States are hiking up a challenging trail to bring their Medicaid programs into compliance with the Affordable Care Act (ACA) by 2014. The ACA and subsequent regulatory guidance make changes that affect nearly all aspects of Medicaid operations. This new checklist provides a comprehensive list of ACA requirements for Medicaid programs. read more
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Getting Ready for Expanded Coverage: State Efforts to Understand Health Care Workforce Needs
Exchange Navigator and Assister Plans Take Shape
With open enrollment less than six months away, state-based and state partnership exchanges are gearing up to hire the people who will assist consumers as they enroll in coverage through the exchange. read more
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Getting the Word Out: Education, Marketing, and Customer Service under Health Reform
Before a client sits down with a navigator or in-person assistor to enroll in a new health coverage option, that client will see, hear, or read multiple advertisements or news articles about health insurance exchanges or expanded access to Medicaid. Many clients will first contact a call center with questions before being directed to additional assistance. Thus, success with education, marketing and customer service efforts will be vital to the success of implementing a Medicaid expansion, an exchange, or both. read more
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Connecticut’s Embrace of Value-Based Insurance Design: Lessons for Health Reform
Guest bloggers Mark Fendrick and Jason Buxbaum are with the University of Michigan Center for Value-Based Insurance Design. read more
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Tell Your Colleagues You Love Their Work
Content rating is your chance to designate documents and comments as useful. Your click on the "useful" button will earn the content an additional star, and will inform the next site visitor that somebody found that piece of content useful. read more
Defining Habilitative Benefits: State Approaches Emerge
In 2014, health plans offered in the individual and group insurance markets will be required to cover a comprehensive set of benefits that fall into 10 categories – the essential health benefits (EHB) package. These EHBs include habilitative services and devices, a set of benefits not traditionally covered by private health insurance. Habilitative services, like rehabilitative services, generally include occupational and physical therapy, as well as speech-language services. read more
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A First Look at Health Plan Requirements in State Exchanges
One of the critical duties of an exchange is to develop a certification process for Qualified Health Plans (or "QHPs," the term for plans approved for sale in exchanges). The first crop of states have released Requests for Proposal (RFPs), solicitations or other documents relating to QHP-certification requirements for their state or partnership exchange. read more
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States Prepare to Roll Out the Welcome Mat
October 1, 2013, when millions of individuals will begin to enroll in new health insurance options, is less than a year away, and many of those consumers will be brand new to the health care system. Many states are hard at work figuring out how best to develop effective messages about obtaining coverage and disseminate them to a diverse audience of residents and stakeholders. In an earlier State Refor(u)m Weekly Insight, we profiled some helpful lessons from CHIP. read more
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Cutting the Coding Clutter: How Revamping Denial and Disenrollment Codes Can Keep People Covered and Lower Costs
States typically don’t have great information on the reasons why people fall off of Medicaid, or are denied coverage in the first place. Complex, outmoded coding systems can obscure the real story behind an applicant's denial or disenrollment. read more
