17 Provider Compliance Tips Fact Sheets





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HHS Community Health News, Sept. 29- Oct. 2, 2020

This month and into October HHS is recognizing National Hispanic Heritage Month with resources from the Office of Minority Health (in English and Spanish).   Also, our friends at the Office of Hispanic Ministries of the Baptist General Convention of Texas hosted the webinar, Familias Saludables: COVID-19 and Flu Prevention, featuring Spanish speaking health experts from the CDC.   Please share the recording with your Spanish speaking communities and stay tuned for additional resources.

As always, please let us know if you have any questions about the information contained in this email and please stay safe.

HHS Community Health News

HHS Takes Action on National Healthcare Plan

Last week the Administration unveiled its America First healthcare plan aimed at delivering Americans better care, lower costs, and more choice. As part of the plan they:

National Sickle Cell Awareness Month 2020

The HHS Office of Minority Health (OMH) is raising awareness about sickle cell disease (SCD) and the growing challenges COVID-19 has had on the SCD community. Visit the OMH Sickle Cell Disease website for materials, videos, and information regarding the latest advances and resources.

COVID-19 Related News and Updates

Fourth Large-Scale COVID-19 Vaccine Trial Begins in the United States

NIH announced that Johnson and Johnson’s COVID-19 vaccine entered Phase 3 of their clinical trial. This is the 4th vaccine to enter Phase 3 clinical trials in the U.S.  The trial is designed to evaluate if the investigational Janssen COVID-19 vaccine (JNJ-78436725) can prevent symptomatic COVID-19 after a single dose regimen. Up to 60,000 volunteers will be enrolled in the trial at nearly 215 clinical research sites in the United States and internationally. Enrollment diversity in the trials is crucial. You and community members can volunteer here.  (Sé un voluntario)

Changing Age Distribution of the COVID-19 Pandemic

CDC released an MMWR on the Changing Age Distribution of the COVID-19 Pandemic in the U.S. between May and August, 2020. A key finding is that during June–August 2020, COVID-19 incidence was highest in persons aged 20–29 years, who accounted for >20% of all confirmed cases. Strict adherence to community mitigation strategies and personal preventive behaviors by younger adults is needed to help reduce infection and subsequent transmission to persons at higher risk for severe illness.

Update on Vaccine Research From the Experts

NIH Director Dr. Francis Collins and NIAID Director Dr. Anthony Fauci teamed up to give an update on NIH COVID-19 research.

Senate HELP Hearing/Update on the Federal Response to COVID-19

Dr. Fauci also joined CDC Director Dr. Robert Redfield, Assistant Secretary for Health Dr. Brett Giroir, and FDA Commissioner Dr. Stephen Hahn to testify in front of the Senate HELP Committee and provide an update on the federal response to COVID-19.

Administration Announces $200 million from CDC to Jurisdictions for COVID-19 Vaccine Preparedness

HHS is announcing upcoming action by the CDC to provide $200 million to jurisdictions for COVID-19 vaccine preparedness.

NIH Expands Clinical Trials to Test Convalescent Plasma Against COVID-19

Preliminary observational studies indicate that convalescent plasma may improve outcomes among severely ill and hospitalized patients with COVID-19.  Two randomized, placebo-controlled NIH funded clinical trials are expanding enrollment to further evaluate convalescent plasma as a treatment for patients hospitalized with COVID-19.

Flu Vaccine Finder and the Race to 200M Campaign

Getting vaccinated to fight flu can save lives and conserve healthcare resources for COVID-19 patients and others struggling with severe illnesses. Find where to get a flu vaccination here. Also learn about The American Nurses Association’s Race to 200M campaign designed to ignite urgency around flu vaccination.

E- Learning Opportunities

Launch of 6 Part Webinar Series: Spirituality and Mental Health

Tues.,  Sept. 29, 2020, 12:00 p.m. EDT, Register here

Research demonstrates that spirituality and religious belief can be a protective factor in the prevention of, and recovery from, mental illness.  Learn more about programs that have translated this research into action and the importance of providing spiritual support for the clinicians themselves.  Join us tomorrow for the first webinar in the series Spirituality in Treatment: Systemic Treatment Models Bridging Faith and Mental Health Professionals.

ONDCP #RecoveryChat

Wed., Sept. 30, 2020, 3 – 4:00 p.m. EDT, the Office of National Drug Control Policy (ONDCP) hosts this Twitter chat on all things recovery from substance use disorder. Use #RecoveryChat to ask questions and speak with experts from ONDCP, Shatterproof, Young People in Recovery, the Association of Recovery in Higher Education, the Global Recovery Initiatives, and Faces and Voices of Recovery.

