Quality and Measurement
FEATURED ARTICLE
Guest Blog: Massachusetts Report Recommends More Health Care Price Transparency and Simpler Payment Methods
/in Policy Massachusetts Blogs Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Hospital/Health System Oversight, Prescription Drug Pricing, Quality and Measurement, State Rx Legislative Action, Value-Based Purchasing /by Amara Azubuike and Sandra WolitzkyAmara Azubuike and Sandra Wolitzky are assistant attorneys general in the Massachusetts Office of the Attorney General. A new report released in October 2018 by Massachusetts Attorney General Maura Healey finds that complicated and varied methods used to determine health care payment rates contribute to administrative cost increases and make it difficult for market participants […]
As Drug Prices Rise, Oklahoma’s Medicaid Agency Advances Alternative Payment Models
/in Policy Oklahoma Blogs Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by Jennifer ReckEscalating drug prices are forcing state Medicaid agencies to explore new payment models. According to Burl Beasley, director of Pharmacy Services for Oklahoma’s Medicaid program, older Medicaid payment strategies, such as negotiating enhanced rebates and multi-state purchase agreements, are not keeping pace with rising drug expenditures. Beasley cited the strain prescription drug costs were putting […]
Medicaid Alternative Payment Models for Prescription Drugs: Do They Add Value for States?
/in Policy Oklahoma Webinars Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by NASHP WritersWednesday, Dec. 12, 2018 2-3 pm (EST) Listen to the Webinar. Download the Slides. As states struggle with the increasing cost of prescription drugs, they are testing various alternative payment models (APMs). The Oklahoma Health Care Authority is a national leader with four alternative payment models in the form of direct contracts with pharmaceutical manufacturers. […]
How States Use the National Standards for CYSHCN to Strengthen Medicaid Managed Care for Children with Special Health Care Needs
/in Policy Arizona, District Of Columbia, Florida, Georgia, Texas, Virginia, Wisconsin Reports 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, Health Coverage and Access, Integrated Care for Children, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Quality and Measurement /by Hannah Eichner and Kate HonsbergerAbout this Fact Sheet The various state examples outlined here resulted from a 12-month learning collaborative facilitated by NASHP, in partnership with the Association of Maternal & Child Health Programs (AMCHP), with support from the Lucile Packard Foundation for Children’s Health (LPFCH). NASHP and AMCHP convened the learning collaborative academy both virtually and in-person, providing […]
Q&A: How Rhode Island Tackles Social Determinants of Health through its Accountable Entity Model
/in Policy Rhode Island Blogs Accountable Health, Blending and Braiding Funding, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Equity, Health System Costs, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by Elinor HigginsAcross the country, states are launching new payment models that reward quality, promote care integration, improve access, and address the social determinants of health (SDOH) in an effort to improve population health. One of these ground-breaking initiatives is Rhode Island’s Accountable Entity (AE) Program, created to improve the health of Rhode Islanders enrolled in Medicaid […]
New NASHP Tool Identifies Key Quality Measures for Children with Special Health Care Needs
/in Policy Blogs 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, EPSDT, Health Coverage and Access, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Hannah Eichner and Kate HonsbergerQuality measurement is a critical component of state health programs, including Medicaid and State Title V CYSHCN programs that serve children and youth with special health care needs (CYSHCN). While quality measurement for children continues to lag behind that of adults, quality measurement efforts for children overall, and CYSHCN in particular, are gaining greater traction […]
How States Address Social Determinants of Health in their Medicaid Contracts and Contract Guidance Documents
/in Policy Colorado, Delaware, Massachusetts, Michigan, Minnesota, New York, Oregon, Rhode Island, Vermont, Washington Charts Behavioral/Mental Health and SUD, Blending and Braiding Funding, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Health IT/Data, Healthy Child Development, Housing and Health, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by Tina KartikaTo encourage investments in population health, states are increasingly using levers available in their managed care and value-based contracts to address social determinants of health, such as housing and employment. With support from the Robert Wood Johnson Foundation, the National Academy for State Health Policy examined Medicaid contracts and contract guidance documents in 11 states […]
Three-Part Series: Improving Care for People Living with HIV: Opportunities for State Medicaid-Ryan White HIV/AIDS Program Collaboration
/in Policy Illinois, Louisiana, New Jersey, New York, Rhode Island, Wisconsin Reports Administrative Actions, Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, HIV/AIDS, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Prescription Drug Pricing, Quality and Measurement, State Rx Legislative Action /by Lyndsay SanbornStates play critical roles in ensuring that people living with HIV (PLWH) have access to quality care through their Medicaid and Ryan White HIV/AIDS programs. PLWH can be among the most medically complex individuals covered by state health programs, and their care can cost five-times more than the average Medicaid beneficiary. Given limited resources, state […]
Flurry of Bills Targeting the Opioid Epidemic’s Impact on Families Reach Congress
/in Policy Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Healthy Child Development, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Social Determinants of Health, Workforce Capacity /by Miara Handler and Carrie HanlonThe country’s opioid crisis has had a devastating effect on women, children, and families, and continues to strain state health, foster care, and social service agency budgets. A flurry of bills has recently been introduced in Congress to prevent or reduce the effects of the opioid crisis and many directly impact families and children. The […]
How State Medicaid and Title V Partnerships Improve Care for Children with Special Health Care Needs in Medicaid Managed Care
/in Policy 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, EPSDT, Health Coverage and Access, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Hannah Eichner and Kate HonsbergerStates are increasingly utilizing Medicaid managed care (MMC) to serve children and youth with special health care needs (CYSHCN), who often require a complex array of services. Many states are finding that forging partnerships between their MMC systems and Title V CYSHCN programs improves care coordination, transitions from pediatric to adult care systems, quality 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. 
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.