Value-Based Purchasing
FEATURED ARTICLE
It Is Time for a Thoughtful, Bipartisan Discussion About What Kind of Health Care America Wants
/in Policy Blogs Cost, Payment, and Delivery Reform, Health System Costs, Quality and Measurement, Value-Based Purchasing /by Trish RileyThe Graham-Cassidy amendment represented a radical overhaul of how health care coverage is financed and delivered, raising anew the question of federalism – what should the federal government guarantee and how much state variation should be supported? The legislation tossed most critical health care coverage and policy decisions to states without giving them sufficient time or […]
SIM Round One Test States Expand Value-Based Payments in Medicaid, and in Some Cases, Beyond
/in Policy Maine, Minnesota, Vermont Blogs Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by Jennifer ReckThe Centers for Medicare & Medicaid Services (CMS) recently released its third annual evaluation of the State Innovation Model (SIM) Round One Test States, which analyzes the ability of states to use policy and regulatory levers to drive statewide health care transformation. The evaluation, completed by a team of researchers from RTI International, the Urban […]
State Medicaid Agencies Venture into Value-Based Purchasing with Federally Qualified Health Centers
/in Policy Colorado, Hawaii, Michigan, Nevada, Oklahoma Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Value-Based Purchasing /by Rachel DonlonState Medicaid agencies have generally found it challenging to include federally qualified health centers (FQHCs) in value-based purchasing initiatives because of a federal law passed in 2000 that regulates how state Medicaid programs pay FQHCs for the care they provide. State Medicaid agencies are required to reimburse FQHCs through the Prospective Payment System (PPS), a […]
Webinar: Value-Based Alternative Payment Methodologies for Federally Qualified Health Centers: Lessons from Colorado and Minnesota
/in Policy Webinars Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Safety Net Providers and Rural Health, Value-Based Purchasing /by Hannah Dorr and Rachel DonlonMeasuring Physical and Behavioral Health Integration: A Look at State Approaches in the Context of Value-Based Purchasing
/in Policy Reports Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Physical and Behavioral Health Integration, Quality and Measurement, Value-Based Purchasing /by Lesa Rair and Rachel DonlonThe case for an integrated approach to care—one that can seamlessly and collaboratively address patients’ physical and behavioral health needs—is compelling. Individuals with behavioral health conditions, either a mental health diagnosis, a substance use disorder, or both, are some of the Medicaid’s most costly enrollees.[i] Analyses indicate this subset of high-cost enrollees typically has a […]
Webinar: Measuring Physical and Behavioral Health Integration in the Context of Value-Based Purchasing
/in Policy Webinars Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Value-Based Purchasing /by NASHP StaffState Leaders Convened for National Issues Teleconference
/in Policy Blogs CHIP, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Expansion, State Insurance Marketplaces, Value-Based Purchasing /by Lesa RairFollowing on the heels of our Leader’s Summit, held in October, last night NASHP convened our Academy members in a national issues forum teleconference to update each other and discuss emerging concerns and opportunities. From that discussion, several themes emerged: The uncertainty of policy direction confounds states and markets and leads to instability As policy […]
How Health System Transformation Efforts are Improving Access to Care for Children and Youth
/in Policy Massachusetts, New York, Ohio Blogs Care Coordination, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Value-Based Purchasing /by NASHP WritersStates are rapidly undertaking major reforms within their health care delivery systems. Though not often specifically targeting children and youth, these reforms offer opportunities to positively impact how this population accesses care. In a recent NASHP webinar several states described how their health system transformation efforts are doing so. Massachusetts State Innovation Model Grant: Massachusetts […]
A Federal-State Discourse on Maintaining Momentum for Payment and Delivery System Reform
/in Policy Reports Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement, Value-Based Purchasing /by StaffStates and the federal government have been undertaking an almost bewildering array of policy initiatives and experiments in an effort to improve value and reduce costs in the health care system. What are we accomplishing and learning from these efforts? And what’s needed to sustain and advance the most promising strategies? In July 2016, a group […]
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 […]