For those working in health and human services, the fact that the COVID-19 pandemic exacerbated the increased need for home- and community-based services (HCBS) among seniors and those with developmental disabilities likely did not come as much of a shock. As members were isolated in their homes, overburdened case managers and providers struggled to deliver care. Similarly, increase in the prevalence of behavioral health concerns, including substance use disorders, coming out of pandemic-era lockdowns were probably not surprising either.
To address these disparities, the American Rescue Plan Act (ARPA) included a broad definition of HCBS, one that included behavioral health and substance use disorders, when determining funding allocation in the $1.9 trillion bill. Under the law, passed in March 2021, Medicaid HCBS initiatives will get an estimated $12.67 billion boost – money that can help state governments improve access to invaluable services for residents living with disabilities and/or behavioral health conditions.
Understanding the Limits
The ARPA included a provision to raise the Federal Medical Assistance Percentages (FMAP) to states for HCBS by 10 percent for a one-year period starting April 1, 2021. States have until March 31, 2024, to reinvest the savings in the allowable HCBS activities.
While state plans for the FMAP increase have already been submitted to the Centers for Medicare and Medicaid Services (CMS) for approval, there were several requirements worth noting.
- States cannot impose eligibility standards, methodologies, or procedures for HCBS programs and services stricter than those in effect on April 1, 2021.
- States must maintain coverage for HCBS and the amount, duration and scope of those services as of
April 1, 2021. - States cannot decrease provider payments below the rate in effect on April 1, 2021.
Ultimately, the law specifies funding must be used to “implement, or supplement the implementation of, one or more activities to enhance, expand, or strengthen” Medicaid HCBS.
FMAP and Health IT
As the law stands, this financial bump will only come once – so there is pressure to leverage and maximize this increase to its full potential. The amount flowing to each state will vary because, as previously noted, this is an increase in a federal matching rate by 10 percentage points, which is unique to individual states.
Improving technological infrastructure can have a long-lasting impact on the delivery of health and human services. In fact, the CMS outlined several potential health IT improvements for states to consider, including:
- Incorporation of HCBS into interoperable electronic health records (EHRs)
- Adoption of enhanced care coordination, such as notification systems and capabilities
- Integration of Medicare and Medicaid data
- Establishment of data sharing and governance agreements
- Incorporating claims and encounter data into incident management systems
With some much-needed cash flow, state governments can use this opportunity to improve access to services in a time when those services may be needed more than ever.
Enhancing Delivery of Care with Health IT
For more than 20 years, FEI Systems has successfully demonstrated our commitment to assisting state agencies in the coordination and delivery of barrier-free, person-centered care that promotes optimal health and well-being for all people, especially the most vulnerable populations on the margins of society.
The ARPA has guaranteed an unprecedented investment in services for Medicaid HCBS beneficiaries in your state, and we are here to help you access, leverage and maximize these funds so you can efficiently expand and improve delivery of care.
Our experienced leadership team has been in your shoes. We understand the challenges you are facing, and our solutions are designed to help you tackle them. At FEI, we specialize in:
- Wait list reduction/management
- Information technology implementation
- Incident management
- Systems assessments
- Telehealth implementation and support
- HCBS quality improvement
Our enterprise-level, comprehensive case management solutions and health IT services currently support HCBS populations within Medicaid Waiver and State Plan programs and we welcome the opportunity to assist you in addressing the identified priorities outlined by the CMS.
