Pro tips: How to work with state Medicaid programs

Medicaid directors have a huge undertaking, ensuring their programs meet budgets, adhere to federal and state guidelines, and provide excellent patient outcomes. One of the rewarding aspects of my role at AAHomecare is that I have the opportunity to work with HME providers and industry stakeholders to educate them on how our services can help meet their overarching goal of providing excellent care to 73 million Medicaid beneficiaries nationwide.

Access to care is an ongoing concern for all state Medicaid programs and focusing on how HME providers can continue to provide care in the least costly setting with excellent outcomes is critical. More discussion regarding outcomes management and the importance of maintaining a strong HME benefit are crucial to the future of both our industry and Medicaid programs. But how do we do this effectively with Medicaid directors?

Let's begin by considering what is involved with running a state Medicaid program. I consider this daily when trying to navigate the Medicaid rules, regulations and rates.  Recently, I had the opportunity to hear from Medicaid directors and regulators on the challenges they face at the National Association of Medicaid Directors Fall Conference. This conference is structured for Medicaid programs to learn from each other and from CMS on important issues facing their programs. Attendees include state Medicaid directors and other Medicaid staff that are integral to running these programs. Also in attendance and exhibiting at this conference are most of the Medicaid managed care organizations, including Centene, Aetna and United Health Care, as well as vendors offering services to ease the burden and workload of the states.

Secretary of Health and Human Services Alex Azar spoke at the opening session. His presentation centered on a major issue Medicaid programs are dealing with currently: treatment of mental health in the states. He noted that one of CMS's goals is to give the states more flexibility on how they treat mental illness, and reiterated inpatient treatment is just one part of what should be a more complete continuum of care in treating these issues. Azar also discussed the recently published Medicaid managed care rule, explaining how it will offer states more flexibility in managing their MCO programs. Comments for this rule are due Jan. 14, 2019. AAHomecare will be submitting comments and will share them with the HME community, suggesting messaging and details on changes to assist providers with formulating their own comments.  The association has been discussing the need for more oversight of MCO plans with state Medicaid programs and CMS officials. We will continue to make this a focal point of our comments in any Medicaid discussions, comments and meetings.

One of the more beneficial aspects of the conference was the opportunity it provided to strengthen partnerships with state Medicaid directors and programs. It was refreshing to hear directors provide open feedback on when and how to engage them on the challenges we face serving their beneficiaries. One recommendation I appreciated is to ask for a 30-minute meeting, which makes it easier to get on their schedule. Medicaid Directors believe most issues can be handled in a 30-minute timeframe, if you get directly to the point. Slide deck presentations are not necessary, and as one Medicaid director explained: “You do not have to take 15 minutes to discuss your concern for the patient. We are all in this business because we care about the patient, so convincing us of that is not necessary.”

Other issues discussed during the conference included strategies states are employing to fight the growing number of “deaths of despair” and other related impacts of increased opioid abuse. One of the more emotional sessions was led by caregivers discussing the obstacles they face in dealing with the Medicaid program and recommendations they have for states to increase the quality of life of both beneficiaries and caregivers. Looking ahead to 2019, state Medical programs will be focusing on improving how they measure quality of care, implementation of the MCO final rule changes, and evaluation of their systems to ensure data accuracy.

This event is a great opportunity to network with state Medicaid directors and get fresh perspectives on their challenges. Where else can you get all of the Medicaid directors across the country in the same room to hear the focus of the Medicaid programs for the next year? I highly recommend it to anyone dealing directly with these professionals and hope to see an even stronger HME presence at next year's conference.

Laura Williard is vice president of payer relations at AAHomecare. You can follow her on twitter @WilliardLaura.