outcomes and Reduce Disparities: Q&A with Louisiana’s Medicaid Director Jen Steele
In this interview with Louisiana's Medicaid Director Jen Steele, she shares her approach to leveraging Medicaid’s role to improve health outcomes and health equity.
States Join National Initiative to Align Early Childhood and Medicaid to Improve Outcomes for At-Risk Children
Eight states will join Aligning Early Childhood and Medicaid, a multi-state initiative aimed at improving the health and social outcomes of low-income infants, young children, and families through cross-agency collaboration.
Medicaid Managed Care: Increasing Expectations and Accountability
This brief reviews considerations for policymakers assessing their state Medicaid managed care programs and exploring strategies for advancing cost, quality, and accountability goals.
Medicaid’s Role in Fighting the Opioid Epidemic
This brief reviews a number of Medicaid strategies states are implementing to prevent and treat substance use disorder and support long-term recovery.
Medicaid’s Role in Addressing Social Determinants of Health
This brief reviews the role that social and economic factors--such as housing, healthy food, and income--play in a “whole person” approach to health care, especially among Medicaid’s low-income enrollees.
Medicaid’s Role in Children’s Health
This brief reviews the opportunities state policymakers have to affect the health—and future well-being and productivity—of their youngest residents through their Medicaid programs.
Medicaid’s Impact on Health Care Access, Outcomes and State Economies
This brief reviews the growing body of research on Medicaid's health and economic impacts, including access to care; self-reported health status; preventive health screenings; delaying care because of costs; hospital and ED utilization; and mortality rates.
Medicaid: The Basics
This brief outlines the basics of the Medicaid program, including financing and eligibility, for new state policymakers in order to lay the groundwork for considering the challenges and opportunities that lie ahead.
Priority Medicaid Issues for New State Officials
This brief highlights priority issues for consideration and potential action, including: the structure of the Medicaid agency; enabling coverage and access; addressing the needs of special populations; and value-based payment policies.
Slow Growth in Medicare and Medicaid Spending per Enrollee Has Implications for Policy Debates
This report finds between 2006 and 2017, growth in spending per enrollee in Medicare and Medicaid was much slower than in private insurance.
Managing Managed Care: Best Practices for Medicaid Pharmacy
This webinar examines the complexities of state Medicaid oversight of the pharmacy benefit in the managed care environment.
Pregnant Women with Opioid Use Disorder and their Infants in Three State Medicaid Programs in 2013–2016
This study analyzed linked maternal and infant Medicaid claims data and infant birth records in three states to assess treatments and outcomes on maternal and infant health.
MACStats from MACPAC: 2018 Medicaid and CHIP Data Book
MACPAC's 2018 Medicaid and CHIP Data Book is a collection of federal and state statistics regarding the Medicaid and CHIP programs.
What Makes an Early Childhood Medicaid Partnership Work? Insights from Three Cross-Sector Collaborations
This report outlines the activities of three pilot sites pursuing Medicaid-driven strategies to support young children and their families, to help inform other cross-sector partnerships at varying stages of development.
Medicaid Buy-In: Emerging Models and Considerations
This webinar discusses state considerations for developing a Medicaid buy-in proposal, as well as evolving models.
StateNetwork.org’s Top Five Resources of 2018
These were the five most-visited resources on StateNetwork.org during 2018.
2018 Elections and State Health Policy: Expect More Innovation
This national scan summarizes the health care reforms and innovations that newly-elected governors promoted in their campaigns and may become policy in 2019.
The SUPPORT Act: New Tools in Medicaid to Address the Opioid Epidemic
The Senate passed H.R. 6, The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the “SUPPORT Act”) on October 3, 2018. This reviews major health provisions of the new law and implications for states.
The Effects of Medicaid Expansion Under the ACA: Select Articles Published Between January 1, 2018 and August 31, 2018
This resource highlights articles published since January 2018 that report on the impact of Medicaid expansion in 33 states and DC, organized by health access and outcomes, economic impacts, and coverage impacts.
