Payment and Delivery Reform
FEATURED ARTICLE
States Take Administrative Actions to Curb Medicaid Drug Costs
/in Policy Ohio, Vermont, West Virginia Blogs Administrative Actions, Cost, Payment, and Delivery Reform, Health Coverage and Access, Medicaid Managed Care, Prescription Drug Pricing, State Rx Legislative Action /by Jennifer ReckDuring the 2018 legislative session, 28 states passed 45 laws to curb the rising cost of prescription drugs. In addition to legislative solutions, states are taking administrative action to better manage state spending on Medicaid pharmacy benefits. Ohio, West Virginia, and Vermont offer examples of states taking innovative administrative approaches to rein in drug costs. […]
A Snapshot of the Key Health Policy Issues at Play in 2018 Governors’ Races
/in Policy Blogs Administrative Actions, 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, Health System Costs, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Expansion, Population Health, Prescription Drug Pricing, Safety Net Providers and Rural Health, Social Determinants of Health, State Insurance Marketplaces, State Rx Legislative Action, Workforce Capacity /by Anita CardwellWith elections just three weeks away, governors’ races in 36 states – with 17 open seats – are down to the wire and important health policy issues, such as Medicaid expansion, stabilizing insurance markets, public options, and prescription drug price controls, are at play in most of them. The National Academy for State Health Policy […]
Comparison of State Pharmacy Benefit Managers Laws
/in Policy Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Model Legislation, Newly-Enacted Laws, Prescription Drug Pricing, State Rx Legislative Action /by NASHP StaffHealth Coverage and Human Service Program Eligibility: Considerations for States Weighing Systems Integration
/in Policy Blogs Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Expansion, State Insurance Marketplaces /by NASHP StaffShould states integrate their health insurance and human services eligibility and enrollment systems? Some state officials are weighing this question now that their revamped, Affordable Care Act (ACA) health coverage systems have been operational for several years and most of the early, initial glitches have been repaired. However, there are multiple factors to consider, some […]
How States Are Meeting the Needs of Children and Families Affected by the Opioid Epidemic
/in Policy Kentucky, New Hampshire, Virginia 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 System Costs, 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, Primary Care/Patient-Centered/Health Home /by Hannah Eichner and Becky NormileThe opioid epidemic is having a devastating impact on children and families and placing a significant strain on states as they work to develop effective programs and find new funding to respond to this crisis. To address the crisis and promote healthy child development, states are implementing innovative whole-family approaches to prevention and treatment (see […]
Oklahoma Signs the Nation’s First State Medicaid Value-Based Contracts for Rx Drugs
/in Policy Oklahoma Blogs Administrative Actions, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health System Costs, Population Health, Prescription Drug Pricing, State Rx Legislative Action, Value-Based Purchasing /by Jennifer ReckOn the heels of Oklahoma’s first-in-the-nation, value-based purchasing deal to improve adherence to an antipsychotic drug, the state’s Medicaid agency just signed its second value-based contract for a prescription drug used to treat serious bacterial skin infections. While several private insurers have initiated value-based contracting, which links payments to a drug’s effectiveness and outcome, Oklahoma […]
States Explore Strategies to Advance Palliative Care at #NASHPCONF18
/in Policy Blogs Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Long-Term Care, Medicaid Managed Care, Palliative Care, Physical and Behavioral Health Integration, Population Health, Workforce Capacity /by Kitty Purington and Hannah DorrStates, as regulators, payers, and innovators of health care, are uniquely positioned to improve the lives of Americans with serious illnesses by promoting access to palliative care. The National Academy for State Health Policy (NASHP) is working with state leaders to expand and improve palliative care, explore how these services align with other initiatives (e.g., […]
State Legislators Take Action to Protect Consumers from Surprise Billing
/in Policy Blogs Consumer Affordability, Cost, Payment, and Delivery Reform, Health System Costs /by NASHP StaffConsumer out-of-pocket spending on health care costs, including “surprise” medical bills – often incurred for costly, out-of-network care — is on the rise and state lawmakers are responding with legislation to protect consumers. Surprise bills happen when consumers receive unexpected charges for medical care that they assumed would be comprehensively covered by their insurance plans. […]
How State Policymakers Spent Their Summer: Stabilizing Their Insurance Markets
/in Policy Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Expansion, State Insurance Marketplaces /by NASHP StaffState policymakers spent their summer crafting policies to educate and protect consumers in response to federal actions that threaten to alter state individual insurance markets. In recent months, the federal government issued new rules expanding the availability and sale of association health plans and short-term, limited duration plans and passed legislation effectively eliminating the individual […]
As States Brace for ACA Lawsuit, Senate Considers Protections for Pre-existing Conditions
/in Policy Blogs Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Medicaid Expansion, Medicaid Managed Care, Population Health, State Insurance Marketplaces /by NASHP StaffTen Republican Senators recently introduced legislation to protect patients with pre-existing conditions. While these protections are already included in federal law though the Affordable Care Act (ACA), the proposed bill would preserve some of those protections in the event the ACA is overturned as a result of ongoing litigation. Specifically, the Senate bill proposes to: […]
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