Medicaid Managed Care
FEATURED ARTICLE
How States Can Improve Access to Care for Children Under the Medicaid Managed Care Rule
/in Policy Colorado, Virginia Blogs Behavioral/Mental Health and SUD, 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, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Kate HonsbergerNext month, states face new federal requirements for establishing and maintaining Medicaid managed care provider networks. As they work to comply with these new rules, states have an opportunity to strengthen access to care for children and youth with special health care needs (CYSHCN). Medicaid and requirements, which address how enrollees access care and the […]
Ohio Implements Value-Based Payment Reform to Improve Population Health
/in Policy Ohio Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health IT/Data, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Quality and Measurement, Social Determinants of Health, State Insurance Marketplaces, Value-Based Purchasing /by NASHP WritersGreg Moody, director of Ohio’s Office of Health Transformation, has quietly spearheaded one of the most effective redesigns of a state health care payment system in the country, generating cost savings and improving public health by showing providers how the cost and quality of their care compares with their peers. This value-based cost-savings and quality improvement […]
How Six States Use Medicaid Managed Care to Serve Children with Special Health Care Needs
/in Policy Arizona, Colorado, Minnesota, Ohio, Texas, Virginia Charts, Reports Behavioral/Mental Health and SUD, Care Coordination, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, 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 NASHP WritersMedicaid managed care provides a unique opportunity for states to strengthen the structure and delivery of care for children and youth with special health care needs (CYSHCN). The National Academy for State Health Policy (NASHP), studied how six states (Arizona, Colorado, Minnesota, Ohio, Texas, and Virginia) designed their managed care systems to serve CYSHCN and […]
Webinar: Increasing Rates of Virologic Suppression: Promising Practices from HIV Health Improvement Affinity Group States
/in Policy Webinars Chronic and Complex Populations, HIV/AIDS, Medicaid Managed Care /by NASHP StaffStates Share Data to Improve the Health of People Living with HIV
/in Policy Alaska, Louisiana, Maryland Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, HIV/AIDS, Long-Term Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Quality and Measurement /by Natalie Williams and Rachel DonlonVirologic Suppression occurs when the amount of HIV in the blood is lowered to below 200 copies per milliliter or undetectable levels.PLWH are more likely to achieve and maintain virologic suppression when they have access to high-quality, coordinated and comprehensive care, antiretroviral therapy, and support services. A substantial body of research shows that virally-suppressed people […]
Policy Levers to Develop Value-Based Payment Models for FQHCs
/in Policy Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Value-Based Purchasing /by NASHP StaffThe National Academy for State Health Policy (NASHP) designed this tool kit to support states interested in developing a value-based alternative payment methodology (APM) for federally qualified health centers (FQHCs). The following section on state policy levers for implementation discusses key considerations and promising strategies based on lessons learned from states during NASHP’s Value-Based Payment […]
States Work to Improve Care for Children with Special Health Needs with Quality Measurement
/in Policy Michigan, New York, Texas 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, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Value-Based Purchasing /by Anisha Agrawal, Becky Normile and Karen VanLandeghemImproving the quality of care that children and youth with special health care needs (CYSHCN) receive is a growing priority for state Medicaid programs. However, many quality improvement efforts are in their infancy as states work to overcome the challenges of measuring and assessing care quality for this vulnerable population. NASHP, with support from the […]
Medicaid Quality Measurement for Children and Youth With Special Health Care Needs
/in Policy Webinars Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Quality and Measurement /by NASHP StaffState Health Policymakers Look to Washington and Each Other to Fight the Opioid Epidemic
/in Policy Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Healthy Child Development, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Social Determinants of Health /by Lyndsay Sanborn and Kitty PuringtonIn the last two weeks, there has been a flurry of federal and state activity focused on the nation’s opioid epidemic that currently kills more Americans than guns or car accidents. In Washington, the President’s Commission on Combating Drug Addiction and the Opioid Crisis released its final report featuring 56 recommendations to stem opioid and […]
Better Together: How Cross-Agency Data Sharing Can Improve the Care Continuum for People Living with HIV/AIDS
/in Policy Georgia Blogs Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, HIV/AIDS, Medicaid Managed Care, Quality and Measurement /by Erin Kim and Lyndsay SanbornSharing health data about people living with HIV/AIDS (PLWHA) across state agencies can be challenging, but evidence shows working through the related legal and technical barriers can be worth it. Successfully sharing data allows states to assess how well clinical and supportive care services are addressing the needs of their population. Virologic Suppression: When antiretroviral […]
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