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Highlights from NASBO Fall 2017 Fiscal Survey of States

This week, our In Focus section highlights some of the key findings of the Fiscal Survey of the States Fall 2017, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state budget officers in all 50 states from August through November 2017. The findings in the report focus on the key determinants of state fiscal health, highlighting data and state-by-state budget actions by area of spending. Below we summarize the major takeaway points from the report, as well as highlight key findings on Medicaid-specific and other health care budget items.

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Dual Eligible Financial Alignment Demonstration Enrollment Update

This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for beneficiaries dually eligible for Medicare and Medicaid (duals) in 10 states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Rhode Island, South Carolina, Texas, and Virginia. Each of these states has begun either voluntary or passive enrollment of duals into fully integrated plans providing both Medicaid and Medicare benefits (“Medicare-Medicaid Plans,” or “MMPs”) under three-way contracts between the state, the Centers for Medicare & Medicaid Services (CMS), and the MMP. As of November 2017, more than 400,000 duals are enrolled in an MMP, the second-highest monthly enrollment since the demonstrations began, according to state and CMS enrollment reports.

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HMA Principal Designs Workshop to Enhance Delivery of Patient-Centered Care

This blog post was written by HMA Principal Jeffrey M. Ring, Ph.D.

There are many great things to do up in California’s majestic Sierras.  The air is fresh and crisp, the water runs clear and the trees stretch up to dizzying heights.

The health care practitioners of Avenal/Aria Community Health in Central California decided to head to the Sierras for a weekend retreat coordinated with Health Net, and an opportunity to learn together about enhancing the delivery of patient-centered care.  I designed an interactive, experiential workshop  that aimed to facilitate team-building, an exploration of the foundations of communication (including empathy, trust and non-verbal communication), and the skills of Motivational Interviewing which has been empirically demonstrated to be more successful in generating patient behavior change than giving advice.

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Texas Issues STAR+PLUS Request for Proposals

This week, our In Focus section reviews the Texas STAR+PLUS request for proposals (RFP) issued on December 4, 2017. The STAR+PLUS Medicaid managed care program covers approximately 519,000 individuals who have disabilities or are aged 65 or older. The program will integrate Acute Care services and Long-Term Services and Supports (LTSS), and cover members including those with intellectual or developmental disabilities (IDD) and dual eligibles. Managed care organizations (MCOs) will also provide access to behavioral health services, such as mental health and substance use disorder counseling and treatment. When fully implemented, Texas expects enrollment to be over 530,000 and annualized spending over $7.5 billion, based on FY 2018 data.

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