Medicaid block grants: Make HME part of conversation, says Laura Williard

WASHINGTON - CMS in late January took a formal step toward so-called Medicaid block grants with Healthy Adult Opportunity, a pathway for states to receive capped federal funds to deliver and pay for healthcare services for able-bodied adult recipients under Medicaid.

Laura Williard, vice president of payer relations for AAHomecare, spoke with HME News about how this latest twist on Medicaid funding represents both challenges and opportunities.

HME News: What's your take on block grants?

Laura Williard: My biggest concern is every state that participates can design their Medicaid program however they like. The program could look completely different with a completely different benefit from state to state. It would be difficult to know what was happening from one Medicaid program to the next.

HME: Have any states applied for a block grant?
Williard: Officially, only Tennessee, and we've submitted comments around that. The only thing we know for certain, based on what they've come out and said—and this is subject to change—is that they will not be eliminating any benefit. But there's a big difference between eliminating a benefit and changing reimbursement.

HME: It's still early days, but what should be the HME industry's strategy as states decide whether or not to take up CMS on this offer and, for those that do, begin to redesign their Medicaid programs.

Williard: Our job is to make sure the HME industry has a seat at the table. We need to show the value we provide and that we're relevant to keeping patients at home in a least costly environment.

HME: How is AAHomecare helping to make that happen?

Williard: One of the things the Payer Relations Council is working on now is developing bullet points that can serve as discussion points to, for example, push for reporting requirements, because we'll have to comment state by state by state.

HME: Do you expect many states to apply for block grants?

Williard: I don't think there will be a mad rush. It's a lot of work to redesign a Medicaid program. It will also depend on where a state is in its administration—will they be getting a new Medicaid director? But once states start seeing other states succeed, we'll start to see it more.