PI Leadership Summit Follow Up
by Vanessa Templeman, NAMPI Vice President
It’s easy to identify big state vs small state, states with an IG model, or even regional UPIC alignment when seeking out peer connections. As of October 2023, CMS statistics identify, “87,289,666 individuals were enrolled in Medicaid and CHIP in the 50 states and the District of Columbia that reported enrollment data for October 2023” (Medicaid.gov). According to statistica.com, “Medicaid is responsible for 19 percent of the nation’s health care bill, making it the 3rd largest payer…..”. This is an increase of about 32.7 million persons into Medicaid since 2012.
NAMPI 2023 conference had a diverse PI Leadership Summitt discussion. In follow up to that joint conversation, NAMPI was tasked with helping to share resources and information from other states that could potentially be of benefit. As stated above, and rather obvious, is that Medicaid is enormous. I’m not sharing anything we all don’t know, but I am hoping to share some ways to identify peers, amongst our vast Medicaid cohort, that are outside of our usual go-tos.
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Wallethub, 2021 attempts to grade and point scale each category. Beyond this, they do identify shared items across states called out in the categories below. Reaching beyond the articles grading rubric, it’s easy to pick up on potential increased partnerships amongst states not typically thought of sharing something in close proximity or commonality with your own state.
Highest State Medicaid Spending as Share of State Budgets-Ohio, Missouri, New Hampshire, Pennsylvania, New York
Lowest State Medicaid Spending as Share of State Budgets-Oregon, Nebraska, Utah, Wyoming, Hawaii
Highest Children Medicaid Eligibility Level-New Mexico, Hawaii, Vermont, Maryland, New Hampshire
Lowest Children Medicaid Eligibility Level-Idaho, Utah, Arizona, Virginia, Arkansas
Highest Total Medicaid Enrollment per Low-income Population-Rhode Island, Connecticut, Alaska, New York, California
Lowest Total Medicaid Enrollment per Low-income Population-Texas, Kansas, South Dakota, Utah, Wyoming
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KFF, Medicaid Fact Sheets, 2023 provides some simple operating numbers that rank us according to percentage of people covered by Medicaid/CHIP:
- ND, UT, WY, NH, SD MO NE KS VA are all states with 9-15% of their population falling into Medicaid/CHIP coverages, while alternatively
- AK, CA, AR, NY, WV, KY, LA, NM have greater than 25% of their populations covered by Medicaid/CHIP.
Another split identified in the article showcases if your state falls above or below the national average of 21.1% of the US population falling into Medicaid/CHIP coverages.
See the full article to see where your state falls and what percentage brackets your peers are according to populations.
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As of February 2024, 8 states [Arizona, Arkansas, California, Massachusetts, New Jersey, New York, Oregon and Washington] all have CMS approved Section 1115 demonstrations under the new Health-related Social Needs (HSRN) 1115 framework that authorizes evidence based services for high need populations. This is just one of many endeavors states are seeking out.
Connecticut, Georgia, Indiana, Louisiana, Missouri, North Carolina, and South Dakota are seven stateds who have set up Structured Family Caregiving (SFC) services. NASHP, 2022 also goes on to identify commonalities amongst Georgia, Missouri, and South Dakota their SFC Medicaid programs.
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KFF, 2023 identifies a key takeaway in their article, stating that, “most enrollees who use Medicaid [HCBS] are under age 65, while most enrollees who use institutional LTSS are ages 65 and older.” KFF further publishes some information outlining:
- Seniors-all people aged 65 or older
- Adults-people aged 19-64
- Children-people aged 18 and younger
States who share low Senior populations include: Wyoming, North Dakota, South Dakota, Alaska, Montana, New Hampshire, Delaware, Utah, Vermont, Nebraska, District of Columbia, Idaho and Rhode Island.
States who share high Senior Populations include: California, New York, Florida, Texas, Pennsylvania, Illinois, Georgia, Ohio, Massachusetts, North Carolina, Michigan, Arizona, and New Jersey.
States who share low Children populations include: Wyoming, North Dakota, Vermont, South Dakota, District of Columbia, New Hampshire, Alaska, Delaware, Maine, Montana, Rhode Island, Hawaii, and Nebraska.
States who share high Children populations include: California, Texas, Florida, New York, Georgia, Illinois, North Carolina, Ohio, Pennsylvania, Michigan, Tennessee, Washington, and Arizona.
Read the full article and interactive table to identify where your state falls and what states would be a peer resource based on shared populations.
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It is NAMPI’s goal to continue to identify ways states and territories can partner to achieve all our various objectives while fostering successful communities of collaboration. As initially stated, there are several ways we already align ourselves and seek out peer Medicaid connections. I hope this article has provided some new ways to identify additional resources for reach out, information sharing, and/or new thoughts of where to connect on commonalities not previously known. As always, thank your for time and feedback.