Coronavirus Scams, Older Adults, & Financial Protection

Thurs., Oct. 8, 2020, 11:00 a.m.- 12 p.m. EDT – Register here.

Join federal experts who will provide an overview of coronavirus-related scams targeting older adults, share resources to help older adults avoid financial distress due to the pandemic, and discuss the role of the aging network, including Adult Protective Services, legal services attorneys and Long-term Care Ombudsman program experts.

Workforce Development and Jobs

U.S. Department of Labor Announces Availability of $40 Million To Address Rural Healthcare Workforce Shortages

The U.S. Department of Labor announced the availability of up to $40 million in funding in the Rural Healthcare Grant Program to address rural healthcare workforce shortages

through investments in successful, employer-driven training models and community partnerships to establish sustainable programs. Read the Press Release here. Closing date: Nov. 13, 2020

October’s HRSA Virtual Job Fair

Wed., Oct. 7, 6:45 p.m. EDT, Register here.

The HHS Health Resources and Services Administration (HRSA) virtual job fair connects healthcare sites with job-seeking primary care trainees and practicing clinicians. HRSA invites medical, nursing, dental, and mental/behavioral health clinicians and trainees to attend, and learn about hundreds of opportunities.

HUD Jobs Plus Initiative

The U.S. Department of Housing and Urban Development (HUD) supports initiatives that improve employment outcomes through job placement, education, technology skills, and financial literacy for residents of public housing. Closing date: Dec. 1, 2020.

Centers for Medicare & Medicaid (CMS Updates

CMS Issues Urgent Call to Action Following Drastic Decline in Care for Children in Medicaid and Children’s Health Insurance Program Due to COVID-19 Pandemic

CMS released preliminary data revealing that rates for vaccinations, primary, and preventive services among children in Medicaid and CHIP have steeply declined during the COVID-19 public health emergency.  For more information read the Fact Sheet and the Preliminary Medicaid & CHIP Data Snapshot released for review.

CMS Announces New Federal Funding for 33 States to Support Transitioning Individuals from Nursing Homes to the Community

CMS announced the availability of up to $165 million in supplemental funding to states currently operating Money Follows the Person (MFP) demonstration programs. This funding will help state Medicaid programs facilitate efforts to transition individuals with disabilities and older adults from institutions and nursing facilities to home and community-based settings of their choosing.

Let’s Talk About Recovery — Resources from NIDA

In acknowledgment of National Recovery Month, the National Institute on Drug Abuse (NIDA) released the following resources to help jumpstart a dialogue with your community and family members.

Conversation Starter: MTV “16 and Recovering” Series

MTV premiered a new four-part docu-series,“16 and Recovering,” spotlighting stories from teens at Northshore Recovery High School in Massachusetts.  The program can be a  conversation starter for parents, caregivers, and educators to help teens realize they’re not alone or different—and that the disease of addiction is treatable.

Words Matter: Preferred Language for Talking About Addiction

NIDA’s preferred language guide helps de-stigmatize conversations about drug use and addiction using person-first, non-judgmental language. Additional information may be found on drugabuse.gov and teens.drugabuse.gov.

NIDA’s Step by Step Guides to Finding Treatment for Drug Use Disorders
This series of publications is filled with resources and information to help you or someone you care about who might have a drug use disorder, including a guide specifically written for young people.

Teens Ask: “Is There a Cure for Addiction?”

During National Drug and Alcohol Facts Week®, teens often ask about a cure for addiction. In this blog post for teens, experts explain that while there may not be a cure, there is treatment that helps people live full, healthy lives.

NIAAA: Ask 10 Recommended Questions

These questions, outlined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), will help you learn whether a substance use disorder treatment provider offers higher-quality treatment and is a good fit for your situation. Here is the link to NIAAA’s tool for recognizing quality care.

Grants and Other Annoucements

Comprehensive High-Impact HIV Prevention Programs for Community-Based Organizations

The CDC supports the development and implementation of high-impact HIV prevention programs, including PrEP and nPEP services. Closing date: Nov. 20, 2020.

Fostering Innovative Research to Improve Mental Health Outcomes Among Minority and Health Disparities Populations

NOT-MH-20-073 — The National Institute of Mental Health seeks time-sensitive input from all interested parties on the most innovative research and research priorities to improve mental health outcomes among racial/ethnic minority and health disparities populations. Learn more hereResponse date: Oct. 30, 2020.

