State Health and Value Strategies (SHVS) Archives

Tracking State Preparation for the Rural Health Transformation Program

This blog tracks state activity related to the Rural Health Transformation Program.

TOPICS Public Health State Innovation

Marketplace Coverage: Tracking State-Specific Estimates of the Impacts of Proposed Federal Changes

This blog tracks state estimates for State-Based Marketplaces based on federal policy changes.

TOPICS Healthcare Spending Marketplace Policy and Strategy

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.

TOPICS Government Medicaid Operations

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.

TOPICS Healthcare Spending Medicaid Operations

Mapping State Efforts to Address Medical Debt

This blog discusses the effects of medical debt on public health and tracks state efforts to reduce medical debt and/or prohibit reporting.

TOPICS Healthcare Spending Public Health

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.

TOPICS Coverage Trends Medicaid Operations

Tracking the Impact of State Medicaid Cuts

This blog shares state-specific estimates of proposed Medicaid cuts.

TOPICS Healthcare Spending State Innovation

New CMS Proposed Rule: ACA Marketplace Integrity

State Health & Value Strategies hosted a webinar to discuss key considerations for states along with an overview of the recent CMS-proposed regulation.

TOPICS Government Marketplace Policy and Strategy

New Executive Directive is Unlikely to Impact Medicaid or Marketplace Spending

This blog post covers the directives and implications for states in light of the recent executive directive.

TOPICS Healthcare Spending Marketplace Policy and Strategy

Protecting Access to Preventive Services: A State Roadmap

This blog post discusses who may be impacted by changes to preventive care requirements and what states can do to protect residents' access to these services.

TOPICS Commercial Insurance Regulation Marketplace Policy and Strategy

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.

TOPICS Medicaid Eligibility Medicaid Operations

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.

TOPICS Government Medicaid Operations

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.

TOPICS Medicaid Operations Public Health Specialized Populations

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.

TOPICS Health Equity Medicaid Operations

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).

TOPICS Coverage Trends Medicaid Operations Medicaid Unwinding

State Spotlight: North Carolina’s Comprehensive Medical Debt Relief and Reform Incentive Program

This blog offers insight into North Carolina’s medical debt relief incentive program and highlights opportunities for other states.

TOPICS Health Equity

Recruiting for the BAC: Template Materials

These customizable resources support state agencies in recruiting members for the Beneficiary Advisory Council (BAC).

TOPICS Medicaid Operations

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.

TOPICS Government Marketplace Policy and Strategy Medicaid Operations Medicaid Unwinding

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS Government Medicaid Operations

States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits

This blog reviews considerations for states weighing whether to add the the flexibility offered by CMS.

TOPICS Health Equity

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.

TOPICS Government Medicaid Operations

Current Considerations for State Reinsurance Programs

This expert perspective summarizes the Health Affairs article and related considerations around reinsurance.

TOPICS

CMS Issues Guidance on Renewal Timeliness Post-Unwinding

This blog post reviews and links to the CMCS Informational Bulletin (CIB) and accompanying slide deck.

TOPICS Government Medicaid Operations Medicaid Unwinding

New CMS Guidance: CAA Requirements for the Provision of Medicaid and CHIP Services to Incarcerated Youth

In this webinar, experts provide a detailed overview of CMS' guidance in the State Health Official (SHO) letter offering states the option to provide full-scope Medicaid and CHIP services to justice-involved eligible children and youth.

TOPICS Medicaid Eligibility

CMS Guidance on Medicaid and CHIP Services to Incarcerated Youth: Considerations for States

This blog offers insight and consideration for states as they implement sections 5121 and 5122 of the Consolidated Appropriations Act, 2023 (CAA).

TOPICS Medicaid Eligibility Specialized Populations

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.

TOPICS Medicaid Operations Public Health

Revisions to the Federal Standards for Race and Ethnicity Data Collection

During the webinar, experts reviewed the new OMB standards for race and ethnicity data collection, described the history of federally-defined race and ethnicity data collection standards, and highlighted the motivations for the revisions.

TOPICS Health Equity

Revisions to the Federal Standards for Race and Ethnicity Data Collection

State Health and Value Strategies will host a webinar on July 15, during which experts will review the new OMB standards for race and ethnicity data collection, describe the history of federally-defined race and ethnicity data collection standards, and highlight the motivations for the revisions.

TOPICS Government Health Equity Specialized Populations

State-Funded Affordable Health Coverage for Non-Citizen Populations

This map gives a detailed description of the status of each state's coverage program or initiative for non-citizens, the vehicle through which the program has been established, if the program provides limited coverage only, and if the program has not yet been implemented for.

TOPICS Health Equity Medicaid Eligibility

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.

TOPICS Government Medicaid Operations

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.

TOPICS Health Equity Medicaid Operations Specialized Populations

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations

Mapping State Efforts to Address Medical Debt

This commentary details a new Health Affairs Forefront article examining the burgeoning trend of state efforts to alleviate medical debt.

TOPICS Government Health Equity

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.

TOPICS Coverage Trends Government Medicaid Operations

States of Innovation: March & April 2024

This inaugural post highlights state activity from March and April 2024.

TOPICS Coverage Trends Health Equity Marketplace Policy and Strategy Medicaid Eligibility Medicaid Operations

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.

TOPICS Coverage Trends Medicaid Eligibility Medicaid Operations

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.

TOPICS Medicaid Operations

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.

TOPICS Government Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS Government Medicaid Eligibility Medicaid Operations Medicaid Unwinding

Short-Term, Limited Duration Insurance Final Rule: Considerations for States

This blog discusses the implications of the final rule for state regulators.

TOPICS Government

Insights on Federal Healthcare Priorities

This expert perspective reviews the healthcare policies and programs recently funded by Congress for FY 2024 as well as the Biden administration’s stated healthcare priorities for FY 2025.

TOPICS Coverage Trends Government Health Equity Healthcare Spending Public Health

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.

TOPICS Health Equity Health Reform Medicaid Operations Specialized Populations

Mapping Health Equity: New Tools for States

This webinar reviews how and why the tools were created and how to use the tools to understand the scope of equity work for a state agency.

TOPICS Health Equity

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.

TOPICS Medicaid Operations Medicaid Unwinding

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.

TOPICS Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS Health Reform Medicaid Operations

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.

TOPICS Medicaid Operations Medicaid Unwinding

State-Based Marketplaces: Continuing Innovations for Open Enrollment 2024

This blog highlights new and innovative initiatives being implemented during the plan year 2024 OEP.

TOPICS Marketplace Policy and Strategy Medicaid Operations Medicaid 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.

