Managing Program Change: Experience From Maximizing Enrollment States in Leadership, Culture Change, Coordination, and Data
Since 2009, eight states participating in the Robert Wood Johnson Foundation’s Maximizing Enrollment program have worked to streamline eligibility and enrollment systems, policies, and procedures. Through the course of the program, state teams pursued programmatic change both to realize their own visions for coverage, and to respond to environmental shifts including a recession, elections, and the enactment of the Affordable Care Act. This Maximizing Enrollment report examines how grantee states wove key strategies together into a tapestry of change management: (1) providing leadership to achieve culture change; (2) improving data analysis to target and track policy changes; and (3) focusing on coordination across the various state and local entities administer eligibility systems.
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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. 
