Managed Care

The White House released a proclamation highlighting the commitment and value of care workers, and recognized this month, April 2024, as Care Workers Recognition Month. It summarizes the efforts taken by the Biden Administration to support care workers in the United States. President Biden mentions the current actions being taken by agencies to achieve proper pay for home care workers by ensuring they receive larger Medicaid payments and promoting programs that support careers in the field. This proclamation expresses the administration’s appreciation of care workers and their dedication.

The Rosalynn Carter Institute for Caregivers, the Virginia Caregiver Support Program, and the Virginia Department of Veterans Affairs (VA) have recently released a toolkit for caregivers of Veterans for disaster preparedness. This resource is designed to empower caregivers of Veterans, providing them with essential tools and knowledge to navigate the challenges of caregiving during disasters. With a focus on increasing caregiver confidence and preparedness, this toolkit aims to help caregivers prepare both themselves and the Veterans they care for in the face of crisis.

The National Institute on Aging (NIA) has released a resource offering insights and guidance on legal and financial planning for people living with Alzheimer's disease or related dementias. This article emphasizes the importance of early preparation and covers essential legal and financial planning documents, including advance health care directives and directives for financial and estate management. This resource offers guidance on seeking assistance with legal and financial planning, including advice on advance care planning discussions with healthcare providers and locating support from elder law attorneys. Additionally, it provides information about available resources for low-income families.

Registration is now open for the 2023 Centers for Medicare & Medicaid Services (CMS) National Training Program (NTP) virtual workshops. Session dates and topics for the upcoming week are as follows: August 1st: Coordination of Benefits August 2nd: Medicare Scenarios (Casework Session) August 3rd: Medicare for People with End-Stage Renal Disease (ESRD) All sessions will start at 1:00 p.m. and conclude no later than 3:30 p.m. ET.

On July 25, The Centers for Medicare & Medicaid Services (CMS) released the 2021 data on Medicaid Managed Care enrollments, program characteristics, and data tables. This national data is broken down by program and population, as well as by individual state. The enrollment data provides an accurate snapshot of Medicaid managed care enrollment for a particular year as of July 1st of each year.

On Tuesday, February 21, 2023 The Association of Community Affiliated Plans, Medicaid Health Plans of America, and Sellers Dorsey released their highlights from the 2022 State of Medicaid Managed Care Report. The report covered five core areas of managed care across the country, the current state of managed care, the history of federal regulations and key changes, effective approaches from six states, innovations and successes from MCOs, and outcomes stemming from managed care.

A new issue brief from Kaiser Family Foundation shares how States can work with Medicaid managed care organizations (MCOs) to prepare beneficiaries for the unwinding process. MCOs deliver to more than two thirds of Medicaid beneficiaries nationally and this article shares insight on the strategic partnerships between states and their MCOs to prepare for the unwinding process.

This past Wednesday, February 1st, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies.

On January 5, 2023 CMS released a State Medicaid Director’s letter that provides a new reporting and oversight framework for states that permit managed care plans to deliver in-lieu-of services (ILOS) to their enrollees. ILOS are cost-effective substitutes for otherwise covered State plan services that may enhance enrollee’s health and wellbeing (for example, medically-tailored meals that enhance the ability of an enrollee to remain at home rather than in an institutional setting). States using ILOS will be required to limit them to no more than 5% of a managed care program’s total capitation payments and provide evaluative data to CMS about their effectiveness beginning in 2027.

MACPAC has released its June 2022 Report to Congress on Medicaid and CHIP. The report recommends measures that Congress can take to better monitor access to care for Medicaid beneficiaries, improve the oversight and transparency of managed care directed payments, increase access to vaccines for adults enrolled in Medicaid, encourage the uptake of health information technology in behavioral health, and better integrate care for Medicaid and Medicare dual-eligibles. The commission also offers policy levers that states and the federal government can use to promote equity in Medicaid.