TOPICS Coverage Trends Medicaid Operations Medicaid Unwinding

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.

TOPICS Coverage Trends Medicaid Operations Medicaid 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.

TOPICS Medicaid Operations Medicaid Unwinding

State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement

This blog examines variations in states' reporting of indicators and data highlights.

TOPICS Medicaid Operations Medicaid Unwinding

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.

TOPICS Medicaid Operations

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.

TOPICS Medicaid Operations Medicaid Unwinding

States of Unwinding: How State Officials Are Innovating to Support Coverage

This blog discusses states' approaches to support coverage through the unwinding period.

TOPICS Medicaid Operations Medicaid Unwinding

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.

TOPICS Medicaid Eligibility Medicaid Operations Medicaid Unwinding

Call Center Strategies to Support Unwinding: State Toolkit

This toolkit identifies opportunities and explores strategies to improve call center functionality.

TOPICS Coverage Trends Medicaid Operations Medicaid Unwinding

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS Medicaid Operations Medicaid 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.

TOPICS Health Equity Medicaid Operations Medicaid Unwinding

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.

TOPICS Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS Health Equity Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS Medicaid Operations

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.

TOPICS Commercial Insurance Regulation Marketplace Policy and Strategy Medicaid Operations Medicaid Unwinding

CMS Issues Guidance on Section 1115 Demonstration Opportunity to Support Reentry for Justice-Involved Populations

The blog discusses parameters for reentry 1115 demonstrations.

TOPICS Commercial Insurance Regulation Medicaid Eligibility Medicaid Operations

Proposed Changes to Federal Standards for Collecting Race and Ethnicity – Summary and Considerations

This blog reviews OMB's efforts to maintain, collect, and present federal data on race and ethnicity.

TOPICS Health Equity

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.

TOPICS COVID-19 Health Equity Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS COVID-19 Marketplace Policy and Strategy Medicaid Eligibility Medicaid Operations Medicaid Unwinding

Proposed Changes to Federal Standards for Collecting Race and Ethnicity – Summary and Considerations

This blog discusses the proposed revisions to OMB Directive No. 15 and comments and considerations from State Health Access Data Assistance Center.

TOPICS Health Equity

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.

TOPICS COVID-19 Health Equity Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS Employer-Sponsored Insurance Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS COVID-19 Government Medicaid Eligibility Medicaid Operations Medicaid Unwinding

New CMS Guidance on “In Lieu Of” Services

On January 4, the Centers for Medicare & Medicaid Services (CMS) issued a new State Medicaid Director Letter on how states can use “in lieu of” services (ILOS) authority, including to address social drivers of health. This blog reviews the letter and discusses why it is significant for state health policymakers.

TOPICS Government Marketplace Policy and Strategy

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.

TOPICS Commercial Insurance Regulation Coverage Trends Medicaid Eligibility Medicaid Operations Medicaid Unwinding

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.

TOPICS Medicaid Eligibility Medicaid Operations Medicaid Unwinding

Collection of Race, Ethnicity, Language (REL) Data on Medicaid Applications: New and Updated Information on Medicaid Data Collection Practices in the States, Territories, and District of Columbia

This issue brief documents how REL data are collected by the Medicaid programs in the 50 U.S. states, the District of Columbia, and five U.S. territories.

TOPICS Government Marketplace Policy and Strategy

Recent Updates to Section 1115 Waiver Budget Neutrality Policy: Overview and Implications for States

This issue brief summarizes the key policy changes established through the Oregon and Massachusetts waiver renewals (and reinforced through the Arizona and Arkansas approvals) and discusses key implications for states.

TOPICS Government Marketplace Policy and Strategy

Communicating the PHE Unwinding: How States Are Conducting Outreach and Planning

This blog introduces the one-stop page to provide states research insights and key messages they can customize and use in their own communications campaigns for their unwinding operational plans.

TOPICS

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.

TOPICS Medicaid Eligibility Medicaid Operations

Unwinding of the Public Health Emergency: What’s Next for States

This webinar reviews COVID-19 flexibilities within Medicaid and what lies ahead in returning to normal eligibility and enrollment processes.

TOPICS COVID-19 Medicaid Eligibility

Reaching Non-Citizen Communities: Resources to Support State Outreach and Education to Drive Healthcare Enrollment

This toolkit includes resources developed for states to customize based on their unique needs, program eligibility criteria, and environments to support outreach and education efforts to drive enrollment in new or existing health coverage programs.

TOPICS Coverage Trends Specialized Populations

State Strategies to Improve Maternal Health and Promote Health Equity Compendium

This brief provides information on strategies to improve maternal health outcomes and synthesizes research about the national state-of-play across four domains: maternal health models, quality improvement, workforce and benefits, and eligibility and enrollment/coverage expansion.

TOPICS Medicaid Eligibility Specialized Populations

Recommended Terms for Direct-to-Consumer Unwinding Communications

his blog provides research-based recommendations regarding terminology that can be used in consumer education and outreach in order for states to communicate with enrollees about coming changes, what they will need to do to complete the renewal process, and where they may be able to find other coverage options if they are no longer eligible for Medicaid.

TOPICS

Supporting Health Equity and Affordable Health Coverage for Immigrant Populations

This blog unveils a new series to highlight strategies for states to expand affordable health coverage to immigrant populations in the United States.

TOPICS Coverage Trends

2021 ACS: Estimates Show Declining Uninsurance Rates Across 28 States, Driven by Rise in Public Coverage and Fall in Private Coverage

This blog highlights national and state-level changes in the broadest categories of insurance and takes a look at the changes in rates by two age groups, nonelderly adults (age 19-64) and children (age 0-18).

TOPICS

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).

TOPICS Commercial Insurance Regulation Medicaid Operations

Overview of the Public Charge Final Rule

This blog discusses the contents of the Public Charge Final Rule.

TOPICS Medicaid Eligibility Medicaid Operations

Federal Court Decision Threatens the ACA’s Preventive Services Benefit: State Options to Mitigate Harm to Consumers

The ACA’s guarantee of free access to preventive services is at risk. If it is ultimately struck down as unconstitutional as the result of a court case that is winding its way through the federal judicial system, Congress will be the only entity that can act to codify and fully restore its benefits. However, there are some actions states can take. This brief explores what state-level health officials can do to mitigate the fallout of the preventive services provision being struck down.

TOPICS Commercial Insurance Regulation Medicaid Eligibility

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.

TOPICS Medicaid Eligibility Medicaid Operations

No Surprises Act Resource Page

This resource page highlight the latest SHVS resources for states on federal NSA guidance and summarizes its implications for state regulators.

