Insights

CMS approves Kentucky Medicaid Waiver

The Centers for Medicare & Medicaid Services (CMS) has approved the “Kentucky Helping to Engage and Achieve Long Term Health” 1115 Medicaid Waiver, a five-year waiver that includes a “community engagement” or work requirement as a condition of eligibility for non-disabled adult Medicaid beneficiaries ages 19-64.

The decision from CMS represents the first approval of a Medicaid waiver that includes a work requirement as a condition of eligibility. Kentucky developed the waiver in collaboration with HMA Medicaid Market Solutions (HMA MMS).

Kentucky defines “community engagement activities” as 80 hours per month of employment, education, job skills training, and community service. Exempted groups include pregnant women, the medically frail, and full-time students. The waiver also includes “consumer-driven tools” that provide incentives for healthy behavior.

Come back to the HMA blog Monday to read more about Kentucky HEALTH.

Read the full text of the press release issued by the Kentucky Governor’s Office here.

Read the Kentucky HEALTH Demonstration Approval here.

Medicaid Managed Care Enrollment Update – Q4 2017

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This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states.[1] Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. Nearly all 27 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2017. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):

Dual Eligible Financial Alignment Demonstration Enrollment Update

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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.

Report Examines Emerging Innovations in Managed Long-Term Services and Supports for Family Caregivers

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The paper—co-written by the AARP Public Policy Institute and Health Management Associates—highlights examples of how progressive managed care plans are supporting family caregivers who are caring for plan members with LTSS needs. The purpose of this paper is for plan administrators, policymakers, and community-based organizations to learn from one another and ultimately adopt these practices, resulting in better care for members and their family caregivers.

Texas Issues STAR+PLUS Request for Proposals

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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.

Ballot Initiative Requirements in Non-Medicaid Expansion States

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This week, our In Focus section examines the 10 states that have not expanded Medicaid under the Affordable Care Act but where citizens can initiate a public vote on the issue. In November, nearly 60 percent of Maine voters approved a ballot initiative expanding Medicaid. Advocates in Idaho, Missouri, and Utah have filed paperwork to begin collecting signatures to place Medicaid expansion on the ballot in November 2018.

New CMS Guidelines to Expedite Approval of 1115 Waivers and State Plan Amendments

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This week, our In Focus section reviews the new guidelines issued by the Centers for Medicare & Medicaid Services (CMS) on expediting the approval process for Medicaid waivers and state plan amendments (SPAs) and improving quality, accessibility, outcomes, and transparency. The guidelines, titled Section 1115 Demonstration Process Improvements and State Plan Amendment and 1915 Waiver Process Improvements to Improve Transparency and Efficiency and Reduce Burden were released on November 6, 2017.

Highlights from Kaiser/HMA 50-State Medicaid Director Survey

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This week, our In Focus section reviews highlights and shares key takeaways from the 17^th annual Medicaid Budget Survey conducted by Health Management Associates (HMA) and the Kaiser Family Foundation (KFF). Survey results were released on October 19, 2017, in three new reports: “Medicaid Enrollment & Spending Growth: FY 2017 & 2018,” “Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018,” and “Putting Medicaid in the Larger Budget Context: An In-Depth Look at Three States in FY 2017 and 2018.” The reports were prepared by Kathleen Gifford, Eileen Ellis, Barbara Coulter Edwards, and Aimee Lashbrook from HMA, and by Elizabeth Hinton, Larisa Antonisse, Allison Valentine, and Robin Rudowitz from the Kaiser Family Foundation. HMA’s Dennis Roberts also contributed. The survey was conducted in collaboration with the National Association of Medicaid Directors.

Annual Survey Finds Medicaid Enrollment Growth Slowing, Uptick in Spending Growth

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Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018

Medicaid enrollment continues to slow in FY 2017 and FY 2018; however, states project an uptick in spending in FY 2018. This is just one finding in the 17th annual 50-state Medicaid Budget Survey conducted by The Kaiser Family Foundation and in collaboration with Health Management Associates (HMA) and the National Association of Medicaid Directors.

Annual Survey Finds Medicaid Enrollment Growth Slowing, Uptick in Spending Growth

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Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018

Medicaid Managed Care Enrollment Update – Q3 2017

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This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states.[1] Many state Medicaid agencies elect to post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. Nearly all 27 states have released monthly Medicaid managed care enrollment data through the third quarter (Q3) of 2017. This report reflects the most recent data posted.

New Mexico Issues Centennial Care 2.0 Medicaid Managed Care RFP

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This week, our In Focus section reviews the request for proposals (RFP) released by the New Mexico Human Services Department (HSD) to reprocure contracts for the state’s Medicaid managed care program in its second phase, Centennial Care 2.0. Centennial Care provides integrated Medicaid managed care coverage, including long-term services and supports (LTSS) and behavioral health, to nearly 700,000 Medicaid beneficiaries in the state, with annual spending of roughly $4.5 billion.

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CMS approves Kentucky Medicaid Waiver

Medicaid Managed Care Enrollment Update – Q4 2017

Dual Eligible Financial Alignment Demonstration Enrollment Update

Report Examines Emerging Innovations in Managed Long-Term Services and Supports for Family Caregivers

Texas Issues STAR+PLUS Request for Proposals

Ballot Initiative Requirements in Non-Medicaid Expansion States

New CMS Guidelines to Expedite Approval of 1115 Waivers and State Plan Amendments

Highlights from Kaiser/HMA 50-State Medicaid Director Survey

Annual Survey Finds Medicaid Enrollment Growth Slowing, Uptick in Spending Growth

Annual Survey Finds Medicaid Enrollment Growth Slowing, Uptick in Spending Growth

Medicaid Managed Care Enrollment Update – Q3 2017

New Mexico Issues Centennial Care 2.0 Medicaid Managed Care RFP

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