Sexual Risk Avoidance Education (SRAE) Program

Forecasted HHS-2021-ACF-ACYF-SR-1927– SRAE funds programs for youth which exclusively implement education in sexual risk avoidance (defined as voluntarily refraining from non-marital sexual activity).  Programs also teach youth the benefits associated with self-regulation, success sequencing for poverty prevention, healthy relationships, goal setting, and resisting sexual coercion, dating violence, and other youth risk behaviors such as underage drinking or illicit drug use without normalizing teen sexual activity. Est. Post date Feb. 24, 2021. Est. Closing date: April 25, 2021

Personal Responsibility Education Program (PREP) Competitive Grants
Forecasted HHS-2021-ACF-ACYF-AK-1929 Department of Health and Human ServicesPersonal Responsibility Education Program (PREP) funds education programs to youth that must teach both abstinence and contraception for the prevention of pregnancy.  Est. Post date March 21, 2021. Est. Closing date: May 20, 2021.


CMS Issues New Roadmap for States to Accelerate Adoption of Value-Based Care to Improve Quality of Care for Medicaid Beneficiaries

CMS Issues New Roadmap for States to Accelerate Adoption of Value-Based Care to Improve Quality of Care for Medicaid Beneficiaries

Today, the Centers for Medicare & Medicaid Services (CMS) issued guidance to state Medicaid directors designed to advance the adoption of value-based care strategies across their healthcare systems and align provider incentives across payers. Under value-based care, providers are reimbursed based on their ability to improve quality of care in a cost-effective manner or lower costs while maintaining standards of care, rather than the volume of care they provide.  Value-based care arrangements may also permit providers to address social determinants of health, as well as disparities across the healthcare system.  Moving toward a more value-driven healthcare system allows states to provide Medicaid beneficiaries with efficient, high quality care, while improving health outcomes.  Value-based care may also help ensure that the nation’s healthcare system is better prepared and equipped to handle unexpected challenges, including the ongoing COVID-19 pandemic.

This guidance includes an assessment of key lessons learned from early state and federal experiences in implementing value-based care reforms, as well as a comprehensive toolkit of available federal authorities for states to adopt innovative payment reform efforts within their individual programs. It stresses the importance of multi-payer alignment in value-based care to drive care transformation, and supports state efforts to align new payment models in Medicaid with Medicare and other private payers.

CMS has made a strong commitment to advancing value-based care in Medicare for its 61.7 million enrollees. This guidance is designed, with the understanding that many of the providers overlap, to ensure that this same commitment can be made at the state level through Medicaid with its nearly 74 million beneficiaries by aligning strategies and common understanding of effective approaches. While these programs serve different populations, they share common goals of lower costs and improved health outcomes, and reduce burden if payers are aligned with value-based care.

“The Trump Administration has long worked to accelerate the overdue move to value-based care, but for too long these efforts have been piecemeal,” said CMS Administrator Seema Verma.  “Our health care providers need Medicare, Medicaid and private insurance payers to work in tandem with one another, and I am calling on our state partners to use this guidance to develop a plan to improve quality for their Medicaid beneficiaries by advancing value-based care in their own programs.”

With Medicaid costs rising and continuing to consume a greater share of state budgets, and with federal costs forecasted to continue to grow according to the CMS Office of the Actuary[1], CMS has a duty to ensure the program remains sustainable.  Moving toward more value-driven reimbursement models is a critical part of this effort, as fee-for-service payment incentivizes higher volume and greater spending, rather than accountability for costs and outcomes.   This guidance is designed to support states as they develop plans to increase Medicaid provider participation in and adoption of value-based care models.

In taking this new direction, CMS is building on its experiences and lessons learned from states and other payers.  Since 2010, CMS has engaged in cooperative partnerships with states and providers to test payment and service delivery models that aim to achieve better care for patients, smarter spending, and healthier communities.  The CMS Innovation Center is testing a growing portfolio of various payment and service delivery models.  All of these models have enabled CMS to better understand the opportunities and challenges that states should consider as they move toward a more value-driven system.  Building on the lessons learned from these models, this guidance discusses those considerations, including multi-payer participation, delivery system readiness, stakeholder engagement, and the scope of financial risk to providers.  In addition, this letter describes pathways, including flexibility available under the state plan, towards the adoption of value-based care models in Medicaid.  States are invited to choose the pathway that best meets their reform goals, and do not need to rely only on time-consuming, complex demonstrations or waivers to achieve better value in their programs, where their proposals can be implemented under a state plan or managed authority.  The guidance discusses how states can build payment models that promote value-based care under both fee-for-service and managed care.