TOPICS Marketplace Policy and Strategy

State Strategies for Sequencing Enrollee Communications When Medicaid Continuous Coverage Ends

When the PHE ends, state Medicaid agencies will redetermine eligibility for as many as 80 million enrollees. This blog analyzes how states can coordinate and sequence communications with clear messaging to inform enrollees about what is happening.

TOPICS Marketplace Policy and Strategy Medicaid Eligibility

Medicaid Managed Care Procurements: A Toolkit for State Medicaid Agencies

This toolkit is designed to help states develop a procurement process focused on improving program performance in specific areas valued by the state.

TOPICS Medicaid Eligibility

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.

TOPICS Coverage Trends COVID-19 Medicaid Operations

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.

TOPICS Medicaid Operations Public Health

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.

TOPICS Health Equity Medicaid Eligibility Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations Public Health

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.

TOPICS Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations Public Health

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.

TOPICS Coverage Trends Medicaid Operations

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.

TOPICS Marketplace Policy and Strategy Medicaid Eligibility Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations

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.

TOPICS Marketplace Policy and Strategy Medicaid Operations

CMS RFI on Access to Coverage and Care in Medicaid & CHIP: Model Comments to Inform State Responses

This blog provides model comments developed to inform and support state responses to the Centers for Medicare & Medicaid Services' RFI to achieve substantial reforms on access to coverage–namely, the processes for enrollment and eligibility redeterminations.

TOPICS Coverage Trends Medicaid Eligibility Public Health

Unwinding the Continuous Coverage Requirement: Developing a Communications Plan

This toolkit provides a communications planning guide designed to support state Medicaid agencies as they prepare for the upcoming end of the continuous coverage requirement.

TOPICS Coverage Trends COVID-19 Public Health

Public Health Emergency (PHE) Unwinding Reporting Requirements: Considerations for States

This blog summarizes the new reporting requirements and presents a set of considerations for states as they begin implementing new unwinding policies, procedures, and reporting.

TOPICS Coverage Trends COVID-19 Health Equity Marketplace Policy and Strategy Medicaid Eligibility

The End of the Public Health Emergency Will Prompt Massive Transitions in Health Insurance Coverage: How State Insurance Regulators Can Prepare

This issue brief identifies several areas in which state departments of insurance may want to coordinate with other agencies or external stakeholders, issue new regulations or guidance, and establish means for minimizing gaps in coverage or access to services once the PHE ends.

TOPICS COVID-19 Public Health

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.

TOPICS Medicaid Operations

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.

TOPICS Coverage Trends COVID-19 Medicaid Operations

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

TOPICS COVID-19 Medicaid Eligibility Medicaid Operations

CMS Solicits Input on Medicaid and CHIP Reforms Regarding Eligibility, Enrollment, and Access to Care

This blog provides an overview of the Centers for Medicare & Medicaid Services' RFI regarding the federal standards that govern access to care in Medicaid and the Children’s Health Insurance Program.

TOPICS Medicaid Eligibility

Supporting Health Equity and Affordable Health Coverage for Immigrant Populations

This brief highlights strategies for states to expand affordable health coverage to immigrant populations in the United States and provides an overview of the status of the public charge rule.

TOPICS Health Equity Specialized Populations

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS Marketplace Policy and Strategy Medicaid Operations

Tracking the Data on Medicaid’s Continuous Coverage Unwinding

This blog summarizes a phased set of priority measures and provides a model enrollment and retention dashboard template that states can use to monitor both the short-term impacts of phasing out public health emergency protections and continuous coverage requirements, as well as longer-term enrollment and retention trends.

TOPICS Coverage Trends COVID-19

New Requirements to Cover Over-the-Counter COVID Tests: Implications for State Insurance Regulators

This blog details new federal rules that require health insurers to cover and waive cost-sharing for over-the-counter COVID-19 tests for the duration of the federal public health emergency.

TOPICS Coverage Trends COVID-19 Public Health

New CMS Guidance on Community-Based Mobile Crisis Services

This blog examines the Centers for Medicare and Medicaid Services' newly released State Health Official letter providing guidance on the scope of and enhanced payments for qualifying community-based mobile crisis intervention services for Medicaid enrollees experiencing a mental health or substance use disorder crisis.

TOPICS Coverage Trends Medicaid Eligibility

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.

TOPICS COVID-19 Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations

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.

TOPICS Coverage Trends Medicaid Operations

Supporting Health Equity and Affordable Health Coverage for Immigrant Populations: CHIP Coverage Option for Pregnant Immigrants and their Children

This brief offers considerations for policymakers around the Children’s Health Insurance Program coverage as a method of enabling states to provide prenatal, labor and delivery, and postpartum services to pregnant individuals, regardless of immigration status.

TOPICS Coverage Trends Health Equity

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.

TOPICS Medicaid Operations Public Health

Conceptualizing Performance Measurement for Social Care Interventions: An Issue Brief for State Medicaid Agencies

This issue brief explores opportunities for state Medicaid agencies to implement performance measures with contracted care entities that could strengthen their growing interest in social care and highlights several barriers to those applications.

TOPICS Medicaid Eligibility Public Health

Medicaid Managed Care Strategies for Increasing Cancer Screening Rates

This brief highlights key state actions to increase cancer screening for adults covered by Medicaid and improving health outcomes.

TOPICS Medicaid Eligibility Public Health

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.

TOPICS Health Equity Medicaid Eligibility Medicaid Operations

IT Systems and Data Strategies to Prepare for Medicaid Continuous Coverage Unwinding

This webinar provide an overview of strategies for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the Medicaid continuous coverage requirement ends.

TOPICS Health Equity Medicaid Eligibility

Promoting Health Equity in Medicaid Managed Care

This webinar reviewed steps states can take to integrate health equity into their Medicaid managed care programs.

TOPICS Health Equity Medicaid Eligibility

State Policy and IT System Strategies to Prepare for PHE Unwinding: Updating Medicaid Enrollee Address Information and Responding to Returned Mail

This brief examines the information technology system, policy, and operational strategies states can consider to update key enrollee contact information to ensure eligible enrollees are able to keep or transition to new affordable health coverage at the end of the public health emergency.

TOPICS Medicaid Eligibility Public Health

The End of the COVID-19 Public Health Emergency: Data and IT “Table Stakes” for Retaining Coverage Gains

This issue brief reviews state Medicaid/Children's Health Insurance Program agency data and information technology system “table stakes”—strategies that will have the highest impact for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the Public Health Emergency continuous coverage requirements end.

