Exchange Governance Chart
This chart highlights steps states have taken to create an exchange. If you’d like to read more about exchange policy decisions, check out our State and Partnership Exchange Policy Decisions chart.
Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. State Refor(u)m captures the health reform comments, documents, and links submitted by health policy thinkers and doers all over the country. And our team periodically supplements, analyzes, and compiles this key content.
Know of something we should add to this compilation? Eager to update a fact we’ve included? Your feedback is central to our ongoing, real-time analytical process, so tell us in a comment, or email the author with your suggestion. She can be reached at rdolan@oldsite.nashp.org.
Notes
1 State abbreviations are linked to exchange websites, where available.
2 For more information on state exchange establishment grants check out our chart and the full list from HHS.
3 For more in-depth analysis of state exchange legislation and board composition, check out our legislation chart.
4 CHIRPA is governed by a nine-member board.
5 Risk adjuster board sets policies related to defined contribution market but does not oversee operations.
6 The Exchange is administered by the Department of Vermont Health Access in consultation with the Medicaid and Exchange Advisory Committee.
7 Total includes Massachusetts, which created the Connector in 2006, prior to the ACA.
Chart Produced by: Rachel Dolan, Sarabeth Zemel and Jeanie Donovan
– See more at: https://www.statereforum.org/exchange-governance-chart#sthash.dGle16OQ.dpuf
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
