Payment and Delivery Reform
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Model Pharmacy Benefit Manager Contract Terms Help States Achieve Prescription Drug Savings
/in Policy Blogs, Featured News Home Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Model Legislation, Prescription Drug Pricing, State Employee Health Plans, State Rx Legislative Action /by Jennifer ReckEighteen Blue Cross Blue Shield Plans Join Civica Rx to Lower Generic Drug Costs
/in Policy California Blogs, Featured News Home Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Prescription Drug Pricing, State Rx Legislative Action /by Trish RileyTwo weeks after California’s governor announced plans to produce generic drugs, 18 national Blue Cross Blue Shield plans said they will join with the non-profit Civica Rx to produce lower-cost generic drugs. As summarized in the National Academy for State Health Policy’s Jan. 13, 2020, blog Can States Really Produce Generic Drugs? The Civica Rx […]
Transforming Systems to Improve Health Upstream: Lessons from Washington’s Accountable Communities of Health
/in Policy Washington Blogs, Featured News Home Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Equity, Health System Costs, Healthy Child Development, Maternal, Child, and Adolescent Health, Oral Health, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Safety Net Providers and Rural Health, Social Determinants of Health /by Amy ClaryFive years ago, Washington State launched a collaborative regional Accountable Communities of Health (ACH) model to improve the health of communities across the state. These ACHs have evolved into independent organizations that are integral to the state’s health system transformation efforts. A 2019 evaluation by the Center for Community Health and Evaluation found this ACH […]
Legislator Q&A: Colorado Enacts Nation’s First Insulin Cost Cap, Requires Attorney General to Investigate Prices
/in Policy Colorado Blogs, Featured News Home Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health System Costs, Newly-Enacted Laws, Population Health, Prescription Drug Pricing, State Rx Legislative Action /by Sarah LanfordCan We Please Stop Fixating on Hospital Chargemasters?
/in Policy Blogs, Featured News Home Cost, Payment, and Delivery Reform, Health System Costs, Hospital/Health System Oversight /by Anya Rader Wallack, Deborah Fournier, Trish Riley and Marilyn BartlettCan States Really Produce Generic Drugs? The Civica Rx Model May Show the Way
/in Policy California Blogs, Featured News Home Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Prescription Drug Pricing, State Rx Legislative Action /by Trish RileyLast week, Gov. Gavin Newsom captured national attention when he announced California’s intention to produce its own generic drugs, building on earlier state efforts. Last year, the governor issued an executive order charging public payers to combine their purchasing power to negotiate better prices, and to eventually expand to include other payers in the state. […]
Kentucky’s Public-Private Initiative Promotes Employment as a Critical Opioid Recovery Tool
/in Policy Kentucky Blogs, Featured News Home Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health System Costs, Population Health, Social Determinants of Health /by NASHP StaffVirginia Advances Integrated Care for Pregnant and Parenting Women with Substance Use Disorder
/in Medicaid Managed Care Virginia Blogs, Featured News Home Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Infant Mortality, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health, Special Populations and Services /by Melissa Caminiti and Ashley HarrellTo tackle the opioid epidemic, which has been the leading cause of unnatural deaths since 2013, Virginia recently developed an integrated physical and behavioral health continuum of care, which spans multiple treatment settings and includes case management and peer recovery support. The initiative, combined with increased access to naloxone and other efforts, has helped reduce […]
New York Recommends Pediatric Preventive Care Improvements in its First 1,000 Days on Medicaid Report
/in Policy New York Blogs, Featured News Home Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home /by Elinor HigginsBy age three, a child’s brain has grown to 80 percent of its adult size and experiences during the first 1,000 days are critical to healthy brain development and social, emotional, cognitive, language, and physical development. Preventive measures taken in the first few years of life can have a significant and lasting impact on a […]
Idaho Develops a Medicaid Value-Based Payment Model for its FQHCs, Based on Cost and Quality
/in Policy Idaho Blogs, Featured News Home Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Safety Net Providers and Rural Health, Social Determinants of Health, Value-Based Purchasing /by Neva KayeStarting in early 2020, Idaho will launch a new value-based payment model that will compensate federally qualified health centers (FQHCs) and other providers based on how much they improve the cost and quality of care delivered to Medicaid enrollees. The agency plans to sign contracts to implement the model in January, with implementation beginning July […]

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