TOPICS COVID-19 Medicaid Eligibility Public Health

Supporting Health Equity and Affordable Health Coverage for Immigrant Populations: State-Funded Affordable Coverage Programs for Immigrants

This issue brief—the first in a series “Supporting Health Equity and Affordable Health Coverage for Immigrant Populations”—provides an overview of the national immigrant health coverage landscape and offers considerations for policymakers related to state-funded affordable coverage programs for low-income individuals who do not qualify for subsidized health insurance under the Affordable Care Act or other public programs due to immigration status.

TOPICS Health Equity

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.

TOPICS Marketplace Policy and Strategy Medicaid Operations

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.

TOPICS Coverage Trends Medicaid Operations

Collection of Sexual Orientation and Gender Identity (SOGI) Data: Considerations for Medicaid and Spotlight on Oregon

This brief documents how information describing sexual or gender minority populations is currently collected at the federal level and in Medicaid.

TOPICS COVID-19 Health Equity Medicaid Eligibility

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.

TOPICS Coverage Trends COVID-19 Health Equity Marketplace Policy and Strategy Medicaid Operations

Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis

This webinar shared findings from a published Manatt Health issue brief for SHVS on Medicaid’s role in combating the maternal mortality crisis.

TOPICS Coverage Trends Health Equity Medicaid Eligibility

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.

TOPICS Health Equity Medicaid Eligibility Medicaid Operations

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS COVID-19 Medicaid Operations

New York State of Health Pilot Yields Increased Race and Ethnicity Question Response Rates

This brief examines how New York is expanding changes to the race and ethnicity questions system-wide for the next open enrollment period and how the state is considering additional revisions in hopes of further enhancing the quality and completeness of its data.

TOPICS Coverage Trends Health Equity

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.

TOPICS Health Equity Medicaid Operations

Strategies for States to Drive Equitable Vaccine Distribution and Administration

This issue brief outlines key barriers states face in their efforts to increase vaccination rates among BIPOC and highlights strategies states are pursuing in partnership with community-based organizations to address these challenges.

TOPICS COVID-19 Health Equity Public Health

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.

TOPICS Health Equity Medicaid Operations

The State of Play: A Mid-Year Update on the Public Option at the Federal and State Level

This commentary examines how Washington implemented the nation’s first public option for the 2021 plan year and in the first six months of 2021, states made significant progress in advancing public option proposals, with public option legislation advancing in Colorado, Nevada, and Oregon.

TOPICS Health Equity Medicaid Eligibility Public Health

Considerations for Telehealth Equity

This commentary explains how since March 2020, many states have rapidly leveraged federal and state flexibilities under the public health emergency to expand telehealth capabilities and reimbursement through both public and private payers.

TOPICS Health Equity Marketplace Policy and Strategy

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.

TOPICS Health Equity Medicaid Eligibility Medicaid Operations

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.

TOPICS Medicaid Operations Value-Based Care

Treasury Issues Rules for $350 Billion Coronavirus State and Local Fiscal Recovery Funds

This article analyzes a key provision of the American Rescue Plan (ARP) to the establishment of the $350 billion Coronavirus State and Local Fiscal Recovery Funds (Fiscal Recovery Funds) for the eligible state, local, territorial and Tribal governments (Recipients) to respond to the COVID-19 public health emergency (PHE).

TOPICS COVID-19 Public Health

Ensuring Equity: State Strategies for Monitoring COVID-19 Vaccination Rates by Race and Other Priority Populations

This blog overviews the state strategies to help ensure the equitable administration of COVID-19 vaccine.

TOPICS COVID-19 Health Equity

Aligning Vaccine and Enrollment Efforts to Maximize Reach

This blog highlights how state-based Marketplaces are launching integrated and innovative outreach campaigns—including tapping into existing public health and COVID-19 vaccination efforts—to reach residents and alert them to the fact that the American Rescue Plan Act provides more people than ever before with access to financial help to pay for health insurance.

TOPICS COVID-19 Marketplace Policy and Strategy

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.

TOPICS COVID-19 Cross-Sector Alignment Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations

American Rescue Plan Provides a New Opportunity for States to Invest in Equitable, Comprehensive and Integrated Crisis Services

This brief analyses the state option established by the American Rescue Plan to provide community mobile crisis intervention services for a five-year period beginning in April 2022.

TOPICS COVID-19 Public Health

The Final 2022 Notice of Benefit & Payment Parameters: Implications for States

This commentary reviews provisions of the U.S. Departments of Health & Humans Services and Treasure final 2022 Notice of Benefit & Payment Parameters of particular import to the state-based marketplaces and state insurance regulators.

TOPICS Marketplace Policy and Strategy

Ensuring Equity: State Strategies for Monitoring COVID-19 Vaccination Rates by Race and Other Priority Populations

This commentary looks at what data states are publicly reporting related to vaccine administration and features an interactive map that explores the extent to which states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography.

TOPICS COVID-19 Health Equity

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.

TOPICS COVID-19 Medicaid Operations

The American Rescue Plan Act’s State Option to Extend Postpartum Coverage

This brief reviews the policy and operational considerations for states of the new option to extend postpartum coverage in the American Rescue Plan Act.

TOPICS Specialized Populations

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.

TOPICS Medicaid Operations

Notice Template Regarding Reconciliation Relief Under Section 9662 of the American Rescue Plan

This toolkit outlines template language that state-based marketplaces can adapt and use in consumer-facing communications regarding new Internal Revenue Service (IRS) information about how consumers can receive relief from repayment of excess advance premium tax credits for 2020 under the American Rescue Plan Act.

TOPICS Marketplace Policy and Strategy

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.

TOPICS Medicaid Operations Specialized Populations

Highlights from the Updated Medicaid Managed Care Contract Language: Health Disparities and Health Equity

This brief provides updates to Medicaid Managed Care Contract Language: Health Disparities and Health Equity, published by SHVS which includes excerpts from managed care contracts, procurement questions, and other policy documents from twelve states and the District of Columbia.

TOPICS Health Equity

Overview of the American Rescue Plan Act of 2021

This brief summarizes the American Rescue Plan Act of 2021, a $1.9 trillion COVID-19 relief bill.

TOPICS COVID-19 Public Health

The American Rescue Plan: An Overview of Private Insurance Provisions

This webinar addresses key provisions of the American Rescue Plan package, the $1.9 trillion budget reconciliation package signed into law by President Biden on March 11.

TOPICS Marketplace Policy and Strategy

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.

TOPICS Coverage Trends Medicaid Operations

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS COVID-19 Medicaid Operations

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.

