Quality and Measurement
FEATURED ARTICLE
Vermont Takes Next Step in Global Budgeting: Releases All-Payer Model
/in Policy Vermont Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Quality and Measurement /by NASHP StaffWe recently published a brief on efforts underway in Maryland, Massachusetts, and Vermont to develop and implement global budgeting. Last week, Vermont took the next step, releasing an overview of its proposal to the Centers for Medicare & Medicaid Services (CMS) for an all-payer model. Vermont’s approach distinguishes itself by setting spending targets for almost […]
The Kentucky ‘Wrap’: Decreasing Administrative Costs for Medicaid and FQHCs in MCO Payment Reconciliation
/in Policy Kentucky Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Quality and Measurement, Safety Net Providers and Rural Health /by Lesa RairStates that have implemented managed care in their Medicaid programs face the complex and time consuming task of reconciling managed care payments to federally qualified health centers (FQHCs) to ensure they are at, or above, their Prospective Payment System (PPS) rates. Several senior Medicaid officials raised this issue during a recent NASHP meeting on the […]
Addressing and Reducing Health Care Costs in States: Global Budgeting Initiatives in Maryland, Massachusetts, and Vermont
/in Policy Maryland, Massachusetts, Vermont Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Quality and Measurement /by Lesa Rair and Sarabeth ZemelIn the five years since the passage of the Affordable Care Act (ACA), 17 states and the District of Columbia have created health insurance exchanges and 30 states and the District have expanded their Medicaid programs to cover low-income populations. More than 16 million people are newly insured under the law. In addition to expanding health coverage, […]
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 NASHPNASHP’s 2015 Health Policy Year in Review
/in Policy Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Quality and Measurement /by Lesa RairNASHP has long been a key health policy go-to for states, and 2015 was no different. It’s hard to believe it’s only been a year since I rejoined the organization. We began 2015 hearing from governors across the country calling for progress in reducing health care cost growth, discussing state based exchanges, improving behavioral health […]
Health Care Cost Institute Emerging Uses of Claims Data
/in Policy Webinars Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by NASHPPolicy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience
/in Policy Colorado, North Carolina, Oregon Reports Cost, Payment, and Delivery Reform, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Mary TakachA new study looks at how leading states stack up to Australia on organizing primary care. Colorado, North Carolina, and Oregon have implemented regionally based Medicaid-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations and improve the capacity of practices. Several countries with highly ranked delivery systems have implemented similar […]
Population Health Components of State Innovation Model (SIM) Plans: Round 2 Model Testing States
/in Policy Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Rhode Island, Tennessee, Washington Charts Accountable Health, 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, Housing and Health, Long-Term Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by NASHP WritersThe Round Two State Innovation Model (SIM) Test Awards granted by HHS to eleven states (Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Rhode Island, Ohio, Tennessee, and Washington) support state efforts to build multi-payer models of health system transformation. As noted in a previous analysis, population health improvement is an important component of the […]
What’s at Stake for States? The Lines are Drawn in Gobeille v. Liberty Mutual
/in Policy Vermont Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Quality and Measurement, Value-Based Purchasing /by Lesa RairOn December 2nd, the US Supreme Court will take up Gobeille v. Liberty Mutual, a case which could limit states’ ability to collect essential data to advance payment reforms, address cost and quality and assure consumers have information and access to care. At issue is whether or not a state can compel a self-insured employer to […]
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.