Payment and Delivery Reform
FEATURED ARTICLE
State Community Health Worker Models
/in Policy Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health System Costs, Population Health /by NASHP and Sara Kahn Troster*Chart updated June 5, 2015 As states transform their health systems many are turning to Community Health Workers (CHWs) to tackle some of the most challenging aspects of health improvement, such as facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health. While state definitions vary, CHWs are typically frontline workers […]
The State of State Health Policy: Governors’ 2015 State of the State Addresses
/in Policy Reports Behavioral/Mental Health and SUD, Chronic and Complex Populations, Community Health Workers, Cost, Payment, and Delivery Reform, Health System Costs, Healthy Child Development, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by NASHPGovernors across the nation have laid out their priorities for the coming year as part of their State of the State addresses. NASHP summarizes the 44 addresses given to date. Seven governors discussed health insurance exchanges, 13 health care costs, and nine addressed issues related to a culture of health. Individual governors also addressed issues […]
A Day in the Life of Local Care Coordinator Michele Brown in the CareFirst Patient-Centered Medical Home Program
/in Policy 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, Quality and Measurement /by NASHP StaffDesigning a successful PCMH program involves policy decisions that create new provider and patient expectations, incentives, and infrastructure to support patient-centered care. An integral feature of the CareFirst PCMH program is the development of a care coordination infrastructure at the central, regional, and local level. Much of the work at the local level is done […]
Transforming the Workforce to Provide Better Chronic Care: The Role of Local Care Coordinators at CareFirst
/in Policy District Of Columbia, Maryland, Virginia Reports Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Workforce Capacity /by Mary Takach and Susan ReinhardPart 6 in the Transforming the Workforce to Provide Better Chronic Care: The Role of Registered Nurses series. Click to see the rest of the series. CareFirst, a commercial insurer serving Maryland, northern Virginia, and the District of Columbia, utilizes local nurse care coordinators to support primary care providers within its patient-centered medical home program. […]
Transforming the Workforce to Provide Better Chronic Care: The Role of a Community Health Nurse in a High-Utilizer Program in Oregon
/in Policy Oregon Reports 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 Coverage and Access, Health System Costs, Physical and Behavioral Health Integration, Population Health, Workforce Capacity /by Mary TakachPart 5 in the Transforming the Workforce to Provide Better Chronic Care: The Role of Registered Nurses series. Click to see the rest of the series. Yamhill Community Care Organization (YCCO), one of 16 coordinated care organizations in Oregon, utilizes a community health nurse to manage its Community HUB program, which helps “super-utilizer” patients more […]
A Day in the Life of Community Health Nurse Emily Williamson
/in Policy Oregon 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 Coverage and Access, Health System Costs, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Workforce Capacity /by NASHP StaffDeveloping a coordinated care organization in northwest Oregon’s Yamhill County presented an opportunity to build an organization that reflected the community’s vision for high-quality, more efficient, integrated care for Medicaid beneficiaries. When assessing the needs of the community, it became clear to Yamhill Community Care Organization’s (YCCO’s) Clinical Advisory Panel (CAP) that a small percentage […]
Australian Policymakers Taking Cues from ‘Shark Tank’ on Disruptive Innovation
/in Policy Blogs Cost, Payment, and Delivery Reform, Health System Costs, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Mary TakachWalkabout Medical Homes with Mary Takach: A 10-month Study of Australia January 2015 Many people are familiar with the U.S. television show, Shark Tank, where budding entrepreneurs pitch business ideas to a panel of industry giants or “sharks,” ultimately convincing one or more of them to invest. Imagine taking a similar premise and adopting it as […]
Integrating Community Health Worker Models into Evolving State Health Care Systems
/in Policy 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, Physical and Behavioral Health Integration, Population Health, Safety Net Providers and Rural Health, Workforce Capacity /by NASHPMonday, February 23, 2015 Moderator: CDR Thomas PryorUnited States Public Health Service, Center for Medicare & Medicaid Innovation Project Officer Presenters: Gail Hirsch Director, Office of Community Health Workers, Massachusetts Department of Public Health Kari ArmijoHealth Care Reform Manager, Medical Assistance Division, New Mexico Human Services Department Allie Gayheart Manager of Health Initiatives, South Carolina […]
Medical Homes & Patient-Centered Care Maps
/in Policy Maps Care Coordination, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health System Costs, Maternal, Child, and Adolescent Health, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by adminIdentifying Value in Multi-Payer Reform: The Nuts and Bolts of Quality Measurement
/in Policy Cost, Payment, and Delivery Reform, Health System Costs, Quality and Measurement, Value-Based Purchasing /by NASHP and Tess ShirasStates across the nation are transitioning their health care systems from fee-for-service to payment models that reward quality and positive outcomes. Public and private payers are moving towards paying for value over volume. But, how do states define high quality? What, precisely, are health insurance carriers rewarding? States and federal agencies are developing aligned measure […]
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