Payment and Delivery Reform
FEATURED ARTICLE
Kansas – Medical Homes
/in Policy Kansas Cost, Payment, and Delivery Reform, Health System Costs, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Medical HomesIn 2007, the Kansas Health Policy Authority (KHPA) (now known as the Kansas Division of Health Care Finance) delivered a comprehensive health reform plan to the Legislature and the Governor intended to improve health in Kansas. A key component of the plan was promotion of the medical home model. In 2008, Kansas lawmakers demonstrated support […]
State Experiences Designing and Implementing Medicaid Delivery System Reform Incentive Payment (DSRIP) Pools
/in Policy Reports Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Primary Care/Patient-Centered/Health Home, Quality and Measurement, State Insurance Marketplaces /by Neva KayeSeveral states are operating DSRIP programs through their Medicaid programs under the authority of Section 1115 demonstrations. These programs incentivize system transformation and quality improvements in hospitals and other providers serving high volumes of low-income patients. This report, prepared by NASHP staff, for the Medicaid and CHIP Payment and Access Commission (MACPAC), provides an in-depth […]
Transition Team Bridge Inpatient to Outpatient Mental Health Services for Complex Mentally Ill
/in Policy Oregon Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Long-Term Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home /by Mary TakachIn my previous “Walkabout Medical Home” blog posts I have highlighted the work Primary Health Care Organizations (PHCOs) in Australia (Medicare Locals) have done to connect people with mild to moderate mental health diagnoses to primary care or community-based services. This blog highlights the innovative work being done stateside by Oregon’s Health Share. Health Share […]
Four Tips from States on Integrating Maternal and Child Health Data Systems
/in Policy Blogs Cost, Payment, and Delivery Reform, Maternal, Child, and Adolescent Health /by NASHPWhat happens when state health programs use separate data systems to serve the same population, such as mothers and children? State policymakers know that when those data systems do not “talk” to one another, states may waste resources on duplicative data entry and system maintenance; providers and state agencies may struggle to access information important […]
Conducting the Orchestra of Multi-Payer Payment Reform: Achieving Harmony in Arkansas and Vermont
/in Policy Arkansas, Vermont Blogs Care Coordination, Chronic and Complex Populations, Community Health Workers, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home /by NASHP, Tess Shiras and Anne GauthierImagine an orchestra filled with providers and plans each playing its own tune to move towards value-based payment to incentivize better care and health. Alone, each tune is recognizable. But without working together, cacophony abounds. Enter the state as conductor and participant in aligned multi-payer payment reform, and sweet sounds emerge. If it only happened […]
Don’t Take Your Eyes Off Vermont: Gobeille v. Liberty Mutual Insurance Company
/in Policy Vermont Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Quality and Measurement, State Insurance Marketplaces /by NASHP and Alice WeissOkay, maybe as a California colleague suggests, it’s one of the “boutique states” and yes, its single payer plan stumbled, but don’t take your eyes off Vermont. Vermont is at work to hold down costs and reform payment and delivery systems. The Green Mountain Care Board (GMCB) is engaged in comprehensive efforts to control health […]
Community Health Worker Models in Evolving State Health Care Systems
/in Policy Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health System Costs, Long-Term Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home /by Jackie LeGrandCommunity health workers (CHWs) are often employed to improve health equity, cultural competency, health literacy and access to care, among other issues. Because they have such varied roles, there are many definitions of CHWs; however, they are commonly identified by their in-depth understanding of the population they serve. On a recent State Refor(u)m webinar, speakers […]
Community Health Worker Models in Evolving State Health Care Systems
/in Policy Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health Equity, Health System Costs, Long-Term Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home /by NASHP and Jackie LeGrandCommunity health workers (CHWs) are often employed to improve health equity, cultural competency, health literacy and access to care, among other issues. Because they have such varied roles, there are many definitions of CHWs; however, they are commonly identified by their in-depth understanding of the population they serve. On a recent State Refor(u)m webinar, speakers […]
States Use Technology to Go the Distance for Rural Populations
/in Policy Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Safety Net Providers and Rural Health /by NASHP and Kaitlin SheedyStates with large rural populations face unique challenges in ensuring access to care. While approximately 16 percent of the U.S. population lives in rural America, only about 11 percent of physicians practice in rural locations. Additionally, individuals in rural areas face long travel distances to see primary care providers and specialists. Many states are using […]
Shaking Up the Delivery of Traditional Mental Health Services
/in Policy Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Workforce Capacity /by Mary TakachSeveral primary health care organizations (PHCOs) that I have spoken with in the states and in Australia during my 10-month fellowship have established a central referral point or “one stop shop” to help primary care practices connect their patients to community-based mental health and/or substance abuse services. These referral centers can take the load off […]
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