Medicaid Managed Care
FEATURED ARTICLE
States Share Innovations to Tackle their Opioid Epidemics
/in Policy Annual Conference, Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Physical and Behavioral Health Integration, Quality and Measurement /by NASHP StaffPORTLAND, OR – State health officials shared wide-ranging innovations in their uphill battle against the opioid epidemic that is sweeping their states at the opening day of the National Academy for State Health Policy’s (NASHP) 30th State Health Policy Conference. Officials explained they are experimenting with new strategies that use data, new treatment approaches, and […]
Success Spurs Growth of Medicaid Managed Care for Children with Special Health Care Needs
/in Policy Blogs Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health /by Karen VanLandeghemTwo decades ago, the majority of state Medicaid programs that served children and youth with special health care needs (CYSHCN) relied on a traditional, fee-for-service model to pay for the complex mix of health care services that this group of children often need. But as states became more adept at designing new health care delivery […]
Data, Delivery, and Decisions as Levers for Enhancing Whole-Person Care for People Living with HIV: Lessons From the Ruth M. Rothstein CORE Center
/in Policy Illinois Reports, Webinars Care Coordination, Chronic and Complex Populations, HIV/AIDS, Long-Term Care, Medicaid Managed Care, Palliative Care, Physical and Behavioral Health Integration /by Charles Townley21st Century Cures Act: Implications and Opportunities for States
/in Policy Blogs 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, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Safety Net Providers and Rural Health /by Jenna BluesteinThe 21st Century Cures Act (“Cures”), signed into law on December 13, 2016, is being heralded as landmark legislation for biomedical innovation. Cures funds new research, streamlines the development of new drugs, and supports the inter-operability of health information systems. State policymakers, however, may want to focus their attention on Cures’ myriad behavioral health provisions, […]
Federal and State Collaboration for Medicare-Medicaid Alignment
/in Policy California, Colorado, Illinois, Maryland, Massachusetts, Michigan, New York, Ohio, Rhode Island, South Carolina, Texas, Virginia, Washington Reports Care Coordination, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Long-Term Care, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Quality and Measurement, State Insurance Marketplaces /by Jenn JensonNASHP recently brought together a group of state and federal policy leaders to discuss the Medicare-Medicaid Financial Alignment Initiative, D-SNP health plans, and other programs and resources aimed at aligning health care payment and delivery to improve care for dual eligibles. See a report from the meeting and sign up for a webinar on state […]
Coverage of Maternal, Infant and Early Childhood Home Visiting Services
/in Policy South Carolina Blogs, Webinars 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, Community Health Workers, EPSDT, Health Coverage and Access, Health Equity, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by Alexandra KingResearch has shown that a quality home visit by a nurse, social worker, early childhood educator or other trained personnel during pregnancy and early parenting can improve the lives of families and their children both at an early age and well into adolescence and early adulthood. The Centers for Medicare and Medicaid Services (CMS) and […]
Challenges and Opportunities for Pediatric Medical Home Implementation and CYSHCN
/in Policy 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, Essential Health Benefits, Health Coverage and Access, Health Equity, Health System Costs, Healthy Child Development, Infant Mortality, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Social Determinants of Health /by Felicia Heider and Barbara WirthNASHP in collaboration with the National Center for Medical Home Implementation developed a new fact sheet addressing challenges and opportunities to provision of care for children and youth with special health care needs (CYSHCN) enrolled in Medicaid managed care. The fact sheet identifies states that leverage Medicaid managed care to advance the pediatric medical home […]
States with Medicaid Incentives for the Prevention of Chronic Diseases Model
/in Policy Maps Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, Long-Term Care, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, State Insurance Marketplaces /by NASHP StaffSection 4108 of the ACA mandated the creation of the Medicaid Incentives for Prevention of Chronic Diseases (MIPCD) program for states to develop evidence-based prevention programs that provide incentives to Medicaid beneficiaries to participate in and complete. In 2011, 10 states were awarded grants to implement chronic disease prevention approaches for their Medicaid enrollees to […]
How Health System Transformation Efforts are Improving Access to Care for Children and Youth
/in Policy Massachusetts, New York, Ohio Blogs Care Coordination, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Value-Based Purchasing /by NASHP WritersStates are rapidly undertaking major reforms within their health care delivery systems. Though not often specifically targeting children and youth, these reforms offer opportunities to positively impact how this population accesses care. In a recent NASHP webinar several states described how their health system transformation efforts are doing so. Massachusetts State Innovation Model Grant: Massachusetts […]
Intervention, Treatment, and Prevention Strategies to Address Opioid Use Disorders in Rural Areas
/in Policy North Carolina Reports Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Health Coverage and Access, Medicaid Managed Care, Physical and Behavioral Health Integration /by Chiara Corso and Charles TownleyA Primer on Opportunities for Medicaid-Safety Net Collaboration The prevalence of substance abuse disorders in the United States has increased dramatically in the past 15 years with catastrophic consequences, especially in rural regions of the United States. Deaths and injuries from illegal opioid and heroin use are more prevalent in rural states, and death from […]
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