Quality and Measurement
FEATURED ARTICLE
New PBM Laws Reflect States’ Targeted Approaches to Curb Prescription Drug Costs
/in Policy Blogs Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Model Legislation, Prescription Drug Pricing, Quality and Measurement, State Rx Legislative Action /by Sarah Lanford and Maureen Hensley-QuinnIn 2019, states built on the momentum that had been gaining in recent years and passed targeted legislation to address the role harmful pharmacy benefit manager (PBM) business practices play in escalating prescription drug prices. The laws supporting these approaches, described below, give states enforcement mechanisms to ensure that the discounts that PBMs recoup are […]
Oklahoma Promotes Healthy Child Development through Increased Well-Child Visits and Screenings Using Innovative Funding
/in Policy Oklahoma Reports Care Coordination, Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, EPSDT, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Megan LentTen States Selected to Attend Palliative Care Summit in Chicago
/in Policy Arizona, Colorado, Hawaii, Kentucky, Massachusetts, Minnesota, Ohio, Oklahoma, Pennsylvania, Texas Blogs, Featured News Home Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Long-Term Care, Medicaid Managed Care, Medicaid Managed Care, Palliative Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by NASHP WritersNASHP is pleased to announce the 10 states selected to attend the State Policymakers Palliative Care Summit, supported by a grant from The John A. Hartford Foundation. Policymakers, including legislators as well as Medicaid and public health officials from Arizona, Colorado, Hawaii, Kentucky, Massachusetts, Minnesota, Ohio, Oklahoma, Pennsylvania, and Texas, will participate in the day-long […]
NASHP Awarded New Grant on Family Caregiving from The John A Hartford Foundation
/in The RAISE Act Family Caregiver Resource and Dissemination Center Blogs Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Council Meeting Materials and Resources, Housing and Health, Long-Term Care, Medicaid Managed Care, Medicaid Managed Care, Palliative Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, The RAISE Family Caregiver Resource and Dissemination Center /by NASHP WritersNASHP has been awarded a three-year grant from The John A. Hartford Foundation to develop a comprehensive resource and dissemination center on family caregiving. The grant will fund NASHP’s RAISE Act Family Caregiver Resource and Dissemination Center, a national focal point for resources, technical assistance, and policy analysis for states and the broader community of […]
A New State Tool to Manage Drug Costs: Experts Share Insights into Outcome-Based Contracts for Medicaid Pharmacy Claims
/in Policy Colorado, Michigan, Oklahoma Blogs Administrative Actions, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Medicaid Managed Care, Population Health, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by Jennifer ReckColorado and Michigan have joined Oklahoma to become the nation’s pioneering states with approved State Plan Amendments (SPAs) that enable Medicaid alternative payment models (APMs) for prescription drugs in the form of outcome-based contracts with pharmaceutical manufacturers. In early May, state experts from Oklahoma, Colorado, and Michigan shared their experiences implementing their APMs during a […]
Vermont Uses an Accountable Care Organization Model to Promote Developmental Screenings during Well-Child Visits
/in Policy Vermont Reports Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Safety Net Providers and Rural Health, State Insurance Marketplaces, Value-Based Purchasing /by Megan Lent and Carrie HanlonWithout early identification and treatment of development delays, children may face long-lasting and costly consequences. With more states reporting their developmental screening Child Core Set measures and new federal initiatives promoting value-based payment for children’s health, Vermont’s innovative affordable care organization’s approach can provide valuable insights. This fact sheet describes Vermont’s strategy to prioritize developmental […]
State Policy Levers for Advancing Quality Improvements in Primary Care
/in Policy Reports Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Johanna Butler, Christina Cousart and Jennifer ReckStates, as major purchasers of health care, have a compelling interest to spur primary care providers to adopt the latest research to improve the quality and cost-effectiveness of care. This new report, the third in the EvidenceNOW: Insights for State Health Policymakers Series, highlights policy levers states can use to support the adoption of evidence-based […]
Colorado Develops New Payment Method for Physician-Administered Drugs – with the Potential to Save Millions
/in Policy Colorado Blogs Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Prescription Drug Pricing, Quality and Measurement /by Johanna Butler and Jennifer ReckThe National Academy for State Health Policy (NASHP) provided a grant to the Colorado Department of Health Care Policy and Financing to develop a new payment methodology for physician-administered drugs (PADs). PADs are drugs delivered by intravenous infusion or injection in clinical settings. The category includes costly drugs, such as chemotherapy and other specialty medications. […]
States Use Policy Levers and Emerging Research to Address Antipsychotic Use in Children in Foster Care
/in Policy Reports Behavioral/Mental Health and SUD, Children/Youth with Special Health Care Needs, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, EPSDT, Health Coverage and Access, Health Equity, Health System Costs, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement /by Johanna Butler, Jennifer Reck and Maureen Hensley-QuinnState policymakers must often take action during an emerging crisis even when evidence identifying the best policy approach is not be available. This report, Evidence-Based Policymaking Is an Iterative Process: A Case Study of Antipsychotic Use among Children in the Foster Care System, explores successful state responses to dramatic increases in antipsychotic prescription rates in Medicaid-enrolled children […]
CMS Releases State Funding to Improve Integrated Care for Children and Pregnant and Postpartum Women Enrolled in Medicaid and CHIP
/in Policy Blogs Behavioral/Mental Health and SUD, Care Coordination, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Infant Mortality, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by NASHP WritersLast week, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated initiatives — the Maternal Opioid Misuse (MOM) Model and the Integrated Care for Kids (InCK) Model — which will provide multi-year funding to states to improve integrated care for maternal and child health populations enrolled in Medicaid and the Children’s Health […]
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.