State Health Policy Highlights: Addressing Social Determinants of Health
This State Health Policy Highlight profiles two issue briefs and a webinar on how state Medicaid programs can address social determinants of health.
How States Address Social Determinants of Health in Their Medicaid Contracts
This chart compares the social determinants 11 states targeted in their Medicaid contracts and contract guidance documents to enhance population health, as well as how states monitored outcomes and funded these efforts.
Work and Community Engagement Requirements in Medicaid: State Implementation Requirements and Considerations
CMS approved state work/community engagement (CE) waivers in Arkansas, Indiana, Kentucky, and New Hampshire; and additional states have submitted or are poised to submit similar waivers. This series of charts outlines the legal, policy, financial and operational tasks and issues that states will face in adding a work/CE condition to their Medicaid program.
KY Work Requirements: What Are the Coverage Risks for Working Enrollees?
This report investigates the work patterns of Medicaid beneficiaries in Kentucky who are are potentially subject to Medicaid work requirements. It finds that the structure of Kentucky’s Medicaid waiver does not seem to align with the reality of some working enrollees’ lives, and that working enrollees losing coverage may not have access to an employer plan.
Implications of the Stewart v. Azar Decision for States
This webinar reviews the Stewart v. Azar decision and potential implications for states with approved, pending or planned Medicaid waivers that include work/community engagement requirements. The court’s findings may shape what analysis will be necessary to demonstrate that future waivers advance the Medicaid statute's objectives.
Opportunities for Medicaid-Public Health Collaboration: Lessons from CDC’s 6|18 Initiative
This webinar provided an overview of Centers for Disease Control and Prevention's 6|18 Initiative and highlighted recent accomplishments from participating Medicaid-public health teams. The CDC 6|18 Initiative is a framework to guide Medicaid-public health collaboration.
Implementing Prevention Strategies to Support State Medicaid Value-Based Payment Reforms
State officials can align prevention strategies with value-based payment goals through a variety of mechanisms outlined in this brief, which draws from state-based 6|18 Initiative implementation efforts to help Medicaid and public health officials make the case for investing in prevention strategies and aligning these efforts to achieve state VBP goals.
Emerging Opportunities and Challenges for Institutions for Mental Disease Exclusion Waivers
Webinar discusses the status of state efforts to secure waivers to use federal Medicaid funding to provide care in Institutions for Mental Disease (IMD), including the requirements states must meet to secure an IMD waiver; the status of requests and approvals; and issues and opportunities arising as states pursue and increasingly implement the IMD waiver.
Medicaid Buy-In: State Options, Design Considerations
States continue to identify and pursue strategies to further reduce the number of uninsured to make coverage more affordable for consumers and to improve access to care. This issue brief presents two possible models for a Medicaid buy-in program for states, and details the design considerations and authorities needed to implement each model.
Map: Where States Stand On Medicaid Expansion
This map tracks state Medicaid expansion decisions and approaches states are taking for expanding eligibility to 138 percent of the Federal Poverty Level. It also includes information on state legislative activity around Medicaid expansion, governors’ stances on the issue, and fiscal and demographic analyses from the state or other institutions. For states that are expanding Medicaid, but using an alternative to traditional expansion, the map also contains brief descriptions of these demonstration waivers.
State Proposals: Medicaid Work and Community Engagement Requirements
In January 2018, the Centers for Medicare & Medicaid Services issued a new policy allowing states to implement work and community engagement requirements for certain Medicaid enrollees. States are permitted to seek federal approval to require non-elderly, non-pregnant, and non-disabled adults to participate in these types of activities to qualify for Medicaid or certain aspects of Medicaid coverage. This chart summarizes states’ pending and approved Section 1115 waivers, waiver renewals, and waiver amendments to implement work and community engagement requirements.
Medicaid’s Role in State Opioid Strategies
The nation’s opioid epidemic claimed more than 42,000 lives in 2016, and more than 2 million people in the United States have an opioid use disorder (OUD). Yet, only 1 in 5 people suffering from an OUD receive treatment. In this issue brief, data from three states—New Hampshire, Ohio and West Virginia—highlight Medicaid’s role as the linchpin in states’ efforts to combat the opioid epidemic.
