Quality and Measurement
FEATURED ARTICLE
Lessons from States on Advancing Evidence-based State Health Policymaking for the Effective Stewardship of Healthcare Resources
/in Policy Alabama, Colorado, Massachusetts, Minnesota, Oregon, Washington Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Quality and Measurement /by Felicia HeiderAn evidence-based approach to policymaking enables states to direct health care resources toward the clinical care and health service delivery models most likely to deliver the results state health policymakers seek: better health outcomes through the efficient stewardship of public funds. As states face changing priorities and rising health care costs there is additional pressure […]
The New Substance Use Disorder Confidentiality Rules: A Work in Progress
/in Policy Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health System Costs, Population Health, Quality and Measurement /by Liz McCamanThe Substance Abuse and Mental Health Services Administration (SAMHSA) recently issued a highly anticipated update to 42 CFR Part 2, the regulation that governs sharing patient information by federally-designated substance use disorder (SUD) providers. The rule is timely: SUD has become a major cost driver, and many state policymakers are focused on the integration of […]
Delaware and Georgia Use Innovative Strategies to Promote Women’s Health in Medicaid
/in Policy Delaware, Georgia Blogs CHIP, CHIP, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Health System Costs, Healthy Child Development, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Population Health, Quality and Measurement /by Liz McCamanUnplanned pregnancies present a challenge for many women, their families and communities, and are associated with a number of costly health outcomes, including delayed prenatal care, premature birth and low birth weight. Federal initiatives like the Collaborative Improvement & Innovation Network to Reduce Infant Mortality (IM CoIIN) have helped to engage state leaders in efforts […]
Using Evidence to Achieve Effective State Health Policy
/in Policy Webinars Cost, Payment, and Delivery Reform, Health System Costs, Quality and Measurement /by Olivia BaconCMS Seeks Input on State Innovations in Pediatric Alternative Payment Models
/in Policy Blogs CHIP, CHIP, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Quality and Measurement /by NASHP StaffHealth care delivery system innovations in Medicaid have primarily focused on adult populations as states seek to improve the quality of care and control costs for beneficiaries with chronic and complex health care needs. Many innovations in child-serving systems have been integrated into broader state reforms for adults and through Centers for Medicaid and Medicare […]
Integrating Substance Use Disorder Treatment and Primary Care
/in Policy Reports Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Hannah Dorr and Charles TownleyAs the largest payers of substance use disorder treatment services, states have a significant incentive to ensure that their residents have access to a health care system that efficiently and effectively identifies and addresses substance use treatment needs. However, national survey data shows that most individuals with an alcohol or opioid use disorder do not […]
New Report Shows Increase in ED Utilizations for Behavioral Health – What States Can Do
/in Policy Delaware, Oregon, Washington Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Social Determinants of Health /by Jenna BluesteinThe Agency for HealthCare Research and Quality (AHRQ) released an eye-opening study this past week, indicating that utilization of emergency department (ED) services due to behavioral health conditions increased sharply from 2006 to 2013. The brief “Trends in Emergency Department Visits Involving Mental and Substance Use Disorders,” highlights a 52 percent increase in ED utilization […]
Measuring Physical and Behavioral Health Integration: A Look at State Approaches in the Context of Value-Based Purchasing
/in Policy Reports Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Physical and Behavioral Health Integration, Quality and Measurement, Value-Based Purchasing /by Lesa Rair and Rachel DonlonThe case for an integrated approach to care—one that can seamlessly and collaboratively address patients’ physical and behavioral health needs—is compelling. Individuals with behavioral health conditions, either a mental health diagnosis, a substance use disorder, or both, are some of the Medicaid’s most costly enrollees.[i] Analyses indicate this subset of high-cost enrollees typically has a […]
Federal and State Collaboration for Medicare-Medicaid Alignment
/in Policy California, Colorado, Illinois, Maryland, Massachusetts, Michigan, New York, Ohio, Rhode Island, South Carolina, Texas, Virginia, Washington Reports Care Coordination, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Long-Term Care, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Quality and Measurement, State Insurance Marketplaces /by Jenn JensonNASHP recently brought together a group of state and federal policy leaders to discuss the Medicare-Medicaid Financial Alignment Initiative, D-SNP health plans, and other programs and resources aimed at aligning health care payment and delivery to improve care for dual eligibles. See a report from the meeting and sign up for a webinar on state […]
A Federal-State Discourse on Maintaining Momentum for Payment and Delivery System Reform
/in Policy Reports Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by StaffStates and the federal government have been undertaking an almost bewildering array of policy initiatives and experiments in an effort to improve value and reduce costs in the health care system. What are we accomplishing and learning from these efforts? And what’s needed to sustain and advance the most promising strategies? In July 2016, a group […]
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. 
Hospital Transparency: State Efforts Reveal More Comprehensive Financial Data than Current Federal Requirements
/in Health System Costs Blogs, Featured News Home Consumer Affordability, Cost, Payment, and Delivery Reform, Health System Costs, Hospital/Health System Oversight, Making the Case for Action, Quality and Measurement, Value-Based Purchasing /by Amanda Attiya and Maureen Hensley-QuinnFederal efforts to increase hospital price transparency are falling short as hospitals fail to fully comply with requirements. However, states with transparency laws that give them access to comprehensive hospital financial data are using the pricing information to more fully analyze hospitals’ fiscal health and inform states’ cost containment efforts.