量子资源网 (量子资源网), 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.
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20th annual state Medicaid budget survey released
The 20th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and 量子资源网 (量子资源网) 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听补苍诲听Medicaid Enrollment & Spending Growth: FY 2020 & 2021.
The reports were prepared by听Kathleen Giff颅ord,听Aimee Lashbrook, 补苍诲听Sarah Barth听from 量子资源网 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.
COVID-19 economic impact on health insurance September 2020
In April 2020, 量子资源网 released COVID-19 Impact on Medicaid, Marketplace, and the Uninsured, by State. Our experts听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, 量子资源网 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.
量子资源网 examines current state of Medicare-Medicaid integration programs
The experts at 量子资源网 (量子资源网) 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 量子资源网’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.
量子资源网 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, 量子资源网 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.听听
量子资源网 releases COVID-19 Medicare regulation tracking tool
The Medicare program has rapidly transformed how it pays for healthcare providers in response to the COVID-19 pandemic. In an effort to capture these changes, 量子资源网, commissioned by 听补苍诲听, tracked, categorized, and analyzed the 212 Medicare policy modifications made in response to the public health emergency.
量子资源网 Senior Consultant听Jennifer Podulka听and Managing Principal听Jon Blum听led efforts to analyze and synthesize COVID-19-related legislative, regulatory, and subregulatory changes to existing Medicare regulations issued beginning January 1, 2020. The resulting issue brief听Regulatory Changes to Medicare in Response to COVID-19听and companion Policy Tracker use nine categories to organize the data and will be periodically updated to include new information.
The issue brief outlines key COVID-19-related changes including providing telehealth reimbursement for more types of services and providers, and waived conditions of Medicare participation permitting patients to be treated in alternative care settings including community facilities, temporary facilities, homes and in some cases, out of state services on a temporary basis.
Congress and the Trump administration waived or changed regulations to allow flexibility to help healthcare providers, Medicare Advantage plans and Part D plans. The policy tracker catalogs and categorizes these regulatory changes based on characteristics, including types of providers and plans affected, effective date, and expected duration.
These changes have affected virtually all healthcare providers and health plans that participate in the Medicare program, and the issue brief examines several questions surrounding the changes moving forward including risk to beneficiary protections and Medicare spending controls established in the original legislation and rules.
Data collection and analysis for the policy tracker was conducted by 量子资源网 colleagues听Jennifer Podulka,听Narda Ipakchi,听Zach Gaumer,听Yamini Narayan, 补苍诲听Elaine Henry. This project was supported by grants from听听 补苍诲听.
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.
量子资源网 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.
量子资源网 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 量子资源网 colleagues Lynn Dierker and Michael Mabanglo also contributed.
2020 Medicare Advantage Supplemental Benefit Flexibilities: Adoption of and Access to Newly Expanded Supplemental Benefits
An 量子资源网-authored issue brief examines beneficiary access to, and plan adoption of, newly expanded Medicare Advantage (MA) supplemental benefit flexibilities and raises questions regarding the expected impacts of new supplemental benefit offerings on beneficiary satisfaction, outcomes, and total cost of care.
The new flexibilities for MA plans include innovative supplemental benefits offered through expansion of primarily health-related benefits, benefits offered non-uniformly, Value-Based Insurance Design (VBID), and Special Supplemental Benefits for the Chronically Ill (SSBCI).
The brief鈥檚 key finding is that enrollment in plans offering these flexibilities is relatively low and varies across geographic areas with 19% of all MA enrollees enrolled in a plan that offered at least one expanded supplemental benefit. 量子资源网 will conduct additional analyses including interviews with key stakeholders to inform the policy community on the opportunities and challenges with the adoption and implementation of new supplemental benefits.
This brief was produced by 量子资源网 Managing Principals Jonathan Blum and Mary Hsieh, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi under a grant from .
量子资源网 report examines COVID-19 toll on Pennsylvania hospitals
A report completed by 量子资源网 colleagues estimated the potential financial impact on hospitals and health systems of the current COVID-19 pandemic in the Commonwealth of Pennsylvania.
The analysis, completed in mid-April, concluded that Pennsylvania hospitals and health systems are likely to experience losses in excess of $7 billion for the final 10 months of 2020 after accounting for federal disaster relief payments, based on emergency relief legislation that had been passed at the time. 量子资源网 Principal Tom Marks and Senior Consultant Mary Goddeeris completed the report, , on behalf of the Hospital and Healthsystem Association of Pennsylvania (HAP). 量子资源网 conducted interviews and collected data from finance officials at a sample of health systems and projected the findings across the population of Pennsylvania hospitals and health systems. The interviews and analysis were completed in mid-April, well before the full effect of the pandemic could be measured. Financial leaders consistently reported enormous declines in patient service from mid-March to mid-April due to the cancellation and deferral of non-emergency services. While there are varying assumptions about the return of pre-pandemic patient service volumes, all leaders projected a bleak forecast for the second quarter and continued negative impact of service disruption for the rest of 2020.
Learn more about 量子资源网鈥檚 multi-faceted COVID-19 response.
量子资源网 experts publish 50-state Medicaid pharmacy study with Kaiser Family Foundation
In conjunction with the Kaiser Family Foundation (KFF), a team of 量子资源网 experts have published survey results and analysis examining administration of the Medicaid pharmacy benefit. 量子资源网 contributing colleagues were Kathleen Gifford, Anne Winter and Linda Wiant.听Rachel Dolan,听Marina Tian, 补苍诲听Rachel Garfield from KFF also contributed.
The report, , summarized the survey conducted in all 50 states and the District of Columbia.
The survey outlines Medicaid pharmacy policy areas and key issues to watch based on feedback from the states in several categories including pharmacy benefit administration, cost-containment and utilization controls, payment and rebates, 340B management and long-term priorities.
Medicare-Medicaid integration: integrated model enrollment rates show majority of Medicare-Medicaid dual eligible population not enrolled
Working in conjunction with Arnold Ventures, a team of 量子资源网 consultants has written an issue brief, Medicare-Medicaid Integration: Integrated Model Enrollment Rates Show Majority of Medicare-Medicaid Dual Eligible Population Not Enrolled. This brief presents key findings on their examination of the availability of integrated programs in states, the growth in enrollment rates, and differences in enrollment and programs across the country.
The 量子资源网 team cited several reasons why Medicare-Medicaid integrated program options are not equally available nationwide and why enrollment is limited in places where programs exist. The result is that millions of people are not enrolled in whole-person, integrated program options 鈥� a reality that is inefficient, and worse yet, inequitable.
The 量子资源网 team, led by Managing Principal Jon Blum and Principal Sarah Barth, includes Narda Ipakchi, Ellen Breslin, Mindy Cohen, Sharon Silow-Carroll and other 量子资源网 subject matter experts.
量子资源网 experts provide guide to California county behavioral health programs
A team of 量子资源网 behavioral health experts have developed a and white paper addressing changes to California鈥檚 county behavioral health programs and provide a guide to help counties and stakeholders determine the best path forward.
Framework examines behavioral health crisis diversion facilities
Individuals with behavioral health needs often find themselves involved with law enforcement or in hospital emergency rooms during times of crisis. 量子资源网 (量子资源网) has released a model framework examining a third option for care 鈥� Crisis Diversion Facilities.