CDC’s 6|18 Initiative: A Cross-Sector Approach to Translating Evidence into Practice
This article explores efforts by nine state Medicaid and public health agency teams to implement 6|18 interventions related to asthma control, tobacco cessation, and unintended pregnancy prevention. It was published in the Journal of Public Health Practice and Management and covers Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina.
State Medicaid Approaches: Defining & Tracking MCO Implementation of APMs
State Medicaid programs are increasingly requiring their Medicaid managed care organizations (MCO) to implement APMs. It is important for states to develop ways to ensure that their MCOs are complying with the APM requirements within their contract, and monitoring the progress and challenges with the implementation of APM strategies with Medicaid providers. This report focuses on different ways in which states may set standard APM definitions to track MCO progress toward meeting state APM goals, and support comparison of APM implementation within a state and nationally.
The Implications of a Medicaid Buy-In Proposal
This brief provides an analysis of legislation recently introduced in the U.S. Senate that would create a mechanism for states to offer their residents the opportunity to buy a Medicaid-based public insurance option.
Impact of New Work & Community Engagement Requirements
On January 11, 2018, CMS released guidance for states seeking 1115 waivers that condition Medicaid eligibility on work and community engagement, quickly followed by approval of Kentucky’s 1115 waivers that include these requirements. Both the new guidance and recent waiver approval represent a significant departure from past Administrations’ positions. This webinar reviews the new guidance and discusses state legal, policy, and operational considerations.
Leveraging Medicaid to Strengthen Coverage
RWJF’s SHVS together with experts from Manatt Health, host this webinar that highlights and defines potential policy options, including the “Medicaid Buy-in,” that states may consider to leverage Medicaid to achieve their goals with respect to coverage availability and affordability. Conditions that make each option more or less favorable for a state, and implementation issues or other considerations in play for states are discussed.
Searching for New Insurance Options: States Consider Medicaid Buy-In and Other Strategies
Uncertainty about the future of health insurance options and concern about the ability of Affordable Care Act (ACA) marketplaces to offer adequate competition and choice have spurred states to look for new coverage approaches. Innovative strategies states are proposing include allowing consumers to buy into state Medicaid programs and developing state-specific coverage options within the ACA’s framework.
Impact: Medicaid vs. Marketplace Coverage on Out-of-Pocket Spending for Near-Poor Adults
This webinar features the Urban Institute's Dr. Fred Blavin, whose SHARE-funded research asks how medical spending burdens for near-poor families in non-expansion states would change if the states were to expand Medicaid.
Federal Guidance Aims to Streamline Section 1115 Demonstration and 1915 Waivers and State Plan Amendments Processes
CMS released two informational bulletins detailing a new, streamlined approach for the review and management of Section 1115 demonstrations and state plan amendments and 1915 waivers. The streamlined approach may enhance states' ability to design innovative health care delivery initiatives in their Medicaid programs. These changes come at a critical time as states develop new approaches to reduce health care costs and stem the opioid epidemic.
Toolkit: Medicaid Value-Based Purchasing
This toolkit is designed to assist states interested in implementing value-based purchasing approaches with their Medicaid managed care organizations (MCOs). Using a value-based purchasing approach can mean significant and ongoing changes for a state Medicaid agency and its MCOs.
States Could Gain More Flexibility to Manage Medicaid Programs: Lessons from the 1990s AFDC Flexibility Experience
The Administration signaled a willingness to give states more flexibility to address health and prevention in new and innovative ways under Section 1115 of the Social Security Act, allowing the Department of Health and Human Services to approve experimental and innovative projects that promote the goals of Medicaid. This comes at a pivotal time when many states are developing new ways to improve health care, reduce costs, and address health-related social needs such as housing.