The guidance encourages states to consider the adoption of models in the context of their individual circumstances and the lessons learned from implementing previous payment and service delivery models.  Examples of payment models include advanced payment methodologies under fee-for-service, bundled payments, and total cost of care models.  Each of these models, and others described in today’s letter to state Medicaid Directors, reflect the Administration’s priorities for a value-driven health care system, such as by:

  • Improving quality of care for beneficiaries;
  • Rewarding providers for reducing the effects and incidence of chronic disease and for helping patients improve their health;
  • Improving value in the larger healthcare system by aligning provider incentives across multiple payers; and
  • Helping the United States and its healthcare system handle unexpected challenges and disruption, including those experienced from the ongoing COVID-19 pandemic.

Many states have made progress in moving toward value-based payments in healthcare, yet there are still growth opportunities for more states to improve health outcomes and efficiency across payers including Medicare, Medicaid, and private insurance, by ensuring healthcare systems are financially incentivized to deliver the best quality, best value care.  Aligning value-based care programs across payers could reduce the burden on providers who participate with multiple payers and improve the healthcare experience for patients.

To view the Value-Based Care Opportunities in Medicaid SMDL, please visit: https://protect2.fireeye.com/url?k=9c9690c2-c0c399d1-9c96a1fd-0cc47adb5650-e4057606ced02c16&u=https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/smd20004.pdf

For a fact sheet on the Value-Based Care Opportunities in Medicaid SMDL, please visit: https://www.cms.gov/newsroom/fact-sheets/value-based-care-state-medicaid-directors-letter

CHIP Buy-in Program Could Contribute to Health Coverage Progress in West Virginia

With New Data Showing Health Coverage Progress in West Virginia Stalled Prior to COVID-19 Crisis, WVCBP’s New Policy Brief Details How State Can Cover All Children

The number of West Virginians without health insurance stayed the same in 2019, further stalling the historic gains made under the Affordable Care Act even before the COVID-19 economic and health crisis caused job and health insurance loss for tens of thousands of West Virginians.

Today’s data release shows that 120,000 West Virginians lacked health insurance in 2019, a statistically insignificant change from 2018. West Virginia’s uninsured rate was 6.7 percent in 2019. Prior to the passage of the Affordable Care Act and the state’s expansion of Medicaid, West Virginia’s uninsured rate was 14.6 percent, with 266,000 people without health insurance coverage.

Just as overall progress in health coverage for all West Virginians has stalled, our state’s children have seen an increase in the uninsured rate as well. Our new policy brief out today highlights how West Virginia can build upon the Children’s Health Insurance Program (CHIP) to reverse course and cover all kids.

“Much progress has been made in recent years to achieve the goal of universal health care coverage for children. But challenges remain, and there is still a need for affordable, comprehensive insurance options. A CHIP buy-in program can act as one of those options, particularly in light of recent changes to federal law that make it easier for states to pursue their own program. A well-designed CHIP buy-in program could be a cost-effective way of moving toward universal coverage for children.”

You can find the full report here.

While concerning, the 2019 data is already out-of-date as many West Virginians have lost health coverage due to the COVID-19 crisis and the current uninsured rate is likely much higher. As many as 100,000 West Virginians, including both those who lost their jobs and dependents of displaced workers, lost their health coverage this year at the height of the COVID-19 economic crisis. If all of those West Virginians remain uninsured for a length of time, the state’s 2020 uninsured rate could spike to over 12 percent. A CHIP buy-in program could help mitigate some of that harm.

RCORP-TA Resource Portal Weekly Update

The portal allows grantees to request technical assistance, find nearby grantees or grantees with a similar focus, and access a repository of resources tailored to support RCORP Grantees.

RCORP-TA Webinar Resources

Portal Resources
New training, templates, and articles are posted daily. Here is a sample of recently posted resources:

Upcoming Events and Webinars
Check our calendar, as new events and webinars are posted frequently.

*These events are not sponsored by RCORP-TA. Please reach out directly to the event organizers with any questions.

New Funding Opportunities
The list of funding opportunities updates continually. Here is a short list by closing date. Check the portal regularly to view all new listings.

September 7, 2023Long-Term Effects of Disasters on Health Care Systems Serving Health Disparity Populations