District of Columbia

State Medicaid Agencies Venture into Value-Based Purchasing with Federally Qualified Health Centers

State Medicaid agencies have generally found it challenging to include federally qualified health centers (FQHCs) in value-based purchasing initiatives because of a federal law passed in 2000 that regulates how state Medicaid programs pay FQHCs for the care they provide. State Medicaid agencies are required to reimburse FQHCs through the Prospective Payment System (PPS), a […]

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  • On Monday, July 10th, the Centers for Medicare and Medicaid Services (CMS) released a tally of issuer submissions to offer individual market coverage through the Federally-facilitated Exchange. The National Academy for State Health Policy (NASHP) conducted an analysis of preliminary rate filings for states that have opted to run a State-based Exchange (SBE), finding that […]

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  • State Health Policy Blog

    Increasingly states are focused on the critical role social determinants play in health, and public coverage programs play a key role in this focus. For more than 20 years, the Children’s Health Insurance Program (CHIP) has worked in coordination with state Medicaid programs to serve the health needs of low-income children. States are leveraging Medicaid […]

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  • State Health Policy Blog

    Stark health disparities make it difficult to move the needle on health outcomes and costs and reflect the fact that states face a variety of political and resource constraints when it comes to implementing health equity initiatives. Minority groups disproportionately bear the burden of disease. The CDC reports that when compared with white adults, African […]

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  • The Round Two State Innovation Model (SIM) Test Awards granted by HHS to eleven states (Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Rhode Island, Ohio, Tennessee, and Washington) support state efforts to build multi-payer models of health system transformation. As noted in a previous analysis, population health improvement is an important component of the […]

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  • Policymakers in Congress are considering the role of the Children’s Health Insurance Program (CHIP) in the context of health coverage options available under the Affordable Care Act (ACA). Federal funding for CHIP is due to end in September, 2015 without Congressional action. To help inform these federal legislative discussions, the leadership of the House Committee […]

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  • This chart highlights marketplace policy decisions related to pediatric dental coverage for the 2014 plan year.  It tracks the kinds of pediatric dental products that marketplaces solicited and offered on the marketplace in 2014, particularly whether dental benefits were offered through stand-alone dental products (SADP), as “bundled” products that paired a specific SADP and a qualified […]

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  • For 2014 legislative activity and other Medicaid expansion updates, see State Refor(u)m’s Medicaid expansion map. At State Refor(u)m, we are continuing to track state Medicaid expansion activities. This revised chart includes additional details on key elements of Medicaid expansion bills that have been introduced in state legislatures, such as proposals to provide coverage to the […]

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  • When open enrollment begins on October 1, consumers will be able to select and purchase health coverage online through a state-based exchange or the federal marketplace. This chart provides useful links to the web portals, where consumers can purchase coverage, as well as links to relevant agency websites containing exchange policy and consumer assistance-related information. […]

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  • Due to the ACA’s new eligibility verification rules, states have developed plans outlining Medicaid and CHIP eligibility verification procedures. This chart highlights key elements from states’ verification plans, such as which eligibility factors are verified through electronic data and the specific data sources states are using, as well as whether self-attestation is accepted for some eligibility […]

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