Value-Based Purchasing
FEATURED ARTICLE
FQHC Readiness and Practice Transformation Strategies
/in Policy Toolkits Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Value-Based Purchasing Physical and Behavioral Health Integration /by NASHP StaffThe National Academy for State Health Policy (NASHP) designed this toolkit to support states interested in developing a value-based alternative payment methodology (APM) for federally qualified health centers (FQHCs). The following section on FQHC readiness and practice transformation discusses key considerations and promising strategies based on lessons learned from states during NASHP’s Value-Based Payment Reform […]
Policy Levers to Develop Value-Based Payment Models for FQHCs
/in Policy Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Value-Based Purchasing /by NASHP StaffThe National Academy for State Health Policy (NASHP) designed this tool kit to support states interested in developing a value-based alternative payment methodology (APM) for federally qualified health centers (FQHCs). The following section on state policy levers for implementation discusses key considerations and promising strategies based on lessons learned from states during NASHP’s Value-Based Payment […]
FQHC Value-Based Alternative Payment Methodologies
/in Policy Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Value-Based Purchasing /by NASHP StaffThe National Academy for State Health Policy (NASHP) designed this toolkit to support states interested in developing a value-based alternative payment methodology (APM) for federally qualified health centers (FQHCs). The following section on value-based APM development discusses key considerations and promising strategies based on lessons learned from states during NASHP’s Value-Based Payment Reform Academy. Key […]
FQHC Measurement and Reporting for Alternative Payment Methodologies
/in Policy Colorado, Hawaii, Michigan, Minnesota, Nevada, Oklahoma, Oregon, Washington Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health IT/Data, Health System Costs, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Value-Based Purchasing /by NASHP StaffThe National Academy for State Health Policy (NASHP) designed this toolkit to support states interested in developing a value-based alternative payment methodology (APM) for federally qualified health centers (FQHCs). The following section on measuring performance discusses key considerations and promising strategies based on lessons learned from states during NASHP’s Value-Based Payment Reform Academy. Types of […]
States Work to Improve Care for Children with Special Health Needs with Quality Measurement
/in Policy Michigan, New York, Texas Reports Care Coordination, Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health System Costs, Healthy Child Development, Integrated Care for Children, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Value-Based Purchasing /by Anisha Agrawal, Becky Normile and Karen VanLandeghemImproving the quality of care that children and youth with special health care needs (CYSHCN) receive is a growing priority for state Medicaid programs. However, many quality improvement efforts are in their infancy as states work to overcome the challenges of measuring and assessing care quality for this vulnerable population. NASHP, with support from the […]
New Federal Guidance Aims to Streamline Section 1115 Demonstration and 1915 Waivers and State Plan Amendments Processes
/in Policy Blogs Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by NASHP StaffOn Monday, the Centers for Medicare & Medicaid Services (CMS) released two informational bulletins detailing a new, streamlined approach for the review and management of Section 1115 demonstrations and state plan amendments and 1915 waivers. The streamlined approach, which CMS promised to undertake last March, is significant for states because it may enhance their ability […]
Proposed Rules Give States Flexibility to Change Essential Health Benefits, and More
/in Policy Blogs Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Quality and Measurement, State Insurance Marketplaces, Value-Based Purchasing /by Christina CousartThe US Department of Health and Human Services (HHS) recently released proposed changes in its annual the rule that governs standards for issuers and the health insurance marketplaces. The annual notice is one of the most significant tools the Administration wields in shaping the health insurance markets and this proposed notice carries significant implications for […]
Community Health Worker Resources for States
/in Policy Minnesota, New York, Utah Reports Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health Equity, Health System Costs, Long-Term Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Social Determinants of Health, Value-Based Purchasing /by Tina KartikaAs states transform their health systems, many are turning to community health workers (CHWs) to improve health outcomes and access to care, address social determinants of health, and help control costs of care. While state definitions vary, CHWs are typically frontline workers who are trusted members of and/or have a unique and intimate understanding of […]
State Medicaid Payment Reform Strategies Promote Improved Birth Outcomes
/in Policy Oklahoma, Tennessee, Wisconsin Blogs Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health System Costs, Healthy Child Development, Infant Mortality, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Value-Based Purchasing /by Derica Smith and Carrie HanlonImproving birth outcomes, including reducing infant mortality, is a priority for state Medicaid agencies that finance nearly half of all births each year. Three states have proven to be creative and effective laboratories in developing initiatives that use Medicaid payment and delivery reform strategies to lower costs, improve access to postpartum care, reward high-quality care, […]
Engaging Stakeholders in FQHC Value-Based Alternative Payment Methodologies
/in Policy Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Value-Based Purchasing /by NASHP StaffThe National Academy for State Health Policy (NASHP) designed this toolkit to support states interested in developing a value-based alternative payment methodology (APM) for federally qualified health centers (FQHCs). The following section on stakeholder engagement discusses key considerations and promising strategies based on lessons learned from states during NASHP’s Value-Based Payment Reform Academy. Key considerations […]
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. 
Independent Analysis Finds Montana Has Saved Millions by Moving Hospital Rate Negotiations to Reference-Based Pricing
/in Policy Montana Blogs, Featured News Home Consumer Affordability, Cost, Payment, and Delivery Reform, Health System Costs, Hospital/Health System Oversight, Making the Case for Action, State Employee Health Plans, Value-Based Purchasing /by Johanna ButlerA new, independent analysis of the Montana state employee health plan’s transition to reference-based pricing – which limits hospital prices to a multiple of what Medicare pays – found significant savings for the state in the two years after its implementation. Further, there is no evidence that utilization artificially increased as a result of the new payment […]