July | August 2017







States Tackle Key Health Issues

By Debra Miller, CSG director of health policy
State leaders attending the CSG 2017 National Conference in Las Vegas will have an opportunity to discuss important health policy areas where state leaders are actively involved in working across partisan lines and developing state solutions. This session from 2:30 to 4 p.m. Friday, Dec. 15, will examine ways in which states are both reacting to federal efforts and leading the charge to create sound health policies.
While the federal government focused earlier this year on the question of repealing and replacing the Affordable Care Act, no proposal was enacted. Nonetheless, one of the challenges facing states in the next year will be navigating signals around the Medicaid program being sent from Washington, D.C.
“As states seek to stabilize their Medicaid programs and individual insurance markets, they are looking for guidance from the administration. This guidance has been slow due to congressional reform efforts, but is expected to pick up through administrative efforts. Knowing how to interpret these signals will help states leverage them as opportunities,” saidLaura Summers, senior director of state intelligence at Leavitt Partners, who will be a speaker.
Leavitt Partners was founded by Mike Leavitt, former governor of Utah and secretary of the Department of Health and Human Services under President George W. Bush, and provides assistance to major players in health care. According to the Leavitt Partners’ website, the organization provides “health care intelligence gathering and filtering process modeled after what [Leavitt] observed used in the national intelligence service to advise presidential decision making.”
Summers will address what we know about the stability of the states’ individual health insurance markets for 2018 and what challenges and opportunities states face to stabilize the individual markets beyond 2018.
Section 1115 Medicaid waivers allow states to shape their Medicaid programs to meet their unique needs. Waivers awaiting approval address work requirements, enrollee cost-sharing and substance abuse issues will signal how the current administration may reinterpret traditional Medicaid program requirements.
In Ohio, for instance, Medicaid managed care company CareSource operates a program to help transition enrollees to employment. A full range of services outside traditional health benefits is covered under the per member per month payment CareSource receives from Ohio Medicaid. Karin VanZant is executive director of Life Service, the employment initiative for CareSource, and will be a speaker in December.
Beyond Medicaid waivers, states are seeking to prepare for Medicaid funding changes in light of on-going block grant and per capita caps discussions.
Perhaps no health policy area has received more recent attention from state leaders that the rapidly escalating opioid epidemic. Many state leaders have conducted listening tours and consulted experts on possible interventions to address the crisis.
“An analysis of the state’s own data and review of policies around substance use disorders, including how those policies compare to evidence-based practices, can identify opportunities for improvement,” said Cynthia Reilly, director of the Substance Use Prevention and Treatment Initiative of The Pew Charitable Trusts.
Reilly will share the Pew research to identify strategies that increase prescriber use of prescription drug monitoring programs. Pew works in partnership with state policymakers and other stakeholders to assist in analyses of state data and policies and to provide information on evidence-based strategies to increase access to treatment.
“Our goal is to assist states in developing a treatment system that provides timely access to comprehensive, quality, and evidence-based care,” Reilly said.
“For prevention, states should promote patient-level interventions, such as education about the risks of long-term opioid use; at the community level, take-back programs can prevent harm by reducing an oversupply of opioids in the community. For treatment, clinician efforts to identify at-risk individuals are essential as is building the capacity to provide quality treatment within our communities by increasing the number of clinicians providing this care.”
Rep. Susan Concannon, co-chair of the CSG Health Public Policy Committee said state leaders are not willing to stand by and wait for federal action on Medicaid and in substance abuse.
“We put this agenda together to highlight actions some states have already taken and that other states can take in the near future,” she said.