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Monday Morning Medicaid Must Reads: May 27, 2019

Helping you consider differing viewpoints. Before it’s illegal.
other MMRS –

In this issue…

Article 1:      A First Look at North Carolina’s Section 1115 Medicaid Waiver’s Healthy Opportunities Pilots, KFF, May 15, 2019

Clay’s summary:     $600M to address SDoH for about 25,000 to 30,000 members. May seem steep, but its our first real attempt to measure this concept we’ve all been yapping about for 5 years.
Key Excerpts from the Article:
Medicaid funds typically cannot be used to pay for non-medical interventions that target the social determinants of health. However, in October 2018, CMS approved North Carolina’s Section 1115 waiver which provides financing for a new pilot program, called “Healthy Opportunities Pilots,” to cover evidence-based non-medical services that address specific social needs linked to health/health outcomes. The pilots will address housing instability, transportation insecurity, food insecurity, and interpersonal violence and toxic stress for a limited number of high-need enrollees.
Read full article in packet or at links provided

Article 2:      Block Granting Medicaid is Still a Terrible Idea, Suzanne Wikle, CLASP, May 15, 2019

Clay’s summary:     Op-ed writer may not realize that what she thinks is a bug is the key feature (reducing spending). Good one to have bookmarked if you are anti-block grants, though.
Key Excerpts from the Article:
While the promise of increased flexibility can sound enticing, the reality is that so-called flexibility pits funding choices against one another and ultimately leads to cuts. Medicaid already has the flexibility it needs to respond to economic downturns or public health crises, and capping funding for the program makes these responses more difficult. Block grants have not worked in the Temporary Assistance for Needy Families (TANF) program. What we know from 20 years of experience with TANF is that funding has not increased with inflation or in response to poverty and need. Moreover, states have used TANF funds to support alternative programs and have significantly decreased the aid going directly to families. Despite assurances they would fund key supports like affordable child care, policymakers haven’t been able to deliver on their promises.
Read full article in packet or at links provided

Article 3:      Medicaid could save $2.6 billion if 1% of smokers quit, Stanton Glanz, JAMA, April 17, 2019

Clay’s summary:      Ain’t nobody gonna tell Medicaid bennies they have to stop smoking. So we all just keep paying…
Key Excerpts from the Article:
 “Medicaid recipients smoke at higher rates than the general population … suggesting that investments to reduce smoking in this population could be associated with a reduction in Medicaid costs in the short run,” Stanton Glantz, PhD, of the Center for Tobacco Control, Research and Education at University of California, San Francisco, wrote. He noted that in fiscal year 2017, Medicaid costs totaled $577 billion. Glantz evaluated Medicaid expenditures and the economic response between changes in smoking prevalence and health care costs. All data were from 2017 and came from all 50 states and Washington, D.C.
Read full article in packet or at links provided