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Resources by Topic: Medicaid

Network Adequacy for Behavioral Health: Existing Standards and Considerations for Designing Standards
Summarizes findings from a technical expert panel and an environmental scan to examine federal and state network adequacy standards for behavioral health across Medicare Advantage, Medicaid managed care, and commercial insurance. Presents considerations and principles for designing, monitoring, and enforcing additional behavioral health network adequacy standards.
Author(s): Katharine Bradley, Allison Wishon, Alexandra C. Donnelly, Amanda Lechner
Date: 11/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Improving Health in Rural Communities: FY 2021 Year in Review
Provides an overview of Centers for Medicaid and Medicare Services (CMS) programs and activities that have affected rural health and healthcare in fiscal year 2021. Focuses on 10 priority areas: COVID-19, Federally-facilitated and State Marketplaces; Medicare payment and policy; practitioner workforce; Medicaid and Children's Health Insurance Program (CHIP) enrollment, payment, and policy; long-term services and supports; maternal health; mental health and substance use disorders; models and demonstrations, and quality and equity.
Date: 11/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MACPAC Response to Senate Finance Committee Request for Information on Behavioral Health
Summarizes the Medicaid and CHIP Payment and Access Commission's (MACPAC) ongoing analysis of behavioral health in Medicaid and CHIP and offers policy recommendations. Discusses the behavioral health workforce; behavioral healthcare service delivery and access; mental health parity; telehealth; and improving access for children and youth. Includes rural references and considerations throughout.
Date: 11/2021
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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The Impact of Aging Baby Boomers in Rural America
Policy brief discussing the impact of the increasing proportion of the population turning 65 years old on rural communities. Offers policy recommendations for addressing barriers rural older adults face accessing healthcare and social services.
Author(s): Sarah Huling, Elizabeth Crouch, Whitney Zahnd
Date: 11/2021
Type: Document
Sponsoring organization: National Rural Health Association
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How States Use ARPA Funds to Support Telehealth, Technology and Data Infrastructure
Interactive map displaying how states used a one-time increase in the federal medical assistance program (FMAP) for Medicaid home and community-based services (HCBS) through March 31, 2022, to support telehealth service delivery, technology-based innovations, and data infrastructure building opportunities.
Date: 11/2021
Type: Website
Sponsoring organization: National Academy for State Health Policy
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The Tennessee Medicaid Medication Therapy Management Program: Early Stage Contextual Factors and Implementation Outcomes
Shares the results of a study examining a multi-faceted implementation strategy to support a medication therapy management (MTM) pilot program for TennCare, Tennessee's state Medicaid program, at both the organizational and individual levels. Describes contextual factors associated with the pilot program implementation based on the consolidated framework for implementation research (CFIR). Table 3 reports characteristics of organizations participating in the pilot program, including information on study participants located in a rural area.
Author(s): Kenneth C. Hohmeier, Chelsea Renfro, Kea Turner, et al.
Citation: BMC Health Services Research, 21, 1189
Date: 11/2021
Type: Document
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Mapping the Location of Health Centers in Relation to "Maternity Care Deserts": Associations With Utilization of Women's Health Providers and Services
Explores the association between community health centers' (CHC) distance to a maternity care desert (MCD) and use of maternity-related healthcare services. Discusses the effects of rural hospital closures and provider shortages on patients' access to maternity care. Includes a county-level MCD map and county-level and CHC-level statistics related to MCDs.
Author(s): Anne R. Markus, Drishti Pillai
Citation: Medical Care, 59(10), S434-S440
Date: 10/2021
Type: Document
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How North Dakota Uses 1915(i) to Provide Supportive Services to People with Behavioral Health Conditions in Rural Areas
Describes how the North Dakota Department of Human Services utilizes the Medicaid 1915(i) state plan authority to fill gaps in community-based services for beneficiaries with behavioral health conditions. Highlights how the program addresses challenges to delivering services in rural areas.
Author(s): Emily Brostek, Neva Kaye
Date: 10/2021
Type: Document
Sponsoring organization: National Academy for State Health Policy
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OIG's Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs: October 2021
Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in OIG's view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the October 2021 edition include: ensuring nursing homes are protecting residents from the spread of COVID-19; reforming the hospital wage index system; ensuring that Medicaid managed care enrollees have timely access to behavioral health services; and developing and implementing a staffing program for recruiting, retaining, and transitioning staff and leadership to remote Indian Health Service hospitals.
Date: 10/2021
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-income Subsidy
Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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