Payment and Delivery Reform
FEATURED ARTICLE
CMS Releases State Funding to Improve Integrated Care for Children and Pregnant and Postpartum Women Enrolled in Medicaid and CHIP
/in Policy 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, Eligibility and Enrollment, EPSDT, 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 Managed Care, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by NASHP WritersLast week, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated initiatives — the Maternal Opioid Misuse (MOM) Model and the Integrated Care for Kids (InCK) Model — which will provide multi-year funding to states to improve integrated care for maternal and child health populations enrolled in Medicaid and the Children’s Health […]
The Case for State Action on Health Prices in 12 Slides
/in Policy Blogs Cost, Payment, and Delivery Reform, Health System Costs, Making the Case for Action, Prescription Drug Pricing, State Rx Legislative Action /by NASHP StaffIn the last few months, NASHP has convened state leaders in two summits that addressed rising health care costs. With assistance from Larry Levitt of the Kaiser Family Foundation and Erin Fuse Brown of Georgia State University College of Law, NASHP compiled a slide presentation documenting the factors behind the health care cost trajectory to […]
Guest Blog: Massachusetts Report Recommends More Health Care Price Transparency and Simpler Payment Methods
/in Policy Massachusetts Blogs Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Hospital/Health System Oversight, Prescription Drug Pricing, Quality and Measurement, State Rx Legislative Action, Value-Based Purchasing /by Amara Azubuike and Sandra WolitzkyAmara Azubuike and Sandra Wolitzky are assistant attorneys general in the Massachusetts Office of the Attorney General. A new report released in October 2018 by Massachusetts Attorney General Maura Healey finds that complicated and varied methods used to determine health care payment rates contribute to administrative cost increases and make it difficult for market participants […]
State Reinsurance Programs Lower Premiums and Stabilize Markets — Oregon and Maryland Show How
/in Policy Maryland, Oregon Blogs Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health System Costs, State Insurance Marketplaces /by NASHP StaffAcross the nation, in response to rising health insurance premiums and unsettled markets, a growing number of states are using reinsurance programs to reduce premiums and stabilize jittery markets. What is reinsurance? A reinsurance program provides funds to health insurers to offset the costs of covering consumers with high medical costs. Generally, reinsurance funds become […]
Q&A: Do Medicaid Alternative Payment Models for Prescription Drugs Add Value for States?
/in Policy Oklahoma Administrative Actions, Cost, Payment, and Delivery Reform, Health Coverage and Access, Medicaid Managed Care, Prescription Drug Pricing /by NASHP WritersIn late December, 2018, the National Academy for State Health Policy (NASHP) hosted a webinar exploring Oklahoma Medicaid agency’s use of innovative alternative payment models (APMs) through contracts negotiated with drug manufacturers, which link supplemental rebates to patient outcomes. The webinar, Medicaid Alternative Payment Models for Prescription Drugs: Do They Add Value for States?, featured […]
As Drug Prices Rise, Oklahoma’s Medicaid Agency Advances Alternative Payment Models
/in Policy Oklahoma Blogs Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by Jennifer ReckEscalating drug prices are forcing state Medicaid agencies to explore new payment models. According to Burl Beasley, director of Pharmacy Services for Oklahoma’s Medicaid program, older Medicaid payment strategies, such as negotiating enhanced rebates and multi-state purchase agreements, are not keeping pace with rising drug expenditures. Beasley cited the strain prescription drug costs were putting […]
Medicaid Alternative Payment Models for Prescription Drugs: Do They Add Value for States?
/in Policy Oklahoma Webinars Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by NASHP WritersWednesday, Dec. 12, 2018 2-3 pm (EST) Listen to the Webinar. Download the Slides. As states struggle with the increasing cost of prescription drugs, they are testing various alternative payment models (APMs). The Oklahoma Health Care Authority is a national leader with four alternative payment models in the form of direct contracts with pharmaceutical manufacturers. […]
Webinar: How States Use 1332 Waivers to Develop Reinsurance Programs to Stabilize Markets
/in Policy Webinars Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, State Insurance Marketplaces /by NASHP StaffTuesday, Dec. 11, 2018 4 to 5 p.m. (EST) Listen to the Webinar. Download the Slides. Section 1332 waivers empower states to think creatively about how they can deliver quality and affordable health coverage to their populations. As new state leaders take office, time will be ripe for states to consider how to best use […]
Medicaid Managed Long-term Services and Supports Programs for Children and Youth with Special Health Care Needs
/in Policy Webinars Behavioral/Mental Health and SUD, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Long-Term Care, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration /by Erin KimTuesday, December 04, 2018 3-4 p.m. (ET) States are increasingly providing services to Medicaid beneficiaries with complex health care needs through managed care delivery systems to help control the cost of care, improve health outcomes of enrollees, and improve the quality of the care enrollees receive. States are also starting to include behavioral health and long-term […]
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 […]
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