Payment and Delivery Reform
FEATURED ARTICLE
Building a More Efficient Marketplace: Lessons from DC Health Link’s Experience with Open Source Code
/in Policy Reports Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health IT/Data, Health System Costs, State Insurance Marketplaces /by NASHP WritersEvery open enrollment affords the health insurance marketplaces new opportunities to introduce innovative ways to improve their systems while lowering costs. For the 2015-16 open enrollment season, DC Health Link, Washington DC’s health insurance marketplace, levied such an opportunity by transferring their marketplace onto a new open source code solution. Agile, efficient, and cost effective, […]
Understanding Medicaid Claims and Encounter Data and their Use in Payment Reform
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Quality and Measurement /by NASHP WritersStates across the country are fully engaged in delivery system and payment reform efforts to improve care and lower costs in their Medicaid programs. Data is a critical component of these efforts. This NASHP brief provides an introduction to two types of Medicaid utilization data—fee-for-service claims data and managed care encounter data—and, based on examples […]
All Eyes on Michigan: Will Assessments on All Health Plans Survive
/in Policy Michigan Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Quality and Measurement /by Lesa Rair and Tamara KramerOn Monday, the United States Supreme Court sent back a Michigan case for a new finding that could forbid state assessments on self funded plans. The Supreme Court told the Sixth Circuit to reconsider its ruling that a Michigan health insurance tax was not preempted by the Employee Retirement Income Security Act (ERISA) in light of the Supreme Court’s decision […]
Value-Based Payment Reform Academy – Frequently Asked Questions
/in Policy Cost, Payment, and Delivery Reform, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by NASHP StaffTechnical Assistance How many hours of technical assistance can a state receive? NASHP does not place restrictions on technical assistance. In addition to the individual monthly calls for each state team, each team will have ongoing access to NASHP staff who can provide technical assistance or connect states with external faculty in response to state […]
Massachusetts Becomes First State to Pass Statewide Cap on First-Time Opioid Prescriptions
/in Policy Massachusetts Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement /by NASHP WritersEarlier this year, Massachusetts Governor Charlie Baker discussed his state’s opioid epidemic during his State of the Commonwealth Address. Less than two months later, on March 14, he signed omnibus legislation designed to tackle the epidemic head-on. Chapter 52 of the Acts of 2016 contains a wide range of provisions, however one specific provision is […]
Gobeille v. Liberty Mutual: Decision
/in Policy Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Quality and Measurement /by NASHP WritersIn a 6-2 decision released today, the U.S. Supreme Court has dealt a blow to state all- payer claims databases. By upholding a lower court’s decision, the Court ruled that states may no longer require self funded plans to submit claims data – that action is preempted by ERISA. In its decision in Gobeille v. Liberty […]
Proposed Rule on Confidentiality of Substance Use Information Released
/in Policy Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Physical and Behavioral Health Integration /by NASHP WritersOn February 9th, 2016, Health and Human Services Department released long-awaited proposed rules on 42 CFR Part 2, the federal regulation that governs how federally-funded substance use disorder (SUD) programs may share health information; public comments are due on April 11th. The proposed changes to 42 CFR Part 2 would, among other things, make it […]
Value-Based Payment Academy: Advancing Value-Based Payment Methodologies for Federally Qualified Health Centers and Rural Health Clinics
/in Policy Cost, Payment, and Delivery Reform, Health System Costs, Value-Based Purchasing /by NASHP StaffCongratulations to the six states selected to participate in the NASHP Value-Based Payment Reform Academy: Colorado Hawaii Michigan Nevada Oklahoma Washington, DC NASHP is pleased to announce it is convening a Value-Based Payment Reform Academy. The goal of this academy is for selected states to develop and implement value-based alternative payment methodologies (APMs) for federally […]
State Health Policy Grant Program Briefs Released
/in Policy Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs /by NASHP StaffSix briefs developed through the State Health Policy Grant Program, a partnership with the Health Care Cost Institute (HCCI) and NASHP; to evaluate and report on state health policy initiatives were released February 25, 2016. The grant program was funded by a $1.5 million grant from the Laura and John Arnold Foundation. The six policy […]
Gobeille v. Liberty Mutual: Everything You Need to Know
/in Policy Vermont Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs /by NASHP StaffIn a 6-2 decision in Gobeille v. Liberty Mutual released on March 1, the U.S. Supreme Court has dealt a blow to state all- payer claims databases. By upholding a lower court’s decision, the Court ruled that states may no longer require self funded plans to submit claims data – that action is preempted by ERISA. […]

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