Payment and Delivery Reform
FEATURED ARTICLE
NEXT STEPS FOR APCDs: US Department of Labor (DOL) Rulemaking
/in Policy Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs /by NASHP StaffComments submitted to the DOL The Gobeille v. Liberty Mutual Insurance Co. decision dealt a blow to state APCDs by denying state all payer claims databases (APCD) the ability to require data submission from self-funded group health plans. Nationally about 63 percent of all workers with employer-based health insurance are in self-funded plans and that […]
Proposed HHS Notice of Benefit and Payment Parameters for 2018
/in Policy Reports Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, State Insurance Marketplaces /by NASHP WritersEarlier this month, the U.S. Department of Health and Human Services released its latest omnibus rule proposing a series of changes impacting insurance markets and the health insurance marketplaces. Our latest blog and accompanying memo break down a few key concerns for states as they finalize their comments due on October 6, 2016. Memo: Proposed […]
Five Things to Watch from HHS’s Latest ACA Proposed Regulations
/in Policy Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, State Insurance Marketplaces /by NASHP WritersOn September 6, 2016 U.S. Department of Health and Human Services released its latest proposed Notice of Benefit Payment Parameters; the annual omnibus rule to put into place regulatory changes impacting the health insurance marketplaces for the next plan year. Notably, the proposal was released several months earlier than usual this year, likely as a […]
A Federal-State Discourse on Maintaining Momentum for Payment and Delivery System Reform
/in Policy Reports Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by StaffStates and the federal government have been undertaking an almost bewildering array of policy initiatives and experiments in an effort to improve value and reduce costs in the health care system. What are we accomplishing and learning from these efforts? And what’s needed to sustain and advance the most promising strategies? In July 2016, a group […]
Treatment for Children with Autism Spectrum Disorders and the EPSDT Benefit
/in Policy Reports Behavioral/Mental Health and SUD, 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, Health System Costs, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Barbara WirthState Medicaid agencies are working to provide comprehensive health care services for children with autism spectrum disorder (ASD), currently the fastest growing developmental disability in the United States for individuals under age 21. This brief highlights information from the 2014 CMS Informational Bulletin providing clarification on services to be provided to Medicaid-eligible children with ASD […]
Value-Based Payment Reform Academy Group Technical Assistance Webinars
/in Policy Webinars Cost, Payment, and Delivery Reform, Health System Costs, Value-Based Purchasing /by Hannah DorrState Financing and Delivery Innovations to Address Disparities in Uncontrolled Childhood Asthma
/in Policy Charts Behavioral/Mental Health and SUD, Care Coordination, CHIP, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Health System Costs, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Safety Net Providers and Rural Health /by Taylor Kniffin and Felicia HeiderThe high prevalence of uncontrolled asthma among child populations served by Medicaid programs and the associated rising costs often are the impetus for states to improve the quality of care provided to children with asthma. New opportunities to comprehensively address asthma and its triggers are emerging through state and national health care delivery system and […]
Federal-State Discourse on Maintaining Momentum for Payment and Delivery System Reform
/in Policy Charts Behavioral/Mental Health and SUD, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Palliative Care, Quality and Measurement, Value-Based Purchasing /by NASHP WritersText
Putting the Evidence to Work for States
/in Policy Oregon, Washington Blogs Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Population Health, Quality and Measurement /by Felicia HeiderEvidence reviews are powerful tools that allow health policymakers to direct resources to certain options that outperform others. Evidence-informed approaches can optimize coverage decisions, increase performance on quality improvement measures, and drive effective responses to major challenges. One way states are utilizing these evidence-informed approaches is in addressing the opioid crisis. The Agency Medical Directors’ […]
Surprise Billing Legislation Passed in 2016
/in Policy Charts Consumer Affordability, Cost, Payment, and Delivery Reform, Health System Costs /by NASHP WritersAs health care costs and consumer out-of-pocket expenses continue to rise, states are paying increasing attention to strategies that address consumer concerns. One issue of focus is the practice of balance or “surprise billing,” the process by which patients receive higher than expected bills from providers, often the result of receiving care out-of-network. In April […]

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