California

The Community Living Policy Center at the University of California, San Francisco and the UC Berkeley Health Research for Action Center have released new findings from their three-year evaluation of Cal MediConnect, the state’s dual eligible demonstration project. The evaluation – funded by The SCAN Foundation – includes interviews with various stakeholders and evaluates the impact of Cal MediConnect on beneficiaries, as well as on the overall health system, identifies areas for improvements and includes recommendations to better coordinate care for dual eligible beneficiaries.

Massachusetts

Massachusetts consumer advocates are rolling up their sleeves to shape the proposed shift of the state’s Medicaid program, MassHealth, to Accountable Care Organizations. Read all about their efforts in the latest Health Policy Hub blog post from the Center. Relatedly, Mannat

MassHealth announced several new updates to the One Care dual eligible demonstration project.

  • One Care has been extended through 2018. A new addendum to the three-way contract extends the timeframe of the program and specifies quality withhold amounts, savings percentages and risk corridor terms for Demonstration Years four and five.
  • MassHealth is accepting letters of intent from organizations interested in participating as One Care Plans in 2018. Letters are due by Aug. 12, 2016.
  • The June enrollment report for One Care has been posted.
  • The next Implementation Council meeting is set for July 22.

In other news, the Massachusetts Health Policy Commission (HPC) has issued its Stakeholder Discussion Series Summary Report on Provider Price Variation. The HPC explored three types of policy solutions to persistent price variation among providers:

  • Demand-side policy options
  • Supply-side policy options
  • Direct limits on variation

The state Legislature also recently passed, and the governor signed into law, a provision creating a Special Commission on Provider Price Variation. The Commission is required to report findings and recommendations to the Legislature by March 15, 2017.

New York

A detailed report released by a coalition of over 100 advocacy organizations in New York documents questionable reductions in home care services for vulnerable Medicaid beneficiaries enrolled in Senior Health Partners and two other managed care plans. As reported in a New York Times article, advocates found a six-fold increase in challenges by consumers to home-care reductions, and in more than 90 percent of those cases, the managed care companies lost or withdrew the proposed cuts. The study highlights both the risks of underservice associated with capitated payment arrangements and the importance of a strong advocacy infrastructure to expose abuses and protect consumers.

In response to persistent urging by advocates, the New York Department of Health (DOH) has released updated enrollment data for FIDA, the state’s demonstration project for dually eligible individuals. The data shows a total of 5,370 individuals enrolled in the demonstration as of  May 2016 and 61,701 eligible individuals opted-out. DOH also gave a webinar update on FIDA on July 22 at which it indicated uncertainty about whether to continue the program through 2019. DOH is seeking input from stakeholders on the question.

The St. Barnabas Health System in the Bronx is designing a 314-unit affordable housing project for low-income or formerly homeless individuals, across the street from the hospital. The project’s developers are building prevention and health into the design of the building by including a rooftop farm, an air filtration system designed to reduce asthma and a test kitchen. Funding for the project includes $7.5 million in Medicaid Redesign Team funds.

Pennsylvania

The Pennsylvania Health Access Network  (PHAN), along with the Housing Alliance of PA, the PA Health Law Project and Project HOME, officially launched the Housing as Health Coalition and campaign. As part of the launch, the coalition released a new analysis of Pennsylvania’s Medicaid program that identifies key gaps and highlights cost-effective opportunities to strengthen the services people need to stay housed and healthy.

Rhode Island

Martha Watson, MS, APRN GCNS-BC, a geriatric provider advocate working with the RI Voices for Better Health partners, conducted a training session on frailty for 32 Nurse Case Managers working in Patient-Centered Medical Homes in the Care Transformation Collaborative of Rhode Island.  Another training session has been scheduled for September on the topic “Dementia-Depression-Delirium.”