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  • A First Look at North Carolina’s Section 1115 Medicaid Waiver’s Healthy Opportunities Pilots

    Issue Brief

    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 Medicaid enrollees. This brief summarizes key features of the pilots.

  • Medicaid Financing Cliff: Implications for the Health Care Systems in Puerto Rico and USVI

    Issue Brief

    This brief provides an overview of the status of the health care systems and Medicaid programs in Puerto Rico and the U.S. Virgin Islands (USVI) about one and a half years after Hurricanes Irma and Maria struck the islands in September 2017. The hurricanes exacerbated the territories’ existing economic and health care challenges by accelerating outmigration of residents and health care providers and destroying homes, schools, health care facilities, and other infrastructure. After the storms, the territories’ Medicaid programs have served as important resources for addressing residents’ health care needs, but they have operated under longstanding financing challenges. This brief focuses on these challenges and includes KFF analysis of the implications for the territories’ Medicaid program finances, as most of the temporary federal Medicaid funds provided through the Affordable Care Act (ACA) and disaster relief are set to expire at the end of September 2019. The other U.S. territories (American Samoa, the Commonwealth of the Northern Mariana Islands, and Guam) also face challenges tied to the scheduled expiration of ACA funds.

  • Addressing the Opioid Crisis: Medication-Assisted Treatment at Health Care for the Homeless Programs

    Issue Brief

    Health Care for the Homeless (HCH) programs, a subset of community health centers, play a significant role in addressing the opioid epidemic by providing medication-assisted treatment (MAT). MAT, which combines one of three medications (methadone, buprenorphine, or naltrexone) with behavioral therapies, is the standard of care for opioid use disorder (OUD). This brief presents findings from an analysis of health center data on the provision of buprenorphine-based MAT, as well as interviews with providers and administrators from 12 HCH programs about strategies they adopted to implement MAT programs.

  • Community Health Center Financing: The Role of Medicaid and Section 330 Grant Funding Explained

    Issue Brief

    This issue brief describes the two primary sources of health center revenue—Medicaid and Section 330 grant funding. The evolution of these funding streams has contributed to significant growth in the health center program, enabling expanded services to millions of additional residents of the nation’s most medically underserved rural and urban communities.

  • States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019

    Report

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia. This report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019 (which began for most states on July 1, 2018). Key areas covered include changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

  • Medicaid Work Requirements in Arkansas: Experience and Perspectives of Enrollees

    Issue Brief

    This brief presents perspectives of enrollees and safety net providers about Arkansas' new Section 1115 Medicaid waiver work and reporting requirements based on focus groups and interviews. The discussions examine enrollees’ awareness of the new requirements and ability to set up online accounts for monthly reporting; the effect of the new requirements on enrollees’ work and common barriers to work; enrollees’ experience with monthly reporting; impacts on particular populations, such as those with disabilities or who are homeless; and the anticipated effects of coverage losses resulting from the new requirements.

  • Re-approval of Kentucky Medicaid Demonstration Waiver

    Issue Brief

    On January 12, 2018, the Centers for Medicare and Medicaid Services (CMS) approved a Section 1115 demonstration waiver in Kentucky, entitled “Kentucky Helping to Engage and Achieve Long Term Health” or KY HEALTH. On the same day that CMS approved Kentucky’s waiver, Governor Bevin issued an executive order directing the state to terminate the Medicaid expansion if a court decides that one or more of the waiver provisions are illegal and cannot be implemented. This fact sheet summarizes key provisions of Kentucky’s approved waiver.

  • The Role of Community Health Centers in Addressing the Opioid Epidemic

    Issue Brief

    This brief presents the results of the 2018 health center survey questions focused on activities releated to addressing the opioid epidemic. It includes information on opioid use disorder among health center patients, on-site provision of medication-assisted treatment (MAT) and naloxone, provider training on providing MAT, treatment capacity issues, and safe prescribing practices. It also compares activities in Medicaid expansion and non-expansion states and discusses the critical role Medicaid plays in health centers’ ability to address the epidemic.