Managed Care

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.

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

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.

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.

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.

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.

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid. Only about 2/3 of states have undertaken any activity to better integrate care for dually eligible beneficiaries; many have encountered a number of barriers in pursuing better integration of the Medicare and Medicaid programs. This issue brief identifies key questions that states should ask themselves before they design an integrated care program.

This AARP Public Policy Institute research report examines support for family caregivers in managed long-term services and supports. The report finds that states have made progress in this area, but have opportunity to continue improving support for family caregivers in their MLTSS programs. One potential solution suggested by the report is to ensure that MLTSS contracts between states and health plans include clearly defined requirements to identify and support family caregivers.

This report presents highlights from a National Governor's Association Roundtable held in December 2018. At the roundtable, state and federal officials, national experts, and industry and consumer experts discussed challenges and opportunities for states to improve care and manage costs for dual eligibles. Based on the conversation at this event, NGA identifies key considerations for governors and their staff.

This issue brief discusses state policy trends using data from KFF’s 18th annual 50-state survey. It discusses policy areas such as implementation of electronic visit verification and value based payment models. The brief highlights key findings across the topics areas of HCBS program flexibility, MLTSS, and response to federal regulations