This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the 鈥淢arch 2020 Medicaid and CHIP Applications, Eligibility Determination, and Enrollment Report,鈥� published on June 22, 2020. Additionally, we review 2020 Exchange enrollment data from the 鈥淗ealth Insurance Exchanges 2020 Open Enrollment Period: Final State-Level Public Use File,鈥� published by CMS on April 2, 2020. Combined, these reports present a picture of Medicaid and Exchange enrollment in early 2020, leading up to the COVID-19 pandemic and representing 70.9 million Medicaid and CHIP enrollees and 11.4 million Exchange enrollees. Medicaid/CHIP and Exchange enrollment is expected to rise in 2020 according to a team of 黑料不打烊 Medicaid experts, health economists, and data analysts. Read the previous In Focus on 黑料不打烊鈥檚 forecast model.
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Webinar Replay: Leveraging the Primary Care Team鈥檚 Strengths During Reopening: Part 1 – The Workforce
This webinar was held on July 15, 2020.
In this three-part series, 黑料不打烊 experts will cover topics that are important for primary care practices to consider and employ as they reopen for face-to-face visits.
As primary care practices reopen around the country, many of them are adopting novel hybrid models combining in-person and virtual care. In this half-hour presentation with primary care leaders and clinical innovators, we discussed the key challenges for flexing the primary care workforce in this hybrid environment.
Learning Objectives
- Learn more about a model of hybrid primary care that combines in-person and virtual visits鈥�
- Identify best practices for changing workflows and managing staff members remotely in the hybrid primary care model.
- Discuss technological strategies for integrating behavioral health into the flow of hybrid primary care.
Speakers
Dr. Barry J. Jacobs, Principal, Philadelphia, PA
Gail Mayeaux, Principal, Albany, NY
Deb Peartree, Senior Consultant, Albany, NY
Caitlin Thomas-Henkel, Senior Consultant, Philadelphia, PA
Webinar Replay: 黑料不打烊 Community Health Worker Webinar Series Part 2: The Role of Community Health Workers as COVID-19 Contact Tracers
This webinar was held on July 13, 2020.听
Aggressive COVID-19 contact tracing is key to state reopening strategies. During this webinar, 黑料不打烊 community health experts addressed how community health workers can play a critical role in contact tracing, leveraging their trusted position in local communities and simultaneously furthering efforts to assist patients with multiple needs, including housing instability, food insecurity and co-morbidity. 黑料不打烊 experts also outlined best practices for establishing a contact tracing infrastructure and discuss how community health workers are positioned to emerge as the vanguard for COVID-19 vaccination efforts.
Learning Objectives:
- Learn how to apply creative workforce strategies to address contact tracing, isolation support, co-morbid disease management, and immunization efforts.
- Obtain creative financing and sustainability strategies for staffing and infrastructure.
- Understand how community health workers and paraprofessionals can play an expanded role in the post-COVID-19 delivery system of the future.
黑料不打烊 Speakers
Kathleen Nolan, Vice President, Washington, DC
Pat Casanova, Principal, Indianapolis, IN
Uma Ahluwalia, Principal, Washington, DC
A recording of the first webinar and supporting materials are now available here.
GAO 50-state Medicaid survey on federal policy challenges
This week our In Focus section summarizes the United States Government Accountability Office (GAO) Medicaid report, State Views on Program Administration Challenges, released earlier this year. GAO conducted interviews with Medicaid officials from 50 states and the District of Columbia to identify challenges related to federal Medicaid policies. 听
Webinar Replay: Nursing Home Revenue Diversification and Care Options Series: Exploring Medicare Advantage as an Alternative Revenue Source for Post-Acute Providers
This webinar was held on July 17, 2020.
Even before COVID-19, post-acute providers such as nursing homes struggled with inadequate reimbursement rates and declining occupancy rates. This, along with additional stressors brought on by the pandemic, has led many nursing homes to consider revenue diversification and service expansion strategies. During this webinar (the first in a series), 黑料不打烊 Medicare Advantage and long-term care experts addressed two such options for nursing homes: Medicare Advantage Institutional Special Needs Plans (I-SNP) and Institutional-Equivalent Special Needs Plans (IE-SNP).
