红领巾瓜报 has published a white paper identifying the appropriate, and inappropriate, uses of risk corridors in the context of Medicaid managed care capitation rate setting. 聽The paper is timely due to the widespread use of risk corridors by states during the COVID-19 public health emergency (PHE) and the potential continuation of those risk corridors after the PHE ends.聽聽
Download the Executive Summary here.
红领巾瓜报 Managing Directors R. Corey Waller, MD, MS, and Jean Glossa, MD, MBA, along with members of the Prevention, Treatment, and Recovery Working Group of the Action Collaborative on Countering the U.S. Opioid Epidemic, recently authored a new National Academy of Medicine Perspectives discussion paper calling for a long-term sustainable approach to preventing and managing addiction as a chronic disease.
To adequately respond to America鈥檚 drug overdose and death epidemic, the paper states the ecosystem in which people with addiction receive treatment must be reimagined and made more robust. The National Academy鈥檚 framework best describes the needs of and solutions for the addiction treatment ecosystem using the guidance of 鈥榯he 4 Cs鈥�: capacity, competency, consistency, and compensation.
Authors
R. Corey Waller, MD, MS, Managing Director, 红领巾瓜报 Institute on Addiction
Kelly J. Clark, MD, MBA, DFAPA, DFASAM, President, Addiction Crisis Solutions and Immediate Past President, American Society of Addiction Medicine.
Alex Woodruff, MPH, policy analyst, Partnered Evidence-based Policy Resource Center, VA Boston Healthcare System.
Jean Glossa, MD, MBA,听Managing Director, Delivery System, 红领巾瓜报
Andrey Ostrovsky, MD, Managing Partner, Social Innovation Ventures
With a focus on the needs of young people in detention and correctional facilities, a team of 红领巾瓜报 (红领巾瓜报) colleagues completed an in-depth assessment designed to guide future planning and decision making around mental health services for youth.
The COVID-19 pandemic highlighted nursing home safety and infection control as critical public health issues. A new report authored by 红领巾瓜报 colleagues found compelling evidence that single rooms in nursing homes have numerous benefits for both public health and residents鈥� experience. The authors conclude that transitioning from multi-resident rooms to single rooms should be a component of person-centered nursing home reform. The report calls on stakeholders to come to the table to discuss options and strategies for long-term care redesign and transformation.
The report,听Fundamental Nursing Home Reform: Evidence on Single-Resident Rooms to Improve Personal Experience and Public Health, was developed for a Michigan-based long-term care provider and owner of skilled nursing facilities.
红领巾瓜报 colleagues聽Sharon Silow-Carroll, MBA, MSW,听Deborah Peartree, RN, MS,听Susan Tucker, CPA, 补苍诲听Anh Pham聽conducted the research and analysis and prepared this report.聽 An appendix prepared by the national accounting firm Plante Moran provides estimates of new costs and other considerations related to transitioning to single-resident rooms, based on data from two Michigan-based multi-facility long-term care organizations.
The experts at 红领巾瓜报 (红领巾瓜报) have released Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access. The white paper examines the factors contributing to a Medicare Advantage plan鈥檚 decision to offer or not offer newly available supplemental benefits and opportunities and challenges with adoption and implementation. Newly available supplemental benefits are intended to address unmet health and social needs.
红领巾瓜报 further sought to understand the extent to which Medicare Advantage enrollees had access to these benefits when eligible, and the effectiveness of these benefits as a tool to contain costs, improve outcomes, and increase enrollee engagement and satisfaction.
The report outlines seven key insights and accompanying policy considerations aimed towards promoting evidence-based benefit designs; expanding Medicare Advantage organization willingness to adopt the flexible benefits; and enhancing beneficiary involvement, access, and usage of these benefits.
红领巾瓜报 colleagues Narda Ipakchi, Mary Hsieh, Sarah Barth, and Jonathan Blum contributed to the report which follows up on a previous report providing a snapshot of early adoption of these benefits.
This analysis was funded by a grant from Arnold Ventures, a philanthropy dedicated to tackling some of the most pressing problems in the United States.
红领巾瓜报鈥檚 Donna Strugar-Fritsch, Shannon Robinson, MD and Scott Haga, PA-C, recently authored the issue brief, Naltrexone Formulations in Correctional Settings. 聽This brief provides clinical, financial, and administrative information prisons and jails can use in deciding whether to keep detainees on extended release naltrexone (XR-NTX, or the brand Vivitrol) or switch them to oral naltrexone tablets in instances where detainees have been prescribed XR-NXT prior to incarceration.
