Quality and Measurement
FEATURED ARTICLE
Washington’s Medicaid Chief Examines the Future of Medicaid and Health Reforms
/in Policy Washington Blogs 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, Medicaid Expansion, Medicaid Managed Care, Population Health, Quality and Measurement, State Insurance Marketplaces, Value-Based Purchasing /by NASHP WritersMaryAnne Lindeblad oversees Washington State’s Apple Health (Medicaid) program, which serves more than 1.8 million residents. She also chairs the National Academy for State Health Policy’s executive committee and is a National Association of Medicaid Directors board member. Lindeblad took time recently to talk to NASHP about the future of Medicaid and health care reform. […]
How States Can Improve Access to Care for Children Under the Medicaid Managed Care Rule
/in Policy Colorado, Virginia 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, 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, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Kate HonsbergerNext month, states face new federal requirements for establishing and maintaining Medicaid managed care provider networks. As they work to comply with these new rules, states have an opportunity to strengthen access to care for children and youth with special health care needs (CYSHCN). Medicaid and requirements, which address how enrollees access care and the […]
An Early Look at Vermont’s Value-Based, Multi-Payer “Next Gen” Model, Designed to Lower Costs and Improve Population Health
/in Policy Vermont Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Population Health, Quality and Measurement, State Insurance Marketplaces, Total Cost of Care Benchmark, Value-Based Purchasing /by NASHP WritersBy Robin Lunge, JD, MHCDS Robin Lunge is a member of Vermont’s Green Mountain Care Board, which regulates health insurance rates, hospital budgets, and accountable care organizations. In this brief, she explores how the state’s transformation from a fee-for-service payment system to a value-based, multi-payer model designed to curb health care spending and improve care […]
The Roadmap Ahead: New York’s Value-Based Payments Reward Communities and Providers for Addressing the Social Determinants of Health
/in Policy New York Blogs Accountable Health, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health, State Insurance Marketplaces, Value-Based Purchasing /by Amy ClaryMedicaid payment models in many states are shifting away from rewarding providers for the quantity of care they provide to models that reward high-quality, coordinated care that addresses some of the broader social factors that influence health and well-being. One example is New York’s Value-Based Payment (VBP) Roadmap, which rewards Medicaid providers and community-based organizations […]
Ohio Implements Value-Based Payment Reform to Improve Population Health
/in Policy Ohio 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 Equity, Health IT/Data, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Quality and Measurement, Social Determinants of Health, State Insurance Marketplaces, Value-Based Purchasing /by NASHP WritersGreg Moody, director of Ohio’s Office of Health Transformation, has quietly spearheaded one of the most effective redesigns of a state health care payment system in the country, generating cost savings and improving public health by showing providers how the cost and quality of their care compares with their peers. This value-based cost-savings and quality improvement […]
Do You Know What’s Really Driving Up Health Care Costs in Your State? Take This Quiz
/in Policy Blogs Cost, Payment, and Delivery Reform, Health System Costs, Quality and Measurement /by NASHP StaffDo you really know what’s driving up health care costs in the United States? Take this true or false quiz to separate fact from fiction. It’s common knowledge that health care spending in the United States is much higher than in other developed countries, and our out-sized spending doesn’t even help us live longer. A new […]
The Evolving Promise of Delivery System Reform Incentive Programs
/in Policy Blogs Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by Jill RosenthalAmong the transformation initiatives states are undertaking to revamp, strengthen, and sustain their Medicaid delivery systems are provider payment incentives designed to lower costs and improve quality of care and health outcomes. A recent National Academy for State Health Policy (NASHP) report on Delivery System Reform Incentive Payment (DSRIP) programs and similar state incentive programs, […]
State and Federal Officials Explore Ways to Promote Healthy Child Development in a New Era
/in Policy Reports Behavioral/Mental Health and SUD, Care Coordination, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Equity, Health System Costs, Healthy Child Development, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Social Determinants of Health /by Carrie Hanlon and Jill RosenthalThe first years of life significantly impact long-term health and well-being and policymakers have worked hard to create initiatives that help children during this important period. Recently, the National Academy for State Health Policy (NASHP) convened state and federal leaders from agencies serving young children to discuss innovative approaches to advance healthy child development in […]
New Program Helps State Medicaid Programs Close an Immunization Disparity Gap
/in Policy Blogs CHIP, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Healthy Child Development, Immunization, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Megan LentState Medicaid programs play a vital role in protecting public health by ensuring that children receive all of their recommended immunizations. If all children born in 2009 were fully immunized, for example, it would prevent 42,000 early deaths and 20 million cases of disease, while saving the country more than $13.5 billion in direct 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.