This week our In Focus section reviews Vermont鈥檚 Global Commitment to Health Section 1115 waiver renewal application. In the proposed five-year demonstration extension, Vermont seeks to move the Medicaid population to a new a risk-bearing public, state-run managed care organization (MCO). Under the arrangement, the Department of Vermont Health Access (DVHA) would transition into the new entity and accept capitated risk for the state鈥檚 Medicaid population, covering physical and mental health, pharmacy services, substance use disorder (SUD) services, and long-term services and supports (LTSS) beginning January 1, 2022.
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红领巾瓜报 prepared issue briefs explore MLTSS impacts on state Medicaid programs
In a recent pair of reports prepared for , 红领巾瓜报 colleagues examined the impact of managed long-term services and supports (LTSS) in state Medicaid programs. The first report, Growth in MLTSS and Impacts on Community-Based Care, examines the historical increase in the adoption of LTSS by state Medicaid programs and how that has contributed to a shift in long-term care from institutions to the community. The second report, Managed LTSS Improves Quality of Care, describes the evidence on the impact of managed LTSS in state Medicaid programs on the quality of care.
Authors:
Principal Stephen Palmer
Senior Consultant Ashlen Strong
Senior Consultant Aaron Tripp
Medicare-Medicaid integration: key elements and policy recommendations for dual eligible care programs
This week, our In Focus section releases a new brief from 红领巾瓜报, Medicare-Medicaid Integration: Essential Program Elements and Policy Recommendations for Integrated Care Programs for Dually Eligible Individuals. The authors are Sarah Barth, Ellen Breslin, Samantha DiPaola and Narda Ipakchi.[1]
Webinar Replay: Value Propositions and Roadmaps for Integrating Children鈥檚 Behavioral Health and Medicaid with Child Welfare Systems
This held on July 15, 2021, was the seventh webinar in the series 鈥淓xploring the Landscape of Behavioral Healthcare,鈥� covering the growing impact of behavioral healthcare on clinical outcomes and cost.
The success of the delivery of state and local child welfare systems is predicated on a strong collaboration across child welfare, children鈥檚 behavioral health and Medicaid, building a multigenerational, multisystem response to the problem of child maltreatment. During this webinar, 红领巾瓜报 behavioral health, child welfare and Medicaid experts broke down what鈥檚 needed to get the integration process started, including a practical approach to workflows as well as an understanding of the touchpoints where integration efforts are likely to have their biggest payoff.
Learning Objectives
- Understand how child welfare services departments currently interact with the behavioral health service continuum.
- Learn how to build value by identifying areas where the intersection of child welfare, Medicaid and children鈥檚 behavioral health helps improve outcomes and mitigate risk.
- Identify potential barriers to integration efforts.
- Learn how other states have applied solutions and strategies aimed at better integrating child welfare systems, Medicaid, and children鈥檚 behavioral health.
- Learn about financing infrastructures that support meaningful whole family approaches to improving protective factors and strengthening family resilience.
红领巾瓜报 Speakers:
Uma Ahluwalia, MSW, MHA, Managing Principal, Washington, DC
Annalisa Baker, MPH, LCSW, Senior Consultant, New York, NY
Caitlin Thomas-Henkel, MSW, Principal, Philadelphia, PA
Heidi Arthur, MSW, Principal, New York, NY
Louisiana Releases Medicaid Managed Care RFP
This week our In Focus section reviews the Louisiana Medicaid managed care request for proposals (RFP) released on June 23, 2021, by the Louisiana Department of Health. Louisiana is seeking full-risk health plans to serve approximately 1.6 million Medicaid beneficiaries. Contracts are worth approximately $9 billion annually.
红领巾瓜报 brief examines state efforts to integrate care across Medicaid FFS LTSS and Medicare Advantage D-SNPs
Funded by UnitedHealthcare, the issue brief, State Efforts to Integrate Care Across Medicaid Fee-for-Service Long-Term Services and Supports and Medicare Advantage Dual Eligible Special Needs Plans, outlines approaches taken by Medicaid programs seeking to coordinate Medicare and Medicaid services for dually eligible individuals without first implementing standalone Medicaid managed long-term services and supports (MLTSS) programs.
Authors are Sarah Barth, Rachel Deadmon and Julie Faulhaber.
Tennessee Releases Medicaid Managed Care RFP
This week our In Focus reviews the Tennessee Medicaid managed care request for proposals (RFP) released on June 11, 2021, by the State of Tennessee, Division of TennCare. Tennessee will select three plans to provide physical services, behavioral services, and Managed Long-Term Services and Supports (MLTSS), including nursing facility services and home and community-based services (HCBS), to beneficiaries enrolled in TennCare (Medicaid), CoverKids (Children鈥檚 Health Insurance Program), and Dual Eligible Special Needs Plans (D-SNP). Current incumbents serve over 1.5 million beneficiaries, with contracts worth $12 billion annually.
Indiana Releases Medicaid Managed Care RFP
This week, our In Focus section reviews the Indiana Medicaid managed care request for proposals (RFP) for health plans serving beneficiaries enrolled in Hoosier Healthwise and Healthy Indiana Plan (HIP) programs. Contracts will be worth over $6 billion annually. The RFP was released on June 7, 2021, by the Indiana Department of Administration on behalf of the Family and Social Services Administration Office of Medicaid Policy and Planning.
California proposed May revision budget adds Medi-Cal expansions
This week, our In Focus section reviews California鈥檚 May Revision to the Governor鈥檚 Budget, which proposes a $267.8 billion budget (with $196.8 billion General Fund) for fiscal year 2021-22. The revised budget includes $24.4 billion in reserves, the largest in history. The May Revision builds on the California Advancing and Innovating Medi-Cal (CalAIM) proposal and introduces several Medi-Cal initiatives and benefits for fiscal year 2021-22.
CMS Interoperability and Patient Access Final Rule 鈥� Part 3
This blog was written by Juan Montanez, Principal, 红领巾瓜报, and Robert Chouinard, VP Public Sector, HealthEC
Where are you going to invest to maximize benefits?
In thinking about the value that can be derived from implementation of the Interoperability Rule, both payers and providers need to ensure their perspective of the rule positions them for long-term success.
CMS Interoperability and Patient Access Final Rule 鈥� Part 2
This blog was written by Laura Zaremba, Principal, 红领巾瓜报, and Robert Chouinard, VP Public Sector, HealthEC
Making the Economics Work for You
Most health care organizations impacted by the Interoperability Rule have very logically focused their attention and resources on interpreting what the new rule requires them to do within their own systems, in what timeframe, and at what cost. And to be sure, scoping the work and deploying the resources required to meet the compliance deadlines is a significant investment of time and money, but the compliance focus should be only the first action step for to the Interoperability Rule.
Nevada Releases Medicaid Managed Care RFP
This week, our In Focus section reviews the Nevada Medicaid and Child Health Insurance Program (CHIP) managed care request for proposals (RFP) released by the Nevada Department of Health and Human Services, Division of Health Care Financing and Policy (DHCFP) on March 17, 2021. The RFP is for the current service area covering two urban counties of the state, Clark and Washoe; however, the state may extend the geographic service area under the contract. Through this RFP, Nevada seeks to advance the state鈥檚 goals of 鈥渋mproved clarity and oversight of requirements; increased focus on care management, member engagement, and access; and continued progress towards integration of services and efficiency.鈥