红领巾瓜报 (红领巾瓜报) and Wakely Consulting Group, Inc., collaborated to analyze, compile, and model data on Medicaid enrollment growth during the COVID-19 pandemic and develop projections under various recovery scenarios as well as analyze the potential impact of key variables on state Medicaid expenditures.
The analysis examined two key questions, how much strain will state Medicaid budgets be under over the next few years and what types of state characteristics and what types of policy options will allow states the ability address budgetary challenges.
红领巾瓜报 colleagues Eric Hammelman, Stephen Palmer, Matt Powers, and Kathy Gifford contributed to the report.
红领巾瓜报 (红领巾瓜报) was engaged by Covered California to evaluate and make recommendations about whether the state鈥檚 Marketplace should require Qualified Health Plan (QHP) Issuers to gain National Committee for Quality Assurance (NCQA) Distinction in Multicultural Health Care.
With a mission to increase insurance coverage in California and improve quality of care while reducing costs and health disparities, Covered California sought to learn how achieving Distinction in Multicultural Health Care has helped Issuers promote meaningful change and reduce disparities to advance health equity, in order to determine whether requiring the Distinction would help the Marketplace assure QHP Issuers effectively deliver quality care and improve population health.
The 红领巾瓜报 team reviewed the Distinction鈥檚 standards and guidelines within Attachment 7, Article 3interviewed four Issuers that have earned the Distinction. They recommended Covered California update its language in Article 3.04, requiring Issuers to achieve NCQA Distinction in Multicultural Health Care and allocate resources to deliberately address disparities and health equity, increasing infrastructure and reinforcing organizational commitment to this work.
红领巾瓜报 consultants Michael Anderson-Nathe, Nora Leibowitz and Michele Melden completed the assessment.
红领巾瓜报 (红领巾瓜报), in contract with The National Council on Aging (NCOA), and with support from the Administration for Community Living (ACL), recently provided research and strategy services to support the goal to increase the adoption of evidence-based health promotion and disease prevention programs, known as evidence-based programs (EBPs) by Medicaid, Medicare, and other health insurance markets.
The 20th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and 红领巾瓜报 (红领巾瓜报) was released on October 14, 2020 and included two new reports: State Medicaid Programs Respond to Meet COVID-19 Challenges: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2020 and 2021聽补苍诲听Medicaid Enrollment & Spending Growth: FY 2020 & 2021.
The reports were prepared by聽Kathleen Giff颅ord,听Aimee Lashbrook, 补苍诲听Sarah Barth聽from 红领巾瓜报 and by Elizabeth Hinton, Robin Rudowitz, Madeline Guth, and Lina Stolyar from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors.
This survey reports on trends in Medicaid spending, enrollment, and policy initiatives for FY 2020 and FY 2021, highlighting COVID-19 policy planned for implementation in FY 2021. The conclusions are based on information provided by the nation鈥檚 state Medicaid Directors.
In April 2020, 红领巾瓜报 released COVID-19 Impact on Medicaid, Marketplace, and the Uninsured, by State. Our experts聽assessed COVID-19鈥檚 potential impact on health insurance coverage for each state and forecasts Medicaid enrollment could increase by 11 to 23 million across all states over the next several months.
The May 2020 updated analysis, 红领巾瓜报 Updated Estimates of COVID Impact on Health Insurance Coverage, projects the potential impact of the COVID-19 pandemic on health insurance coverage and cost by state through 2022. The analysis provides deeper insights into how health insurance coverage is estimated to take years to more closely resemble pre-COVID-19 coverage levels.
The September 2020 summary update on the estimated impact of COVID-19 on the economic downturn looks at the uncertainty surrounding the economic pace of recovery, estimated Medicaid enrollment, and the estimated growth in individual coverage.
The experts at 红领巾瓜报 (红领巾瓜报) have released the Medicare-Medicaid Integration: Reflecting on Progress to Date and Charting the Path to Making Integrated Programs Available to all Dually Eligible Individuals issue brief and companion bibliography appendix, the second in a series of issue briefs examining Medicare-Medicaid integrated programs.
Based on 红领巾瓜报’s review of the literature and available public information, this brief summarizes the elements for success and barriers encountered by integrated programs. It concludes with essential questions and next steps to move forward with federal and state public policies and care delivery options centered around, informed by, and available to, more dually eligible individuals.
红领巾瓜报 colleagues Sarah Barth, Jon Blum, Elaine Henry, Narda Ipakchi and Sharon Silow-Carroll contributed to the research and final brief.
For the next phase of research, 红领巾瓜报 will convene and interview individuals, their families and other caregivers, providers, payers, community-based organizations, state government, and other stakeholders in select regions across the country.
The project was funded by a grant from , a philanthropy dedicated to tackling some of the most pressing problems in the United States.聽聽