Happy 2024! This article will focus on a couple of news highlights that emerged over the holiday break.
First, the LOINC and Health Data Standards by the Regenstrief Foundation, developed in partnership with the Gravity Project, have been awarded a $4 million grant to support an initiative to standardize documentation and data elements in electronic medical records (EMRs) for social determinants of health (SDoH) collection.
Currently, SDoH elements in patient medical records range from free text notes to specific data fields. These fields are in variable locations of the medical record and are often customized not only by the type of EMR but also by hospital location, making it nearly impossible to develop scaling information. This project aims to improve current conditions and to standardize SDoH data elements such as food access and neighborhood safety.
Second, maybe some of you will recall the Medicaid unwinding last year when state Medicaid plans had to fall back into compliance with the removal of federal protections from the COVID-19 pandemic. This has been a struggle, understandably so, with the gap in years and providers now trying to track down reenrolling information or qualify adults and children who are Medicaid-eligible. Over the holiday break, the Centers for Medicare & Medicaid Services (CMS) made public acknowledgments commending states that followed automatic renewal practices and condemning the 10 states that elected not to expand Medicaid coverage, leading to increased disenrollment. Those 10 states have a combined rate of disenrolling children more than the rest of the country’s enrollment rate. The highest category of disenrollment was 19-year-olds, who accounted for 27.6 percent of the total across the non-Medicaid expansion states.
Federally, CMS is concerned, because there is a coverage decline of approximately 35 million children between pre-pandemic and 2023 Medicaid Children’s Health Insurance Program (CHIP). U.S. Department of Health and Human Services (HHS) Secretary Becerra did issue letters, which are publicly available, to the nine states with the highest disenrollment rates by numbers and percentage. Becerra also provided recommendations to combat their declining rates and encourage enrollment and healthcare coverage, such as decreasing call times and eliminating burdensome processes for reenrollment. The letters also called again for applicable states to expand Medicaid coverage and remove barriers such as CHIP enrollment fees or premiums.
As we step into the new year, the mix of social needs and healthcare will continue to demand our attention. The initiative to standardize SDoH data collection marks a positive stride toward greater data and documentation alignment.
Meanwhile, challenges persist with Medicaid, demonstrating the continued need for proactive measures to address disenrollment and ensure healthcare access, particularly for children and young adults.
These events emphasize the ongoing importance of unified efforts to navigate healthcare complexities and promote equitable access to services.
Programming note:
Listen to Tiffany Ferguson report this story live today during Talk Ten Tuesdays with Chuck Buck and Dr. Erica Remer, 10 Eastern.
The Centers for Medicare & Medicaid Services (CMS) released in its 2025 Outpatient Prospective Payment System (OPPS) Final Rule a new Conditions of Participation (CoPs)
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