TOPICS Medicaid Operations Value-Based Care

How States Are Managing the COVID-19 Recession and the Implications for State Health Programs

This commentary provides an updated view of the current state budget landscape and examines in greater detail the health care implications of choices states made to address deficits and balance their budgets in the face of the severe budget shortfalls they confronted for fiscal year 2021.

TOPICS COVID-19 Public Health

Ensuring Equity: State Strategies for Monitoring COVID-19 Vaccination Rates by Race and Other Priority Populations

This commentary examines the extent to which all 50 states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography.

TOPICS COVID-19 Health Equity

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.

TOPICS COVID-19 Medicaid Operations Public Health

The COVID-19 Relief Package and the “No Surprises Act”: Implications for States

This webinar features experts reviewing the provisions of the No Surprises Act and implications for states, providing an overview of the next steps for implementing the federal balance billing protections and what the law will mean for state-level protections.

TOPICS COVID-19 Public Health Value-Based Care

StateNetwork.org’s Top Ten Resources of 2020

The ten most-visited resources on StateNetwork.org during 2020.

TOPICS Coverage Trends COVID-19 Health Equity Marketplace Policy and Strategy Medicaid Eligibility Medicaid Operations Public Health Specialized Populations Value-Based Care

CHART Model Community Transformation Track: Value Proposition for States

This commentary reviews the key features of the Community Health Access and Rural Transformation Model, an initiative of the Centers for Medicare and Medicaid Services, and outlines considerations for states.

TOPICS Specialized Populations Value-Based Care

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.

TOPICS COVID-19 Medicaid Operations Public Health

Proposed 2022 Notice of Benefit & Payment Parameters: Implications for States

This commentary focuses on several provisions of the proposed 2022 “Notice of Benefit & Payment Parameters" that have implications for state oversight of insurance markets and the state-based marketplaces.

TOPICS Commercial Insurance Regulation Marketplace Policy and Strategy

State Strategies for Overcoming Barriers to Advance Health Equity

This brief explores impediments and accelerants to advancing health equity as states are increasingly being called upon to drive change.

TOPICS Health Equity Public Health

More States Looking to Section 1332 Waivers

This map current state activity related the Affordable Care Act’s Section 1332 waivers.

TOPICS Marketplace Policy and Strategy Medicaid Operations

COVID-19 and MLR Guidance On Risk Corridor Recoveries: State Options For Restoring Funds To Policyholders and the Public

This commentary considers ways states could potentially redirect insurers’ extra cash to benefit policyholders and the public.

TOPICS COVID-19 Marketplace Policy and Strategy

Ensuring Access To the COVID-19 Vaccine For Enrollees In Private Health Insurance: A Roadmap For States

This commentary explores recent federal efforts to expand private insurance coverage of a COVID-19 vaccine, and provides a roadmap for states to close remaining coverage gaps that could inhibit vaccine uptake.

TOPICS Commercial Insurance Regulation COVID-19 Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Collaborating To Connect Consumers To Coverage

This commentary explores the importance of clearly communicating to consumers what health coverage options are available for the remainder of 2020 and heading into 2021.

TOPICS Marketplace Policy and Strategy

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.

TOPICS Cross-Sector Alignment Medicaid Operations

Tracking Medicaid Enrollment Growth During COVID-19 Databook

This toolkit provides a detailed look at 2020 Medicaid enrollment trends, including enrollment details by state across four eligibility categories.

TOPICS Coverage Trends COVID-19 Medicaid Eligibility

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.

TOPICS Health Equity Medicaid Operations

Buying Value: Measures that Matter for Quality and Equity

This webinar explores the Buying Value suite of resources to support states' use of performance measures as they assess and improve value with managed care plans and accountable provider entities.

TOPICS Value-Based 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.

TOPICS COVID-19 Cross-Sector Alignment Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Value-Based Care

Adjusting Open Enrollment Outreach to Meet a New Moment

This commentary highlights several strategies states can pursue to help ensure a successful open enrollment period this year amid the COVID-19 pandemic.

TOPICS COVID-19 Marketplace Policy and Strategy Public Health

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.

TOPICS COVID-19 Medicaid Operations Value-Based Care

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.

TOPICS Cross-Sector Alignment Medicaid Operations Value-Based Care

CMS Premium Rebate Guidance – Implications for States and Other Stakeholders

This commentary summarizes recent guidance from the Centers for Medicare & Medicaid Services on permitting health insurance issuers to provide certain premium rebates for 2020 and the conditions rebates must meet.

TOPICS Commercial Insurance Regulation COVID-19 Value-Based Care

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.

TOPICS COVID-19 Medicaid Eligibility Medicaid Operations Public Health

Essential Workers in Challenging Environments: How States Are Working to Protect Farmworkers

This commentary analyzes how states are working to protect farmworkers during COVID-19.

TOPICS COVID-19 Public Health Specialized Populations

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Eligibility Medicaid Operations Public Health

SHVS Two-Part Webinar Series on Preparing for OEP 2021

Two webinars on open enrollment period 2021 explore COVID-19 implications and effective strategies to consider as states design their outreach and education campaigns in a shifting health care environment.

TOPICS Coverage Trends COVID-19 Marketplace Policy and Strategy

Preparing for OEP 2021: State of Play and Communications Considerations

This webinar highlighted how states should adapt their strategies during COVID-19 as they plan their open enrollment outreach and education campaigns, and how to ground these efforts in terms of audience targeting and messaging.

TOPICS COVID-19 Marketplace Policy and Strategy Public Health

Advances in States’ Reporting of COVID-19 Health Equity Data

This commentary provides updated interactive maps that explore the current status of all 50 states and the District of Columbia’s reporting of COVID-19 case and death data breakdowns by age, gender, race, ethnicity, and health care workers.

TOPICS COVID-19 Health Equity Public Health

Essential Workers in Challenging Environments: How States Are Working to Protect Farmworkers

This commentary examines approaches states are taking to protect farmworkers during the COVID-19 pandemic and recommendations for policymakers.

TOPICS COVID-19 Public Health Specialized Populations

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Update on Federal Mandates to Cover COVID-19 Testing Services: New Guidance for States, Plans, and Insurers

This commentary provides an overview of new federal guidance that attempts to answer questions about requirements for coverage of COVID-19 testing services.

TOPICS Commercial Insurance Regulation COVID-19 Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS Health Equity Medicaid Operations

Addressing Equity through COVID-19 Response: Communications Approaches in States

This commentary features insights from state health agencies and health insurance marketplaces that have actively identified opportunities to conduct outreach in communities disproportionately affected by COVID-19.

