The Commonwealth Fund

🧾 New Rules for Paying Medicaid Managed Care Plans Likely to Improve Access and Equity Medicaid could become a more competitive health care payer under new federal rules that have major implications for access and equity. Writing on To the Point, Manatt Health’s Avi Herring, Cindy Mann, and Anne Karl report that the recently finalized rules allow states to direct Medicaid managed care plans to pay providers at rates up to those of commercial plans, which historically have far exceeded Medicaid payment rates. Researchers have previously documented the relationship between higher payment rates and improved access to care. The authors note that higher payment rates could also increase the pool of providers that serve Medicaid patients while also providing critical support to the health care safety net for people with low income. “Allowing Medicaid to pay rates more akin to Medicare or commercial levels is also a matter of equity.”

⚕️ How “Dual-Eligible” Beneficiaries Fare in Traditional Medicare vs. Medicare Advantage Nearly 13 million Americans are enrolled in both Medicare and #Medicaid for health coverage. In addition to having low income and few resources, “dual-eligible” beneficiaries typically have more complex health care needs than the average Medicare enrollee. A new resource from The Commonwealth Fund offers insights into how the health care experiences of dual-eligible beneficiaries enrolled in the traditional #Medicare program compare with those in #MedicareAdvantage, which provides Medicare benefits through private insurance plans. In nine charts, we show: 📈 How the proportion of dual-eligible beneficiaries enrolled in Medicare Advantage plans has grown. 📊 How the demographic profiles of dual-eligible beneficiaries in Medicare Advantage and traditional Medicare compare. ⭐️ Differences in satisfaction ratings, cost-related delays in care, access to dental, vision, and hearing services, and more.

Understanding health insurance options can be tricky. This is why the State Health Insurance Assistance Program was created for Medicare. But, to date, it's been unclear who the program helps, and a new study finds that in-person counseling services may be inequitably located. Izabela Sadej summarizes this study in a new TIE post. Check it out! (Some of the authors: Melissa Garrido Allison Dorneo David Biko Austin Frakt) https://lnkd.in/ePv5FHWP

🚧 Understanding the Challenges of Medicare Enrollment for Low-Income Beneficiaries Navigating the Medicare system can be daunting, especially for low-income individuals who qualify for both Medicare and Medicaid. Choosing the wrong plan can significantly impact their out-of-pocket costs and access to necessary healthcare services. The State Health Insurance Assistance Program (SHIP) plays a vital role in providing counseling on Medicare coverage options. However, interviews with SHIP counselors and coordinators, conducted by Melissa Garrido, David Biko, Allison Dorneo, Paul Shafer, Austin Frakt, highlight several areas where improvements are needed To better serve low-income #Medicare beneficiaries and ensure they receive the best possible advice on their health care options, the authors suggest investing in both the expansion of the pool of counselors and the enhancement of their training. Full report at the link below:

Will you be at AcademyHealth’s Annual Research Meeting? The Commonwealth Fund will be! The Commonwealth Fund is proud to participate in AcademyHealth’s Annual Research Meeting in Washington, D.C., an important gathering for health services researchers, health care providers, and key decision-makers. See below to learn about presentations and posters by Fund staff and grantees at this year’s conference, to be held June 29–July 1. 📅 Saturday, June 29th
📅 2:15PM – 3:30PM ET
 328-329 (Level 300, Baltimore Convention Center)
 Panel Discussion: “Medicaid in the Public Health Emergency and Unwinding”
 Adrianna McIntyre (Grantee) 📅 Sunday, June 30th
📅 8:00 AM – 9:15 AM ET A-45, Hall A (Level 100, Baltimore Convention Center)
 Poster Session: “Characterizing #MedicareAdvantage Approaches to Providing Post-Acute Home Health” Kali S. Thomas (Grantee) 9:30 AM – 10:45 AM ET
 324-326 (Level 300, Baltimore Convention Center) Panel Discussion: “#Medicaid Unwinding Winds Down: What State Policies Worked for Children? What’s Next?” 
 Genevieve Kenney (Grantee) 1:45 PM – 03:00 PM ET
 328-329 (Level 300, Baltimore Convention Center)
 Panel Discussion: “First Year Policy & Implementation Lessons from New Equity-Focused Value-Based Models” 
 Hector Rodriguez (Grantee) 3:30 PM – 4:45 PM ET
 308 (Level 300, Baltimore Convention Center)
 Best of ARM Panel Discussion: “Policy and Economic Implications”
 Ateev Mehrotra (grantee) 5:00 PM – 06:15 PM ET
 B-254, Hall B (Level 100, Baltimore Convention Center)
 Poster Session: “How Do Primary Care Physicians’ Practices Differ When Paid By Traditional Medicare or Medicare Advantage?”
 Arnav Shah and Gretchen Jacobson
 📅 Monday, July 1st
📅 9:30 AM – 10:45 AM ET
 C-239, Halls A-B (Level 100, Baltimore Convention Center)
 Poster Session: "Health Care Workers Want Health Systems to Address #ClimateChange" Arnav Shah and Lovisa Gustafsson
 
