Payment and Delivery Reform
FEATURED ARTICLE
New Medicaid Funding Could Help States Better Integrate Care for Children with Medical Complexity
/in Policy Blogs Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care /by Hannah Eichner and Kate HonsbergerEarlier this month, the Senate passed the Medicaid Services Investment and Accountability Act of 2019 (H.R. 1839), which contains funding mechanisms and reforms that allow states to improve care coordination for children enrolled in Medicaid. As of early this week, the bill was on the President’s desk awaiting his signature. This legislation significantly gives states […]
State Initiatives Using Purchasing Power to Achieve Drug Cost Containment
/in Policy Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Prescription Drug Pricing /by Jane HorvathThis report focuses on several state purchasing strategies designed to achieve concessions in negotiations with drug manufacturers and in other parts of the prescription drug supply chain. The highlighted strategies include intrastate actions, which combine state agencies’ purchases of drugs to improve their negotiating clout, and interstate activities, such as multi-state organizations that unite to […]
State and Federal Resources to Address Surprise Medical Balance Billing
/in Policy Blogs, Toolkits Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs /by NASHP WritersSurprise medical balance bills – charges for unexpected, out-of-network medical care – affect thousands of consumers each year. These bills can leave consumers stuck with hundreds, if not thousands, of dollars in unexpected medical expenses. States are taking the lead in cracking down on surprise balance bills, passing consumer protection laws that range from strict […]
States Lead on Surprise Medical Billing Protections, Congress Poised to Follow
/in Policy Charts Consumer Affordability, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs /by Christina CousartInformation below references federal bills developed prior to January 2019. For an updated version of this chart, click here.
Webinar: State Tools to Lower Medicaid Prescription Drug Costs – Exploring Payment Methodologies for Retail and Physician-Administered Drugs
/in Policy Webinars Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Prescription Drug Pricing, State Rx Legislative Action /by NASHP StaffGoverning Accountable Health Entities: Examples from 12 States
/in Policy California, Colorado, Connecticut, Delaware, Massachusetts, Michigan, Minnesota, New York, Oregon, Rhode Island, Vermont, Washington Charts Accountable Health, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Equity, Health System Costs, Housing and Health, Population Health, Social Determinants of Health /by NASHP StaffMore than a dozen states are developing accountable health models to improve population health and control costs by addressing community needs, such as transportation, recreation, and housing. These entities’ mission — to build healthy communities through cross-sector partnerships — is supported by innovative and evolving governance structures. This NASHP chart and a companion blog highlight […]
New Report Highlights Successful, Cross-Agency Strategies to Address Substance Use Disorder
/in Policy Reports Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Equity, Healthy Child Development, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health /by NASHP WritersStates are realigning policies, funding, staffing, and data across agencies to better meet the needs of people living with or at risk of developing substance use disorder (SUD). In 2018, NASHP and the Association of State and Territorial Health Officials (ASTHO) convened a group of Medicaid and public health leaders to discuss state strategies for […]
Webinar: Cross-Agency Approaches to Substance Use Disorder Prevention and Treatment
/in Policy Webinars Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by NASHP StaffWednesday, March 20, 2019 4-5 p.m. (ET) Watch this NASHP-ASTHO webinar. Cross-agency collaborations are critical to develop and execute comprehensive approaches to substance use disorder (SUD) prevention and treatment. State public health and Medicaid agencies must look beyond their traditional roles to design a strategy greater than the sum of individual agency activities to achieve […]
Colorado Develops New Payment Method for Physician-Administered Drugs – with the Potential to Save Millions
/in Policy Colorado Blogs Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Prescription Drug Pricing, Quality and Measurement /by Johanna Butler and Jennifer ReckThe National Academy for State Health Policy (NASHP) provided a grant to the Colorado Department of Health Care Policy and Financing to develop a new payment methodology for physician-administered drugs (PADs). PADs are drugs delivered by intravenous infusion or injection in clinical settings. The category includes costly drugs, such as chemotherapy and other specialty medications. […]
How the President’s Proposed Budget Impacts Critical State Health Programs
/in Policy Blogs Administrative Actions, Behavioral/Mental Health and SUD, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Prescription Drug Pricing, State Insurance Marketplaces /by NASHP WritersThe President’s 2020 budget request proposes a 12 percent reduction in the US Department of Health and Human Services (HHS) budget, compared to 2019 federal fiscal year (FFY) funding levels. The following highlights some of the key components of the President’s proposed $87.1 billion HHS budget proposal that could impact state health programs. Affordable Care […]
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. 
State Delivery System and Payment Reform Map
/in Policy Maps Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Value-Based Purchasing Cost, Payment, and Delivery Reform /by NASHP