TOPICS COVID-19 Health Equity Marketplace Policy and Strategy Public Health

Advances in States’ Reporting of COVID-19 Health Equity Data

This commentary provides interactive maps that explore the status of the 50 states' and District of Columbia’s reporting of COVID-19 case and death data breakdowns by demographic categories.

TOPICS COVID-19 Health Equity Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Equitable Recovery Strategies

This commentary provides a survey of actions that state and local governments have taken to intentionally incorporate equity into their COVID-19 recovery and reopening policies.

TOPICS COVID-19 Health Equity Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Is COVID-19 the End of Fee-for-Service Payment?

This commentary assesses how the COVID-19 pandemic may accelerate a shift away from fee-for-service payments models in health care.

TOPICS COVID-19 Public Health Value-Based Care

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.

TOPICS COVID-19 Medicaid Operations Public Health

Responding to COVID-19: State-Based Marketplaces Take Action

This commentary examines strategies that successfully drove enrollment in state-based marketplaces during the COVID-19 pandemic.

TOPICS Coverage Trends COVID-19 Marketplace Policy and Strategy

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Marketplace Policy and Strategy Medicaid Operations Public Health

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.

TOPICS Coverage Trends COVID-19 Medicaid Operations Public Health

Health Equity and COVID-19: Tracking and Taking Action to Address Disparities

This webinar reported on how states are tracking the disproportionate impact of the disease on vulnerable populations and provided a framework for states to examine their COVID-19 response efforts to yield better outcomes for such populations.

TOPICS COVID-19 Health Equity Public Health Specialized Populations

States’ Reporting of COVID-19 Health Equity Data

This commentary looks at which states are regularly reporting data that helps shed light on the health equity issues of the COVID-19 crisis.

TOPICS COVID-19 Health Equity Public Health

Five Key Questions State Health Officials Can Ask Right Now to Advance Health Equity During COVID-19 Response Efforts

This commentary argues states can begin to foster a more equitable and just COVID-19 response, relief, and recovery effort by employing a few key guidelines. Asking a series of core questions and immediately responding with appropriate action can strengthen initial responses and lay the foundation for broader reforms to advance health equity.

TOPICS COVID-19 Health Equity Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Medicaid COVID-19 Messaging

This document provides examples of potential Medicaid messaging states can use during the COVID-19 pandemic.

TOPICS COVID-19 Medicaid Operations Public Health

States’ Reporting of COVID-19 Health Equity Data

This expert perspective looks in depth at states that are regularly reporting COVID-19 health equity data.

TOPICS COVID-19 Health Equity Public Health

Recent COVID-19 Stimulus Legislation and Guidance: Opportunities and Considerations for States

In this webinar, experts from Manatt Health and Georgetown University’s Center on Health Insurance Reforms summarize recent federal legislation and guidance related to COVID-19.

TOPICS COVID-19 Public Health

Pathways to Coverage for COVID-19 Testing and Treatment for Adults in Medicaid Expansion and Non- Expansion States

This toolkit provides an overview for states of various coverage pathways for individuals, including those who are uninsured, in need of COVID-19 testing and treatment.

TOPICS Coverage Trends COVID-19 Medicaid Eligibility Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health Specialized Populations

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Impact of COVID-19 on Medicaid Managed Care Performance Incentives

This webinar discuses the impact of COVID-19 on Medicaid Managed Care Performance Incentives.

TOPICS COVID-19 Medicaid Operations Public Health

CARES Act Unemployment Insurance Expansion and Stimulus Payments – Considerations for States

This commentary discusses details of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) signed into law on March 27, 2020. It considers the policy implications and challenges for states, and discusses potential state measures to address these challenges.

TOPICS COVID-19 Public Health

Implications of Health Care Provisions for States in the CARES Act

This webinar highlights funding opportunities and key provisions relevant to states included in the CARES Act.

TOPICS COVID-19 Public Health

State Policy Options to Encourage Greater Use of Telehealth in State-Regulated Health Plans

This commentary discusses the use of Telemedicine during the COVID-19 pandemic. It summarizes the federal legislation and guidance and discusses actions state departments of insurance can take to encourage greater access to telehealth services.

TOPICS Commercial Insurance Regulation COVID-19 Public Health

COVID-19 Communication Best Practices for States

This commentary features recommended communication strategies and examples for how states can elevate coverage options and help ensure that more residents can access health insurance during these uncertain times.

TOPICS COVID-19 Marketplace Policy and Strategy Public Health

State COVID-19 Data Dashboards

This commentary reviews the key indicators currently being tracked by states via their COVID-19 dashboards and also provides an overview of “best practices” states can consider when developing or modifying these same COVID-19 dashboards.

TOPICS COVID-19 Public Health

State COVID-19 Communication Examples

This brief includes communication examples to help states answer questions on how health insurance covers COVID-related testing and treatment, encourage consumers to enroll in coverage, and engage with providers to keep them informed.

TOPICS COVID-19 Marketplace Policy and Strategy Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Paid Social Platform Policies on COVID-19

This brief discusses the new established guidelines regarding placing COVID-19 related ads on social platforms.

TOPICS COVID-19 Public Health

Marketplace Communications on COVID-19

This brief is a compilation of state marketplace communications examples during the novel coronavirus outbreak.

TOPICS COVID-19 Marketplace Policy and Strategy Public Health

Health Insurance Options During COVID-19

This brief provides a template for states to inform residents of health insurance options during the COVID-19 pandemic.

TOPICS COVID-19 Marketplace Policy and Strategy Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

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.

TOPICS COVID-19 Marketplace Policy and Strategy Medicaid Operations Public Health

State COVID-19 Communication Examples

This brief is a compilation of communication examples from state departments and agencies during the COVID-19 pandemic.

TOPICS COVID-19 Marketplace Policy and Strategy Medicaid Operations Public Health

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.

TOPICS COVID-19 Medicaid Operations Public Health

Grace Periods: A Good Start But Not Sufficient

This commentary explains insurers' moves to extend coverage grace periods during the COVID-19 crisis.

TOPICS Coverage Trends COVID-19 Public Health

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.

TOPICS Health Equity Medicaid Operations Specialized Populations

Public Charge Final Rule: Frequently Asked Questions

This FAQ answers questions about whom the Department of Homeland Security (DHS) public charge rule will impact, what benefits are implicated by the rule, and how the rule might be administered.

TOPICS Specialized Populations

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.

TOPICS Cross-Sector Alignment Health Equity Medicaid Operations

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.

TOPICS Medicaid Operations

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.

TOPICS Cross-Sector Alignment Medicaid Operations

Standardizing Health Plan Benefit Design: Opportunities and Implications for States

This perspective outlines benefits and risks of health plan standardization, raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.