Medicaid and Social Determinants of Health: Adjusting Payment and Measuring Outcomes
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. Social determinants include a broad array of social and environmental risk factors such as poverty, housing stability, early childhood education, access to primary care, access to healthy food, incarceration and discrimination. This report digs into opportunities that states have to account for SDOH in Medicaid programs.
Medicaid and Social Determinants of Health: Adjusting Payment and Measuring Outcomes
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This report digs into opportunities that states have to account for SDOH in Medicaid programs.
Emerging Themes: Proposed State Medicaid Waivers
CMS has signaled a willingness to evaluate new types of Medicaid proposals from states, such as Medicaid waiver applications that include programs to connect individuals to employment or incorporate features of private market coverage. In response to CMS’ letter, some states have developed proposals that include these types of requirements for certain individuals covered by the Affordable Care Act’s Medicaid expansion—and a few states are seeking similar changes for their non-Medicaid expansion populations.
Using DSRIP to Improve Population Health
Under the authority of Section 1115 demonstrations, some states have implemented DSRIP programs to improve care, improve health, and lower costs. DSRIP programs restructure Medicaid funding into a pay-for-performance arrangement in which providers earn incentive payments outside of capitation rates for meeting certain metrics or milestones based on state-specific needs and goals, which are used to measure success.
Braiding Funds to House Complex Medicaid Beneficiaries: Lessons from Louisiana
This report explores Louisiana’s permanent supportive housing program. The program, administered jointly by the state’s Medicaid agency and housing authority, is a cross-agency partnership that braids funding to serve vulnerable cross-disability populations, address homelessness, reduce institutionalizations, and save money for the state.
Medicaid’s Role in Public Health Emergencies and Health Crises
Medicaid can play a unique and critical role in responding to public health emergencies and health crises. This brief explores the role Medicaid has played in responding to events such as the opioid and HIV/AIDS epidemics, the 2001 World Trade Center attacks, the Flint, Michigan lead contamination crisis, and Hurricane Katrina.
State Strategies: Value-Based Payment for Complex Care Medicaid Populations
Driven to improve care coordination and contain costs by moving away from a volume-based payment model, an increasing number of states are implementing risk-based managed care programs to deliver long-term services and supports (LTSS). As the primary payer for LTSS, state Medicaid programs have a significant interest in ensuring that entities with which they contract deliver high quality and cost-effective care to members. This report identifies ways states can learn from value-based payment models being applied elsewhere to create more accountability for the quality and cost of LTSS.
Repealing Eligibility and Enrollment Modernization — What Would it Mean for States?
While the focus of debate regarding repeal of the Affordable Care Act (ACA) has been on Marketplaces and the Medicaid expansion, myriad other provisions of the ACA are at risk of repeal—including those that streamline Medicaid eligibility and enrollment systems and implement a national, simplified standard for income eligibility. As of January 2016, 37 states are able to complete an eligibility determination in real time, defined as less than 24 hours, and among these, 11 states report that at least half of their applicants receive an eligibility determination in real time. The future of the ACA’s streamlined eligibility and enrollment-related provisions and the system improvements states have invested in to implement them are the subject of this issue brief.
State Policies and Partnerships: Lowering Infant Mortality
State agencies across the country, from Medicaid to public health, to social services and corrections, are deeply engaged in multi-sector initiatives to reduce infant mortality. And for good reason: the United States ranks 25th among industrialized countries in infant mortality with a disproportionate number of being African Americans.
Using SNAP to Facilitate Medicaid Enrollment and Renewal
In order to assist states in the facilitation of Medicaid enrollment and renewal for eligible SNAP participants, this webinar presents some of the necessary considerations for leveraging these data for enrollment purposes.
Improving Care for Medicaid Beneficiaries Experiencing Homelessness
This report stems from technical assistance provided to California’s Department of Health Care Services (DHCS). The technical expert facilitated webinars and meetings with DHCS staff and medical directors of contracted MCOs, in order to share information about housing resources and emerging practices for improving care and achieving savings by linking more Medicaid beneficiaries with permanent supportive housing.