Payment and Delivery Reform
FEATURED ARTICLE
How States Access and Deploy Data to Improve SUD Prevention, Treatment, and Recovery
/in Policy Behavioral/Mental Health and SUD, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Quality and Measurement /by Kitty Purington and Jodi ManzAs state policymakers confront the substance use disorder (SUD) epidemic, they require a wide range of data – often found in disparate systems – to understand its impact and craft more effective treatment programs and interventions. This report explores best practices and sources for data gathering and describes how states can help communities access and […]
New Federal “No Surprises Act” Extends Medical Billing Protections Beyond State Reach
/in Policy Blogs, Featured News Home Consumer Affordability, Cost, Payment, and Delivery Reform, Health System Costs, Hospital/Health System Oversight, Quality and Measurement /by Christina CousartThe “No Surprises Act,” the most comprehensive federal legislation enacted to date designed to prohibit surprise medical bills, is part of the recently enacted Consolidated Appropriations Act of 2021.
States Quickly Retool Strategies to Maximize Vaccination Coverage
/in COVID-19 State Action Center Blogs, Featured News Home Cost, Payment, and Delivery Reform, COVID-19, Health Coverage and Access, Health Equity, Population Health, Quality and Measurement, Quality and Measurement, Social Determinants of Health, Vaccines, Workforce Capacity /by Ariella Levisohn, Rebecca Cooper and Jill RosenthalFaced with limited vaccine supplies, a slow rollout of federal funds, and new federal guidelines allowing vaccination of those 65 and older, states face distribution challenges as they quickly evaluate which mass immunization practices are most effective.
Texas Improves Access to Routine Oral Health Services for Very Young Children
/in Policy Texas Child Oral Health, Chronic Disease Prevention and Management, Consumer Affordability, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Oral Health, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Quality and Measurement, Social Determinants of Health /by Veronnica ThompsonThough largely preventable, tooth decay (caries) is the most common chronic disease in US children, affecting approximately 23 percent of children ages 2 to 5.[1],[2] Texas’s First Dental Home and its enhanced bundled payment has increased access to preventive dental service and improved the oral health of Medicaid-enrolled children ages 6 to 35 months. Providing […]
Michigan Medicaid Addresses Social Determinants of Oral Health through Dental and Medical Contracts
/in Medicaid Managed Care Michigan Blogs, Featured News Home Child Oral Health, CHIP, Consumer Affordability, Cost, Payment, and Delivery Reform, EPSDT, Health Coverage and Access, Health Equity, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Oral Health, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Social Determinants of Health, Special Populations and Services, Workforce Capacity /by Ariella LevisohnInequities in dental care are prevalent across the United States, with significant disparities based on age, race, ethnicity, and socioeconomic status. Economic factors, such as ability to pay for dental insurance, and social factors such as food insecurity and access to nutritious food options also play a large role in oral health outcomes. In Michigan, […]
State Approaches to Reimbursing Family Caregivers of Children and Youth with Special Health Care Needs through Medicaid
/in The RAISE Act Family Caregiver Resource and Dissemination Center Children/Youth with Special Health Care Needs, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, COVID-19, EPSDT, Health Equity, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health, State Resources, The RAISE Family Caregiver Resource and Dissemination Center /by Olivia Randi, Eskedar Girmash and Kate HonsbergerStates Use Appendix Ks to Provide Innovative Flexibilities for Medicaid Enrollees and Caregivers during COVID-19
/in The RAISE Act Family Caregiver Resource and Dissemination Center Connecticut, Georgia, Washington Blogs, Featured News Home Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, COVID-19, Long-Term Care, Medicaid Managed Care, Population Health, State Resources, The RAISE Family Caregiver Resource and Dissemination Center /by Salom Teshale, Paige Spradlin, Wendy Fox-Grage and Kitty PuringtonDuring the COVID-19 pandemic, states have used the Appendix K Emergency Preparedness and Response authority to amend Medicaid 1915(c) home- and community-based services (HCBS) waivers and quickly provide more flexible services and supports to Medicaid enrollees and, indirectly, their caregivers.
State Use of Patient-Centered Outcomes Research in Telehealth Policymaking
/in Policy Featured News Home, Reports Chronic Disease Prevention and Management, Consumer Affordability, Cost, Payment, and Delivery Reform, COVID-19, Health Equity, Health System Costs, Population Health, Quality and Measurement, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by Amanda Attiya, Christina Cousart and Maureen Hensley-QuinnThe adoption and use of telehealth have exploded across states, spurred by the COVID-19 pandemic, the need for social distancing, and swift federal and state action to enable how telehealth is delivered and covered by insurers. These changes will have a lasting impact on how health care is delivered, affecting payers, medical providers, and patients […]
Medicaid Supports for Family Caregivers
/in The RAISE Act Family Caregiver Resource and Dissemination Center Featured News Home, Reports Children/Youth with Special Health Care Needs, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Council Meeting Materials and Resources, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health, Program Design, State Resources, The RAISE Family Caregiver Resource and Dissemination Center /by Neva Kaye and Salom TeshaleFamily caregivers help Medicaid enrollees safely stay in their own homes, prevent or delay hospital and nursing facility stays, and provide personal care services that Medicaid agencies would otherwise need to pay for. However, there are strong indications that family caregivers need additional supports, which would benefit the Medicaid enrollees in their care. Recognizing family […]
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