TOPICS Marketplace Policy and Strategy

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.

TOPICS Medicaid Operations

Public Charge Final Rule: Frequently Asked Questions

This FAQ examines who will be affected by the Department of Homeland Security's final public charge rule, what benefits are implicated, and how the rule might be administered.

TOPICS Specialized Populations

Final Public Charge Rule: Analysis and Potential Implications

This webinar reviewed the Department of Homeland Security's final version of its public charge rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers.

TOPICS Medicaid Eligibility Specialized Populations

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.

TOPICS Health Equity Medicaid Operations

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.

TOPICS Medicaid Operations

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.

TOPICS Medicaid Operations

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.

TOPICS Cross-Sector Alignment Medicaid Operations

Leveraging Multi-Payer Claims Databases for Value

This issue brief looks at progress made in using multi-payer claims databases for various strategic purposes, and offers considerations for states seeking to optimize claims databases to improve health care system performance improvement.

TOPICS Value-Based Care

Leveraging Multi-Payer Claims Databases for Value

This webinar explored how several states are using their multi-payer claims databases, including how they are employing claims databases to enhance the value of care and lessons learned for others.

TOPICS Value-Based Care

What, if Anything, Do the Latest Cost Sharing Reduction (CSR) Court Rulings Mean for 2020 Premiums?

This commentary provides a brief background on the recent litigation surrounding cost sharing reductions, including executive actions, and state and insurer responses, as well as what could happen next.

TOPICS Value-Based Care

State Reinsurance Programs: Design, Funding, and 1332 Waiver Considerations for States

The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.

TOPICS Marketplace Policy and Strategy

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.

TOPICS Medicaid Operations

Overview of the HHS Proposed Notice of Benefit and Payment Parameters for 2020

This webinar walked through key components of the proposed annual Notice of Benefit and Payment Parameters for 2020, and discussed potential state considerations for states.

TOPICS Marketplace Policy and Strategy

Medicaid Buy-In: Emerging Models and Considerations

This webinar discusses state considerations for developing a Medicaid buy-in proposal, as well as evolving models.

TOPICS Medicaid Operations

HRA Proposed Regulations: State Implications and Responses

This webinar discusses the implications of the proposed regulations easing the rules governing health reimbursement arrangements (HRA) and other account-based, tax-preferred health care benefits; and possible state responses.

TOPICS Commercial Insurance Regulation Marketplace Policy and Strategy

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.

TOPICS Medicaid Operations Public Health

Public Charge Proposed Rule: Frequently Asked Questions

The Department of Homeland Security’s (DHS) proposed rule, Inadmissibility on Public Charge Grounds, proposes significant changes to how it will determine whether an immigrant is likely to become a “public charge” including, for the first time, the use of Medicaid benefits as a key factor in that analysis.This resource answers popular questions about the rule.

TOPICS Medicaid Eligibility Specialized Populations

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.

TOPICS Coverage Trends Medicaid Eligibility Medicaid Operations Specialized Populations

State Health Policy Highlights: Service Integration and Joint Accountability Across State Agencies and Programs

This State Health Policy Highlight profiles three State Health and Value Strategies issue briefs that provide states with practical approaches to improve individual and population health and create joint accountability across health care and other sectors.

TOPICS Public Health

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.

TOPICS Cross-Sector Alignment Medicaid Operations

State Reinsurance Programs: Design, Funding, and 1332 Waiver Considerations for States

The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.

TOPICS Marketplace Policy and Strategy

Using Hospital Admission, Discharge, and Transfer (ADT) Data to Coordinate Care: Lessons from Tennessee and Washington

This webinar featured the use of admissions, discharge, and transfer (ADT) data feeds to coordinate care for patients with behavioral health and other complex care issues in Tennessee and Washington. It provided lessons learned, including operational and financing strategies, linkages to quality metrics and outcomes, and alignment with other statewide payment and delivery system efforts.

TOPICS Specialized Populations

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.

TOPICS Medicaid Eligibility Medicaid Operations

Safeguarding Financial Stability of Provider Risk-Bearing Organizations

This report explores options for states as they consider oversight of risk-bearing organizations (RBOs), with a focus on states that have elected to act to protect against provider insolvency. The State Health Policy Highlight reviews specific state considerations when overseeing RBOs; case studies examine approaches in California, Massachusetts, New York and Texas.

TOPICS Marketplace Policy and Strategy Value-Based Care

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.

TOPICS Medicaid Eligibility Medicaid Operations

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.

TOPICS Medicaid Eligibility Medicaid Operations

State Considerations For Hospital Global Budgeting

This issue brief provides an overview of hospital global budgeting, which represents a middle-ground approach between the narrow bundling of services and global capitation that transfers higher levels of financial risk to a hospital. It provides a brief overview of hospital global budgets for state health officials interested in whether global budgets may be an option for their state.

TOPICS Value-Based Care

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.

TOPICS Medicaid Eligibility Medicaid Operations

State Implications of the 2019 Affordable Care Act Payment Notice

This webinar untangles HHS's annual Notice of Benefit and Payment Parameters and its many implications for states. The rule is a collection of policies governing the ACA’s marketplaces, insurance reforms, and premium stabilization programs. Speakers include Sabrina Corlette and Justin Giovannelli from Georgetown’s Center on Health Insurance Reforms, Joel Ario from Manatt Health, and Jason Levitis.

TOPICS Commercial Insurance Regulation Marketplace Policy and Strategy

Children’s Health Insurance Program Extended through 2027

This issue brief summarizes key features of the February 9, 2018 10-year CHIP extension. CHIP covers nearly 9 million children and is a key contributor to record-low levels of uninsurance among children.

TOPICS Public Health Specialized Populations

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.

TOPICS Medicaid Operations Public Health

State Reinsurance Programs: Design, Funding, and 1332 Waiver Considerations

Many states continue to encounter challenges in stabilizing their individual health insurance markets, including large premium increases and declining insurer participation. One solution is a state-based reinsurance program similar to the federal program that reduced premiums by more than 10 percent per year from 2014 to 2016. The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.

TOPICS Marketplace Policy and Strategy

New Work and Community Engagement Requirements: Overview of Federal Activity and State Considerations

On January 11, CMS released a State Medicaid Director letter providing 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. In this webinar, State Health and Value Strategies and Manatt Health review the new guidance, including key design parameters, budget neutrality requirements, and monitoring and evaluation criteria.

TOPICS Medicaid Eligibility

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.

