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2015 Managed Care Data Available, plus other Updates

Recent Releases and Announcements

2015 Managed Care Enrollment Data

CMCS is pleased to announce that the 2015 Managed Care Enrollment Data is now available. The nationwide data is broken down by program and population, as well as by individual state. The enrollment data provides an accurate snapshot of managed care enrollment for a particular year as of July 1st.

New Medicare Card: Web Updates

To help prepare for the transition to the Medicare Beneficiary Identifier (MBI) on Medicare cards beginning April 1, 2018, review the new information about remittance advices.

Beginning in October 2018, through the transition period , when providers submit a claim using a patient’s valid and active Health Insurance Claim Number (HICN), CMS will return both the HICN and the MBI on every remittance advice. Here are examples of different remittance advices:

Find more new information on the New Medicare Card provider  webpage.

Medicaid Innovation Accelerator Program

Comment Period Due February 14, 2018: Medicaid IAP Quality Measures 

CMS’s Medicaid Innovation Accelerator Program (IAP) is working on a multi-year measurement development contract with Mathematica Policy Research, the Medicare-Medicaid Coordination Office, and the Center for Medicaid and CHIP Services’ Disabled and Elderly Health Programs Group. The IAP portion of the contract entails the development or refinement of a small number of measures in key gap areas related to the IAP program areas. IAP is seeking public comment on the following two quality measure concept currently under development:

  • Follow-up after hospitalization or residential treatment for substance use disorder
  • All-cause emergency department utilization rate for Medicaid beneficiaries who may benefit from integrated physical and behavioral health care
    The anticipated comment period is January 25, 2018 to February 14, 2018. We ask that you submit comments to SUDQualMeasures@mathematica-mpr.com.

To learn more about these measure concepts, visit the Download section . On this page you will find separate memos for each measure listing the questions on which we request public comment, as well as zip files with Measure Information Forms (MIF) and Measure Justification Forms (MJF). 

New Technical Support Opportunity for States: Value-Based Payment for Home and Community-Based Services
Expression of Interest Forms Due February 15, 2018

The Medicaid Innovation Accelerator Program (IAP)’s Community-Integration through Long-Term Service and Supports (CI-LTSS) Program Area is launching an 11-month long technical support opportunity for up to 10 states seeking to design Value-Based Payment (VBP) strategies for Home and Community-Based Services (HCBS). Selected states will have the opportunity to work with HCBS industry experts through their individualized technical support and state-to-state learning activities. 

This technical support opportunity is open to states at all levels of experience and progress in developing a VBP strategy for HCBS.  States that have previously participated in the Medicaid IAP CI-LTSS Incentivizing Quality and Outcomes (IQO) tracks are welcome to submit an expression of interest for this technical support opportunity.

Review the VBP HCBS Program Overview (PDF, 177 KB) (PDF 177 KB) and Information Session Slides (PDF, 1.57 MB) (PDF 1.57 MB). Interested states are asked to complete and email the Expression of Interest (DOCX, 70.84 KB) (MS Word 70.84 KB) form by February 15, 2018.

New Technical Support Opportunities for States: Reducing Substance Use Disorders
Expressions of Interest Forms Due February 23, 2018 for the Opioid Data Analytics Cohort

The CMS Medicaid Innovation Accelerator Program’s (IAP) Reducing Substance Use Disorder (SUD) program area is launching new technical support opportunities for state Medicaid agencies. All interested states are encouraged to review the Program Overview (PDF, 161.62 KB) (PDF 161.62 KB) for the technical support opportunities available to states in 2018. Additional information can be found in the Information Session slides (PDF, 1.5 MB) (PDF 1.5 MB).

The Program Overview (PDF, 161.62 KB) (PDF 161.62 KB) describes state-to-state learning collaborative and individualized technical support opportunities offered through the Medicaid IAP SUD, including an Opioid Data Analytics Cohort. The Opioid Data Analytics Cohort (April 2018-September 2018) is designed to support states that are in the early stages of conducting analyses to:

  • Size and stratify their opioid problem,
  • Assess the distribution and availability of medication-assisted treatment, and
  • Understand the size and characteristics of neo-natal abstinence syndrome and opioid-related maternity care in Medicaid.

Expression of Interest (DOCX, 48.21 KB) (MS Word 48.21 KB) forms are due February 28, 2018 for the Opioid Data Analytics Cohort.

The Program Overview also describes additional opportunities available to states, such as a Data Dashboards Flash Track, Rapid Response on Best Practices, Medication-Assisted Treatment Model/Payment Design, and 1115 SUD Strategic Design Support.

Register Now: Medicaid IAP National Learning Webinar (January 31, 2018)
Determining Performance Benchmarks for a Medicaid Value-Based Payment Program

On Wednesday, January 31, 2018 from 2:00 pm - 3:30 pm ET, the CMS Medicaid Innovation Accelerator Program (IAP) is holding a national webinar for state Medicaid agencies and other interested stakeholders to learn about various benchmarking methods and considerations for setting performance benchmarks in a Medicaid value-based payment program. The webinar will also include presentations and insights by state Medicaid officials from Oregon’s Coordinated Care Organizations Pay-For-Performance Program and Vermont’s Medicaid Shared Savings Program.

Register Now: Medicaid IAP National Learning Webinar (February 6, 2018)
Medicaid Strategies for Promoting Provider Capacity for Physical and Mental Health Integration

To assist Medicaid and CHIP agencies, CMS’s Medicaid Innovation Accelerator Program (IAP) Physical and Mental Health Integration program area is hosting a national learning webinar on Tuesday, February 6, 2018 from 3:00 pm - 4:30 pm ET about Medicaid strategies for promoting provider capacity for physical and mental health integration. 

Webinar participants will hear from Dr. Ben Miller, a national expert in the field, who will provide an overview of key components for providers to increase physical and mental health integration capacity. This webinar will also feature speakers from Medicaid agencies in Hawaii and New Hampshire, who will share physical and mental health integration provider capacity strategies and lessons learned.

Register Now: Medicaid IAP Information Session (February 8, 2018)
New Opportunity for States: Data Analytic Technical Support for State Medicaid Agencies

CMS’s Medicaid Innovation Accelerator Program (IAP) Data Analytics functional area is launching a new technical support opportunity for state Medicaid agencies to assist in building their data analytic capacity as they design and implement delivery system reforms. All interested states are encouraged to attend the information session on Thursday, February 8, 2018 from 3:00 pm – 4:00 pm ET to learn more.   During this information session, states will hear about the technical support opportunity, have an opportunity to ask questions, and learn about the state selection process. Webinar participants will also learn about the types of technical support that IAP has provided to states interested in building their data analytic capacity, such as developing an analytic plan, designing an approach to integrate non-Medicare datasets, interpreting statistical output, or developing statistical programs to analyze and monitor their Medicaid programs.

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