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The Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.

June 12, 2023

Health Centers Step In as Public Health Emergency Ends

Community health centers are playing a pivotal role in identifying people at risk of losing their Medicaid coverage as states determine whether beneficiaries are still eligible. These “redeterminations,” usually done annually, were suspended during the COVID-19 public health emergency. To understand how health centers are approaching the challenge, the authors of our new feature article reached out to four health center CEOs to find out about their strategies for helping patients keep their Medicaid or find other coverage.

Preparing for the Next Pandemic: PAHPA Reauthorization

Will there be another pandemic? Experts believe the question isn’t if, but when, the next one strikes. The pending reauthorization of the Pandemic All-Hazards Preparedness Act (PAHPA) presents an opportunity for Congress to not only improve emergency response but also to strengthen day-to-day public health infrastructure — an essential part of preparedness. Join the Bipartisan Policy Center on Wednesday, June 14, at 2:00 p.m. for a webinar on the PAHPA reauthorization and ways we can better ready our nation for the next crisis.

FEATURED CHART

The Pandemic’s Toll on Health Centers

In serving as a health care safety net for 30 million patients, the nation’s community health centers operate under tight financial margins and other challenges, many exacerbated by COVID-19. On To the Point, the Commonwealth Fund’s Celli Horstman analyzes how federal and state policy supported these providers during the pandemic. As policymakers debate future funding, health centers’ “invaluable role in providing their communities with equitable care should be kept at the forefront of discussions,” she says.

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States Can Improve Access to Behavioral Health Care

Longstanding problems in access to behavioral health care have worsened since the pandemic, which increased demand for services amid workforce shortages. Millions of people are likely going untreated. JoAnn Volk and Christina Goe of the Georgetown University Center on Health Insurance Reforms describe how states can ensure that health plans cover treatment for mental health and substance use disorders on par with other health services.

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A Better Mental Health Care System: Lessons from Chile

Two decades ago, Chile began revamping the way mental health services are delivered to residents. Health care leaders recognized that by working together in teams, primary care providers and behavioral health specialists can more effectively address mental health needs while also helping to overcome the short supply of specialists. In International Insights, the Commonwealth Fund’s Evan Gumas looks back over Chile’s successful effort, which vastly expanded treatment of depressive disorders.

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Expanding Maternity Care in Rural America

Lack of access to obstetric care contributes to the high number of maternal deaths and complications in many rural areas of the U.S. Kaiser Health News recently reported that despite producing promising results, the federal grant program Rural OB Access and Maternal Services will soon run out of funds in New Mexico and two other states. Transforming Care recently wrote about the program in a feature examining regional efforts to expand access to maternity care across rural America.

A “Continuum” Approach to Maternal Health in Medicaid

The road to better maternal health care starts with Medicaid, which covers two of five births in the U.S., mainly through managed care plans. In their examination of state Medicaid contracts, Sara Rosenbaum and colleagues at George Washington University found wide variation in which maternal care services are covered. As they discuss on To the Point, the nation’s fragmented approach could be improved by “developing comprehensive maternal health care treatment guidelines that span the full continuum of care and guide state purchasing expectations and plan performance.”

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New Federal Rules Could Improve Access to Care

The Centers for Medicare and Medicaid Services has proposed two rules for Medicaid and the Children’s Health Insurance Program (CHIP) that could improve access to care for millions of enrollees. Cindy Mann and collegues from Manatt Health discuss how the rules could simplify and standardize how patients receive care in both fee-for-service and managed care settings, while also allowing officials to monitor care delivery better.

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Medicaid Work Requirements Are Not the Answer

Researchers have found that work requirements in public programs don’t increase employment rates, and administrative glitches can actually lead to disenrollment of people who are working. Sherry Glied and Dong Ding of NYU’s Wagner School examine how much health care is used by Medicaid enrollees who aren’t currently employed and are unlikely to receive an exemption from work requirements. According to their estimates, only 1.7 million fall into this category — meaning that disenrolling this population would achieve little in the way of program savings.

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