Payment and Delivery Reform
FEATURED ARTICLE
Building a statewide support system to transform primary care
/in Policy Blogs Cost, Payment, and Delivery Reform /by NASHP StaffBy Jill Rosenthal June 2012 North Carolina’s success in developing a statewide infrastructure that supports a robust primary care system has resulted in better health outcomes, lower cost, and a new way of organizing and improving health in the state. This success is due largely to its ability to synchronize and align initiatives within the […]
Implementing Section 2703 Health Homes: Lessons from Leading States
/in Policy Webinars Chronic and Complex Populations, Cost, Payment, and Delivery Reform /by NASHPSection 2703 of the Affordable Care Act provides states with an enticing opportunity to provide health homes for chronically ill Medicaid enrollees. States are able to draw an enhanced federal match to integrate primary care with behavioral health and long-term services and supports for two years. Join Melinda Abrams of The Commonwealth Fund and state […]
National Organizations of State and Local Officials (NOSLO) Cooperative Agreement
/in Policy Cost, Payment, and Delivery Reform, Health Coverage and Access /by NASHPIn 2011, NASHP was awarded a National Organizations of State and Local Officials (NOSLO) national cooperative agreement with the federal Health Resources and Services Administration (HRSA). By facilitating collaboration between Medicaid agencies and the safety net, the NOSLO cooperative agreement, which builds on NASHP’s prior work with HRSA (see Community Health Centers), aims to support […]
lmplications of Health Care Competition for Cost, Choice, Quality, and Innovation: The Role of Antitrust Policy Prepared
/in Policy Reports Cost, Payment, and Delivery Reform /by NASHPThe US. health care environment is changing rapidly. As employers and public agencies have tried to control spending, more health care is provided through managed care organizations. This approach to delivering care has reduced hospital use and led to thousands of empty beds. It also has spurred provider collaboration, for example through hospital mergers, physician […]
Managed Care for Dually Eligible Beneficiaries: Key Program Design Choices for States
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform /by NASHPThis is the third and final in a series of papers on dual eligibility supported by The Pew Charitable Trusts, with additional support from The Henry ]. Kaiser Family Foundation, Center for Vulnerable Populations. The first paper, Managiiig Care for Older Beneficiaries of Medicaid and Medicare: Prospects and Pitfalls (September, 1994), describes the fragmentation of […]
Managed Care, Medicaid and the Elderly: The Florida Experience
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform /by NASHPIncreasingly, states are turning to managed care to deliver health services to Medicaid recipients. In a 1994 survey of states conducted by the National Academy for State Health Policy, 16 states reported that they enroll elders in Medicaid managed care programs. A few states (Arizona, Minnesota, Oregon, Tennessee, Utah) require mandatory enrollment and others allow […]
Managed Care, Medicaid and the Elderly: Five State Case Studies
/in Policy Reports Cost, Payment, and Delivery Reform, Health Coverage and Access /by NASHPIncreasingly, states are turning to managed care to deliver health services to Medicaid recipients. In a 1994 survey of states conducted by the National Academy for State Health Policy, 16 states reported that they enroll elders in Medicaid managed care programs. A few states (Arizona, Minnesota, Oregon, Tennessee, Utah) require mandatory enrollment and others allow […]
Managed Care for the Elderly: A Profile of Current Initiatives
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform /by NASHPThe purpose of this document is to summarize the current state-of-the-art in managed care for the elderly and to provide states with background information needed to launch their own initiatives to provide quality, cost effective care to the rapidly aging population. As you will see, attempts to truly coordinate primary, preventive, acute, and long term […]
Public Managed Care for Older Persons and Persons with Disabilities
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform /by NASHPMajor Issues and Selected Initiatives Interest in managed care for older persons and persons with disabilities has intensified in recent years, as states and the federal government have searched for ways to make publicly funded programs more effective and less costly. The heightened interest has stimulated a lively debate among consumers, policy makers, advocates and […]
Reducing the Cost of Institutional Care: Downsizing, Diversion, Closing and Conversion of Nursing Homes
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform /by NASHPMedicaid today pays for 41% of the nation’s long term care bill. Most of that spending (85%) is on institutions. As the Congress grapples with efforts to reduce Federal expenditures and balance the budget, the Medicaid program and its investment in long term care are particularly vulnerable to cuts. Indeed, Medicaid comprises nearly half of […]

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