California: Marketplace Proposes 1332 Waiver Exploration Process
Covered California Executive Director Peter Lee proposed to the Marketplace board a process for partnering with the Department of Health Care Services (DHCS), the State's Medicaid agency, to assess potential ideas for a 1332 waiver proposal. Lee did not describe a preliminary vision or possible components of a waiver, but rather indicated that Covered California and DHCS staff will work together from January through April 2016 to develop potential waiver elements that align with the needs and goals of the State's Marketplace and Medicaid programs. Lee indicated that "pursuing a 1332 waiver would require significant time and resources" and that proposals should be directly related to the current Marketplace mission, achieve savings or administrative simplification, and improve processes rather than completely redesign them. The board and DHCS leadership will assess proposed options in summer 2016 and identify next steps for pursing a waiver, if appropriate.
Rhode Island: Statewide Healthcare Survey Reveals Primary Care Access Gaps and Delayed Care
The Department of Health (DOH) released the results of a statewide healthcare access and utilization survey of facilities and community members, conducted as part of a State Innovation Model (SIM) initiative to reform Rhode Island's healthcare delivery and payment systems. The survey's key findings include: there are 40% fewer primary care physicians in the State than previously estimated and 10% less than the national standard for adequate care access; available data on race, ethnicity, and patients' language needs is insufficient; nearly a third of Rhode Islanders delayed care because of cost and nearly half of those people became sicker before receiving care; and, 51% of assisted living residences are not accepting new Medicaid patients. Rhode Island's Health and Human Services Secretary Elizabeth Roberts noted that "there are many promising initiatives in Rhode Island that will benefit from such a robust data source," the findings and recommendations from which the State intends to use to develop population and behavioral health plans as part of the State's SIM initiative.