 09:30 AM - 10:45 AM ET
 C-206, Halls A-B (Level 100, Baltimore Convention Center)
 Poster Session: “”Feeling the Pinch Now": Surviving Shifts in #PrimaryCare Revenue”
 Xenia Mendez, Emilia De Marchis, Taressa Fraze, Corinne Lewis, MSW, Ulrike Muench 1:00 PM - 1:30 PM ET
 Halls A-B (Level 100, Baltimore Convention Center) Continue the Conversation Session: “Working with TAF Data to Advance the field of Medicaid Research” 
 Medicaid Data Learning Network 5:15 PM – 6:00PM ET 
 D-274, Halls A-B (Lvl 100 Baltimore Convention Center)
 Poster Session “”How Do We Connect the Dots?” Perspectives of Medicare Advantage Plan Representatives on Addressing Social Determinants of Health”
 Kali Thomas 📅 Tuesday, July 2 📅 9:00 AM – 10:15 AM ET
 301-303 (Level 300, Baltimore Convention Center)
 Panel Discussion: Using Evidence to Address Unsustainable Health Care Costs 
 Lovisa Gustafsson Find the full ARM agenda below.

✍️ Easy-Enrollment Programs Help States Sign People Up for Affordable Coverage ☂ An increasing number of states are experimenting with simple, low-cost ways to connect uninsured people with comprehensive, affordable coverage options. On To the Point, Georgetown University’s Rachel Swindle, Rachel Schwab, and Justin Giovannelli describe how these easy-enrollment programs combine tax or unemployment filing forms with targeted outreach to find people who may be eligible for subsidized marketplace plans or Medicaid. The results have been promising. Maryland, the first state to enact such a program, has enrolled more than 13,500 people since 2020. Additional states have followed, and others are considering adopting what the authors call “an efficient and relatively low-cost mechanism” to get their uninsured residents covered.

🚼 Transforming #MaternityCare with a Community-Led Approach 🏘️ When Birth Detroit opens this fall, it will be the first Black-led birth center in Michigan. It’s a dream a decade in the making for its founders, who seek to prevent deaths in a place where Black women are four times more likely to die of pregnancy-related causes than white women. Birth Detroit is one of 40 efforts across the country to establish or sustain birth centers in low-income communities where health disparities abound. In the latest issue of Transforming Care, The Commonwealth Fund’s Sarah Klein and Laurie Zephyrin, M.D., explore how women in the communities most affected by maternal health disparities are rallying together to build safer systems of care. This distinctly collectivist approach is uniting providers, public health experts, and community residents around the common goal of helping families thrive. Read about the impact these #birthcenters are having, along with the steps policymakers, philanthropists, and investors could take to help ensure their success.

In 2020, more than 53 million Americans were caregivers, and 60% were women. See this week’s Data Perspective to learn how Bogotá’s innovative CARE System provides support for caregivers and what the U.S. can learn from it.

🥪 Meet-and-Greet Lunch with the Commonwealth Fund at ARM
 Join Commonwealth Fund staff for lunch at the AcademyHealth Annual Research Meeting (ARM) to learn more about our foundation’s mission and programs.
 Find us (and food) at the Hilton Baltimore Inner Harbor on Sunday, June 30, 2024 at 12:30 - 1:30 p.m. Space is limited and registration is required. REGISTER: https://buff.ly/3V96jTu