Medicaid Managed Care
FEATURED ARTICLE
How States Use Medicaid Managed Care to Deliver Long-Term Services and Supports to Children with Special Health Care Needs
/in Policy Reports Care Coordination, Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health System Costs, Healthy Child Development, Integrated Care for Children, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Primary Care/Patient-Centered/Health Home /by Kate Honsberger, Erin Kim and Karen VanLandeghemAn increasing number of state Medicaid agencies are using managed care to provide long-term services and supports to children and youth with special health care needs (CYSHCN). This new NASHP issue brief explores the strategies and critical contract language and policies that states are using to implement these Medicaid managed care programs to provide long-term […]
How States Provide Long-Term Services and Supports to Children in Medicaid Managed Care
/in Policy Blogs Behavioral/Mental Health and SUD, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by Kate Honsberger and Erin KimFor years, states have used managed care delivery systems to help control costs and improve health care and outcomes for adult Medicaid beneficiaries with complex health care needs. Now, more than a dozen states are using managed care to provide long-term services and supports (LTSS) to children and youth with special health care needs (CYSHCN). […]
Strengthening Health Care Delivery Systems for Children with Special Health Care Needs and the Role of Quality Measurement
/in Policy Webinars Behavioral/Mental Health and SUD, Care Coordination, Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, EPSDT, Health Coverage and Access, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care /by Hannah EichnerWednesday, Nov. 28, 2018 2-3 p.m. (EST) States are in the midst of rapid transformation of their health care delivery systems, including how they provide services to children and youth with special health care needs (CYSHCN). As of June 2017, 47 states and Washington, DC, use some form of managed care to provide services to […]
State Health Officials Concerned about the Proposed Public Charge Rule
/in Policy Blogs Behavioral/Mental Health and SUD, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health /by Anita CardwellState officials are concerned that the proposed federal public charge rule could increase the uninsured rate, which would have a negative financial impact and increase health programs’ administrative burden. The Department of Homeland Security (DHS) has proposed significant changes to public charge determination policies that would affect the immigration status of certain individuals. The concept […]
Medicaid Managed Care Proposed Rule Would Give States More Flexibility
/in Policy Blogs CHIP, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care /by Kate HonsbergerThe Centers for Medicare & Medicaid Services (CMS) has proposed a new regulation that gives states more flexibility to design and implement Medicaid managed care programs for Medicaid and Children’s Health Insurance Program (CHIP) enrollees. The proposal aligns with the Trump administration’s goal to reduce regulatory requirements imposed on states. The majority of the proposed […]
New NASHP Tool Identifies Key Quality Measures for Children with Special Health Care Needs
/in Policy Blogs Care Coordination, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Hannah Eichner and Kate HonsbergerQuality measurement is a critical component of state health programs, including Medicaid and State Title V CYSHCN programs that serve children and youth with special health care needs (CYSHCN). While quality measurement for children continues to lag behind that of adults, quality measurement efforts for children overall, and CYSHCN in particular, are gaining greater traction […]
#NASHPCONF18: As the HIV Population Ages, States Redesign their Long-Term Services Programs
/in Policy New York, South Carolina Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, HIV/AIDS, Long-Term Care, Medicaid Managed Care, Palliative Care, Primary Care/Patient-Centered/Health Home /by Lyndsay Sanborn and Rachel DonlonPeople living with HIV (PLWH) are living longer due to advances in antiretroviral therapies and disease management. In 2016, 47 percent of PLWH in the United States were over age 50. This population often needs long-term services and supports at an earlier age due to increased risk of dementia, chronic illness, and the social isolation […]
State Options for Promoting Recovery among Pregnant and Parenting Women with Opioid or Substance Use Disorder
/in Policy Webinars Behavioral/Mental Health and SUD, Care Coordination, Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration /by NASHP StaffWebinar: State Strategies for Using Shared Plans of Care to Improve Care Coordination for Children and Youth with Special Health Care Needs
/in Policy Webinars Behavioral/Mental Health and SUD, Care Coordination, Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by NASHP StaffHow States Promote Recovery for Pregnant and Parenting Women with Substance Use Disorder
/in Policy Colorado, Pennsylvania, Texas Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Essential Health Benefits, Health Coverage and Access, Healthy Child Development, Infant Mortality, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by Hannah Eichner, Becky Normile and Carrie HanlonSubstance use disorder (SUD), including opioid use disorder (OUD), is prevalent among pregnant and parenting women, and these women have unique and often un-met treatment needs. Despite significant efforts, states report that access to treatment continues to lag for this population. In 2014, half of pregnant women with OUD who were enrolled in publicly-funded treatment […]
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. 
States Use Appendix K and Emergency Waivers to Support Home- and Community-Based Services in Response to COVID-19
/in COVID-19 State Action Center Charts, Featured News Home, Maps Care Coordination, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, COVID-19, Health Equity, Long-Term Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Social Determinants of Health /by Salom Teshale