CONCORD, N.H. – In a significant move to improve healthcare for its residents, New Hampshire has announced a major overhaul of its Medicaid program. Starting September 1, 2024, the state will see increased Medicaid rates and expanded coverage for primary care and preventive services. This initiative, spearheaded by Governor Chris Sununu, aims to enhance residents’ health, improve patient experiences, and boost the financial health of the Medicaid program.

Earlier today, Governor Sununu, alongside the Executive Council, approved contracts with three managed care organizations (MCOs) to include preventive treatments in primary care for Medicaid enrollees. “Prevention is the best medicine,” Sununu emphasized. He highlighted the new structure’s role in addressing the state’s ongoing mental health crisis by promoting preventive services, ultimately reducing healthcare costs and maintaining New Hampshire’s leadership in healthcare innovation.

Hospitals in New Hampshire will benefit from substantial Medicaid rate increases totaling $76 million. This includes more than doubling the base rate for inpatient services, with critical access hospitals seeing a 120 percent increase and Prospective Payment System (PPS) hospitals experiencing a 133 percent rise. Outpatient service rates will also see enhancements, which include direct payments for these services.

The new patient-first services covered by the New Hampshire Medicaid Program will now include health risk assessments, preventive screenings, mental health screenings and counseling, comprehensive medication reviews, and care coordination performed in primary care offices. For instance, the current inpatient base rate for Critical Access Hospitals will jump from $3,345 to $7,351, and for PPS Hospitals, from $3,011 to $7,001.

This updated model is expected to be financially beneficial for hospitals, with a projected $363.2 million in reimbursements for inpatient and outpatient services. Moreover, the redesign leverages improved federal matching funds, bringing an additional $129.6 million to the system and incentivizing hospitals to provide comprehensive and critical services.

New Hampshire will introduce health risk assessments in primary care settings to develop personalized health plans tailored to patients’ needs and risk factors. Medicaid will now reimburse primary care practices for care coordination, helping patients access necessary resources and treatments.

Expanded services under the new Medicaid enhancements include:

  • Preventive screenings in primary care offices for early signs of depression, anxiety, substance use disorders, alcohol misuse, obesity, and other conditions.
  • Counseling services for tobacco cessation and substance use disorders.
  • Comprehensive medication reviews.
  • Preventive services related to maternal and child health, including outpatient lactation support, doula services, and donor breast milk.
  • Federal incentives to increase blood lead screenings for one- and two-year-olds.

Dr. Jonathan Ballard, Chief Medical Officer of the Department of Health and Human Services (DHHS), remarked, “New Hampshire is among the healthiest states in the country. The contracts approved today create an opportunity for an even healthier state by expanding coverage for preventive services and improving primary care.”

New Hampshire Medicaid Director Henry Lipman added, “Medicaid’s focus on preventive services and primary care for children and adults with low incomes will help increase access to these services for those who need them the most. We thank Governor Sununu and the Executive Council for this significant investment to improve the health of the Granite State for many years to come.”

The rollout of these services aligns with the goals of the DHHS Roadmap 2024-2025 to “promote thriving communities.” For more details on the Roadmap, visit the DHHS website.