EPSDT Guidance: State Implications and Approaches to Behavioral Health for Children and Youth
On September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official letter to states on federal Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements. This issue brief outlines actions for states to review the EPSDT guidance with an eye towards how they can continue to improve coverage, access, and quality of behavioral healthcare for children and youth enrolled in Medicaid and the Children’s Health Insurance Program.
Potential Impact of Federal Changes on State Healthcare Programs
On Wednesday, February 26, State Health and Value Strategies hosted a webinar discussing the Medicaid and Marketplace reforms under consideration by the new administration and the 119th Congress, including adjustments to program financing, eligibility, and other policy requirements, with potential broad implications for state Medicaid and Marketplace programs. During the webinar, experts from Manatt Health provided an overview of potential federal policy changes to Medicaid and Marketplace coverage programs, vehicles for advancing and anticipated timing of such changes, and implications for states.
Regulating Financialization in the Healthcare System: A Toolkit for States
This toolkit is intended to support states in understanding the landscape of financial activity in the healthcare sector. It identifies opportunities to strengthen a state’s regulatory framework to protect residents from the potential harms associated with financialization. The toolkit provides an overview of trends and a summary of the literature on the impact of financialization on the healthcare delivery system.
Recommendations for States as They Create Medicaid Beneficiary Advisory Councils: Thoughts From People With Medicaid Experience Who Have Served on Medicaid Committees
The Centers for Medicare & Medicaid Services issued a rule in April 2024 requiring states to establish a Medicaid Beneficiary Advisory Council (BAC) by July 2025 to provide states with guidance on the program from people with lived experience. This issue brief offers recommendations for states developing BACs, drawing on insights from people with Medicaid experience who have served on existing Medicaid committees.
Medicaid Beneficiary Advisory Council Reporting Toolkit
Medicaid Beneficiary Advisory Councils (BACs) are an important mechanism by which states can implement transformational community engagement within their Medicaid programs. The process of publicly and transparently documenting and reporting BAC activities is key to building trusted relationships, as well as documenting and measuring success of this group. States can customize the content of these materials, which include data collection templates for: BAC member composition, BAC meeting data, BAC discussion topics, BAC recommendations, and BAC member engagement.
Beneficiary Advisory Council State Toolkit: Establishing a Governance Process
This toolkit is intended to support states in planning for implementation of provisions in the Medicaid Program: Ensuring Access to Medicaid Services final rule to establish a Beneficiary Advisory Council (BAC) and Medicaid Advisory Committee. States may use the Toolkit to inform the development of a governance model for the BAC, identify key steps and timelines for implementation and assign roles and responsibilities for state staff implementing the BAC.
The Role of Medicaid Continuous Enrollment in Improving Children’s Health and Wellbeing: State Toolkit
This toolkit is intended to support states in leveraging 12-month and multi-year continuous enrollment (CE) for Medicaid/Children’s Health Insurance Program (CHIP)-eligible children and youth to promote access to care, ensure delivery of critical preventive and behavioral health services, and monitor child health outcomes in partnership with key stakeholders. States may use this toolkit to inform planning related to implementation of CE policies; adoption of alternative payment models to encourage providers to embrace innovative pediatric care delivery practices; and development of an oversight and quality improvement strategy to promote improved health and wellbeing outcomes for young children.
State Strategies to Compensate Beneficiary Advisory Council Members
The Ensuring Access to Medicaid Services final rule requires states to create and support a Beneficiary Advisory Council (BAC) as well as a Medicaid Advisory Committee (MAC), which together are intended to create a more formalized way for enrollees and interested parties to provide bidirectional feedback to the state about the Medicaid program. This issue brief, revised as of November 2024, offers considerations for determining how to fairly compensate BAC members for their time and expertise without adversely affecting their eligibility for Medicaid.
Protected: Member Engagement Leaders’ Support Group
Password protected resource page for members of the Member Engagement Leaders’ Support Group.
Recruiting for the BAC: Template Materials
Under the Ensuring Access to Medicaid Services final rule, state Medicaid agencies will need to create and support a Beneficiary Advisory Council (BAC) and Medicaid Advisory Committee (MAC) by July 2025, with some requirements phased-in over a longer time period. These template materials are designed to support state agencies in recruiting members for the BAC. States can customize the content of the materials, which include a recruitment flyer, template social media graphics, core messages, website copy, and newsletter copy.