Managed Care

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Medicaid Home- and Community-Based Services: Evaluating Covid-19 Response Could Help CMS Prepare for Future Emergencies

States received approval for temporary changes to their HCBS programs from CMS, within the Department of Health and Human Services to enable states to limit in-person contact to reduce the spread of COVID-19. This GAO report describes the temporary changes to Medicaid HCBS programs and examines CMS’s monitoring and evaluation of the effects of those changes.

Short URL: http://www.advancingstates.org/node/73028

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Medicaid and CHIP Managed Care Monitoring and Oversight Tools

CMS has released a Center Informational Bulletin providing tools to states and CMS to improve the oversight of managed care and increase beneficiaries’ access to care. In the bulletin, CMS shares resources to improve compliance with managed care standards and requirements and guidance setting the content and format of the Annual Managed Care Program Report. The bulletin also outlines multiple tools and resources for improving managed care oversight that are currently in development at CMS.

Short URL: http://www.advancingstates.org/node/72716

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Better Care Experiences and Quality of Life: New Evidence Favors Managed Care Delivery of Long-Term Services and Supports

This Mathematica article summarizes some of their key findings from a recent study utilizing NCI-AD data. The study contributes important information to the field of managed care long-term services and supports (MLTSS) and quality outcomes. One finding shares “MLTSS enrollees rated their experience of care and quality of life more favorably than fee-for-service beneficiaries.”

Short URL: http://www.advancingstates.org/node/72477

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LTSS Choices: A Series on Transforming Long-Term Services & Supports

The AARP Public Policy Institute recently launched a three-year initiative which aims to transform long term care in the United States. LTSS Choices will be a series of reports, blogs, videos, podcasts, and virtual convenings that seek to catalyze reform and spark ideas to modernize LTSS, long term services and supports. The goal is a long-term care system that provides a wide range of choices to meet the dynamic needs and preferences of consumers and their families.

Short URL: http://www.advancingstates.org/node/72291

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New Updates to theCoverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration and Cost Sharing under Medicaid, the Children’s Health Insurance Program, and Basic Health Program Toolkit

CMS released an update to the COVID-19 Vaccines Toolkit that was released on 10/28/20 and first updated on 11/23/20. This update includes more information on vaccine administration reimbursement and outlines a streamlined review process available to states looking to quickly adjust vaccine administration reimbursement rates in state plans. The toolkit also provides more clarification on managed care network adequacy and the phased distribution and administration approved COVID-19 vaccines.

Short URL: http://www.advancingstates.org/node/72290

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Person-Centered Practices Self-Assessment

This resource aims to help human service agencies in states, tribes, and territories to measure their progress in developing person-centered systems. The Self-Assessment was designed to be used by staff at all levels. The Self-Assessment measures progress in eight different domains: Leadership; Person-Centered Culture; Eligibility & Service Access; Person-Centered Service Planning & Monitoring; Finance; Workforce Capacity and Capabilities; Collaboration & Partnership; and Quality & Innovation

Short URL: http://www.advancingstates.org/node/72236

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Integrated Care Programs for Dually Eligible Individuals in the Era of COVID-19: Response Efforts and Policy Recommendations

CHCS and Speire Healthcare Strategies released a report about COVID-19 response efforts from states and health plans that offer integrated care programs for duals. People who are dually eligible for Medicare and Medicaid are among the nation’s most vulnerable to the coronavirus. The report outlines opportunities to support integration and identifies opportunities to strengthen programs and policies to best support the dual eligible population during the pandemic and in the future.

Short URL: http://www.advancingstates.org/node/72191

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De-Mystifying Data: How Medicare Data Can Support Medicaid Agencies

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid (dually eligible individuals).The brief provides a primer on the ways that Medicare data can help states better deliver care to dually eligible individuals; it also details information about data sources and other resources available to help obtain and analyze Medicare data.

Short URL: http://www.advancingstates.org/node/72175

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State Actions Addressing COVID-19 in Long-Term Care Facilities

NGA recently published a policy memo including a detailed table that provides an overview of state actions to address COVID-19 in long-term care facilities. The table includes notable actions from states with helpful links to relevant guidance and resources for each state. Updates on additional state actions and examples will be added to the table regularly and states are encouraged to contact NGA with changes.

Short URL: http://www.advancingstates.org/node/72172

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Exploring Options for Integration: State Considerations to Better Coordinate Medicare and Medicaid

This webinar discussed two issue briefs from the MLTSS Institute on aligning Medicare and Medicaid for dually eligible individuals. The briefs covered were, "Starting from Square One: Considerations for States Exploring Medicare-Medicaid" and, “The Value of Integration to State Medicaid Agencies”. The webinar also highlighted the perspective of the District of Columbia, which is planning to launch new program elements to better integrate care.

Short URL: http://www.advancingstates.org/node/72036

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