TOPICS Medicaid Operations

LAN Framework Value-Based Payment Models

The Health Care Payment Learning and Action Network Alternative Payment Models Framework (the LAN APM Framework) is an increasingly common method being used by states to measure plan progress toward implementation of APMs. This report provides real-world examples of APMs within the LAN categories and can help states and other interested purchasers develop a common understanding of what types of payment models fit within the framework categories.

TOPICS Value-Based Care

Impact of Proposed Rule for Short-Term Insurance Plans

In response to President Trump’s October 12 executive order, the U.S. Departments of Health and Human Services, Labor and Treasury have published proposed rules to expand the availability of health coverage sold through short-term, limited duration insurance (STLDI).

TOPICS Commercial Insurance Regulation Marketplace Policy and Strategy

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.

TOPICS Medicaid Eligibility Medicaid Operations

Association Health Plan Proposed Rule: Summary and Implications for States

In response to President Trump’s October 12 executive order (EO), the U.S. Department of Labor (DOL) published proposed rules to expand the availability of health coverage sold through associations to small businesses and self-employed individuals. The full brief provides state health officials with a detailed review of the content of the proposed rule and examines the implications for states.

TOPICS Commercial Insurance Regulation Employer-Sponsored Insurance

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.

TOPICS Marketplace Policy and Strategy Medicaid Operations

Innovation in State Public Employee Health Benefits

This report provides an overview of three areas of value-based innovation and then affords a deeper examination into specific examples of state employee purchaser activity in California, Connecticut, Massachusetts, Minnesota, Tennessee, and Washington.

TOPICS Employer-Sponsored Insurance Value-Based Care

Planning Ahead: Preparing for 2019 Plan Year Reinsurance Waivers

With three states using Section 1332 waivers to help fund reinsurance programs for the 2018 plan year, many more state officials are considering the model for their state in future years. Having worked directly with the 2018 reinsurance states, State Health and Value Strategies presents a to-do list for states as they consider reinsurance for 2019.

TOPICS Marketplace Policy and Strategy

Communities in Crisis: Local Responses to Behavioral Health Challenges

As the opioid and mental health crises continue to gain national attention, local leaders are stepping up to implement programs to address the prevalence and impact of untreated serious mental illness (SMI) and substance use disorders (SUD). This report explores how cities and counties have launched local initiatives to address the human and economic impact of untreated SMI and SUD.

TOPICS Public Health

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.

TOPICS Medicaid Operations Value-Based Care

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.

TOPICS Cross-Sector Alignment Medicaid Operations

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.

TOPICS Cross-Sector Alignment Medicaid Operations

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.

TOPICS Medicaid Operations Public Health

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.

TOPICS Medicaid Operations Value-Based Care

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.

TOPICS Marketplace Policy and Strategy Medicaid Eligibility Medicaid Operations

Leveraging CHIP to Protect Low-Income Children from Lead

CHIP can provide critical financial support to states as they seek to implement cost-effective lead abatement activities to protect children. This issue brief describes the CHIP State Plan option, which does not require a waiver, and the opportunity it provides for states to make significant tangible reductions in lead exposure and improvements to children’s health. The brief includes specific examples in case studies from Michigan and Maryland.

TOPICS Public Health Specialized Populations

Strategies for Selecting Measures and Developing Aligned Measure Sets

The “Buying Value Measure Selection Tool” was developed to assist state agencies, private purchasers and other stakeholders in creating aligned measure sets, and was first released in 2014. This webinar explains this tool and recent updates for state officials and other stakeholders involved in developing and maintaining aligned quality measure sets for health care entities and programs including for health plans, accountable care organizations, and patient-centered medical homes. This webinar presents strategies for selecting measures and reveals an updated version of the tool.

TOPICS Value-Based Care

Using Shared Measurement and Joint Accountability Across Sectors as Tools for Improving Population Health Outcomes

Health care leaders are well-positioned to use cross-sector approaches to drive improvements in population health in collaboration with state leaders. Through the use of joint measurement and accountability tools, policymakers can help to improve health outcomes to an extent not possible through isolated, medical-centric efforts. This report outlines how state agencies can use shared measurement and joint accountability across sectors as tools for improving population health outcomes.

TOPICS Cross-Sector Alignment Public Health

Integrating Health Care and Social Services: Moving from Concept to Practice

This report describes six potential integration strategies that state agencies might employ to better integrate social services and health care delivery. For each, the report contains examples from several states that have utilized these strategies in their own efforts to increase integration.

TOPICS Cross-Sector Alignment

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.

TOPICS Medicaid Operations

Tricky Problems with Small Numbers: Measuring PCMH and ACO Performance

This report identifies methodological challenges in measuring cost of care performance for organizations with a small number of attributed patients, and provides concrete strategies and resources for state purchasers to address this methodological challenge when evaluating PCMH and ACO cost performance and applying financial incentives and disincentives.

TOPICS Value-Based Care

Integrating Public Health and Health Care: Getting Beyond the Theory

Changes in population-based payment models in health care delivery have spurred enhanced efforts toward closer integration between state purchasers of health care and state, county, and local public health officials. This issue brief investigates approaches that state agencies might employ in order to better integrate public health and health care delivery as a means of improving health and the value of health care, and it is organized according to seven features of integration. The issue brief is accompanied by three case studies providing additional detail to some of the examples cited in the brief.

TOPICS Public Health Value-Based Care

Provider Donations and Assessments: Options for Funding State Costs of Medicaid Expansion

In this brief, we explore two revenue sources states may deploy to fund the non-federal share of expansion: provider assessments and provider donations. Both are authorized by federal law and both have been used by states in connection with expansion.

TOPICS Medicaid Eligibility Value-Based Care

Safety-Net Provider ACOs: Consideration for State Medicaid Purchasers

This issue brief examines seven safety-net ACOs across five states to understand their origins, organization, characteristics and functions and to identify federal and state policy questions associated with their emergence. The issue brief identifies both challenges facing safety-net provider ACO aspirants and state strategies to support safety-net provider development of ACOs.

TOPICS Value-Based Care

Implementing State Payment Reform Strategies at FQHCs

As state Medicaid programs increase their focus on value-based payment, it is important to consider how FQHCs may participate in payment reform strategies. Through their focus on improved health outcomes, patient satisfaction, and access to appropriate care, alternative payment methodologies can benefit FQHCs, the state purchaser, and most importantly Medicaid beneficiaries. This brief describes a number of state-level payment reform strategies that include FQHCs and offers strategies and considerations for states and FQHCs alike.

TOPICS Value-Based Care

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.

TOPICS Cross-Sector Alignment Medicaid Operations Value-Based Care