Learning Objectives
- Understand Medicare Advantage, its significance and its growth
- Identify types of Medicare Advantage options for residents and community-based beneficiaries
- Explore how Medicare Advantage can serve as a potential revenue diversification strategy
- Learn about the benefits and risks of 听听Medicare Advantage, in particular for I-SNPs
- Identify how to assess if an I-SNP or an IE-SNP is the right opportunity for your organization
黑料不打烊 Speakers
Mary Hsieh, Managing Principal, Atlanta, GA
Susan Tucker, Principal, Tallahassee, FL
CMS updates Medicare Advantage and Section 1876 cost plan network adequacy
This week, our In Focus section examines new guidance issued by the Centers for Medicare & Medicaid Services (CMS) regarding Medicare Advantage (MA) plan network adequacy requirements. On June 17, 2020, CMS released updated Medicare Advantage and 1876 Cost Plan Network Adequacy Guidance for Medicare Advantage (MA) health plans to use now for Contract Year 2021 network submission.
Webinar Replay: 黑料不打烊 Community Health Worker Webinar Series Part 1: Health and Human Services Workforce Needs in the Context of COVID-19
This webinar was held on June 30, 2020.
In the midst of the COVID-19 pandemic, state and local governments and safety net providers are faced with a clear indication of disparities in population health outcomes and looming budgetary challenges across the nation. These entities are committed to their residents and are looking for creative strategies to mitigate health risks and deliver responsive health and human services despite budgetary challenges. As such, the role of the community health worker or the navigator rises to the top. Engaging and integrating trusted community health workers and other paraprofessionals is a promising, cost-effective and trust-building practice that can support the seamless dissemination of these essential services in these unprecedented times.
This webinar was the first in 黑料不打烊鈥檚 Community Health Worker Series. During this webinar, 黑料不打烊 experts put forth a value proposition for the timely engagement and integration of community health workers/navigators/peer support specialists in the delivery of health and human services. Presenters provided several compelling case studies and three successful implementation models for integrating paraprofessionals into the delivery system. Participants learned how community health workers are poised to support the unique needs of residents in urban, suburban, rural, and public health and human services settings. Finally, respondents reflected on the paraprofessional role from a social determinants of health standpoint and from the perspective of minority populations and their communities.
Learning Objectives:
- Understand the role community health workers and other paraprofessionals can play in the health and human services workforce in the COVID-19 era.
- Learn how select states explored the certification, education, financing and roles of community health workers and other paraprofessionals when integrated into specific health and human services.
- Find out how to build trust in minority communities, incorporating social determinants of health in the COVID-19 recovery response at the crossroads of health disparities and racial inequities.
黑料不打烊 Speakers
Uma Ahluwalia, Principal, Washington, DC
Heidi Arthur, Principal, New York, NY
Stephanie Denning, Principal, Denver, CO
Julia Elitzer, Senior Consultant, San Francisco, CA
Iliana Gilman, Principal, Austin, TX
Catherine Guerrero, Principal, Denver, CO
Lori Weiselberg, Managing Principal, Chicago, IL
Reference Materials:
has a great website of state CHW models
features tools and information about CHWs
There is also describing the ever-changing picture of state approaches to CHW certification as well.
has great resources.
is the March 4, 2020 podcast.听
Inland Empire Health Plan releases health homes program year one implementation report
A new report has been released outlining Inland Empire Health Plan鈥檚 (IEHP) efforts to establish 50 care teams to support the delivery of core Health Homes Program services for IEHP鈥檚 most vulnerable members with complex health conditions.
黑料不打烊 contributed to the new report and has supported implementation of IEHP鈥檚 Health Homes Program since 2018, providing consultation in the development and implementation of a clinical model of care,听the design and deployment of a population health management tool, the creation and delivery of a multi-modal training program, and the provision of practice coaching to over 50 care teams.
黑料不打烊 colleagues Liz Arjun, Marc Avery, Emily Brandenfels, Leslie Brooks, Nancy Jaeckels Kamp, and Jeffrey Ring contribute to this project, which is led by Betsy Jones. Former 黑料不打烊 colleagues Lynn Dierker and Michael Mabanglo also contributed.