Health Coverage and Access
FEATURED ARTICLE
#NASHPCONF18: State Policymakers Share Views on the Evolving Individual Insurance Markets
/in Policy Annual Conference, Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Expansion, State Insurance Marketplaces /by NASHP StaffDuring NASHP’s 31st Annual State Health Policy Conference last week, experts and state officials assessed the dramatic sea changes that recent federal action has imposed on their individual health insurance markets, what they are doing to stabilize them, and what the future holds. Below, NASHP summarizes what panelists said about the current state of their […]
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 […]
Lower-Cost, Short-Term Insurance Plan Approved, But at What Cost to State Markets and Consumers?
/in Policy Blogs Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, Medicaid Expansion, State Insurance Marketplaces /by NASHP StaffLast week, the federal government released its final rule expanding the availability of short-term health insurance plans, which are usually less costly and do not have to cover pre-existing conditions or certain health care services. Increased enrollment in short-term plans is expected to upend states’ individual insurance markets unless states take steps to offset their […]
State Strategies to Incorporate Oral Health into Medicaid Payment and Delivery Models for People with Chronic Medical Conditions
/in Policy Alabama, Missouri, Ohio, Rhode Island, South Dakota, Washington Reports Child Oral Health, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Oral Health /by Amy Clary, Carrie Hanlon and Najeia MentionState health policymakers know oral health is an essential component of overall health and well-being, but state Medicaid programs face increasing costs and growing demands. Many of their enrollees struggle with high-cost, chronic conditions — often linked to oral health issues. To explore possible approaches to improve oral health care, NASHP interviewed key Medicaid officials […]
Overcoming Payment Challenges to Realize the Promise of Telehealth
/in Policy Blogs 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 Managed Care, Physical and Behavioral Health Integration, Population Health, Safety Net Providers and Rural Health /by Johanna ButlerTelehealth– using telecommunications to improve patient care – has the potential to improve health care access and quality, especially in rural and medically-underserved areas. But inconsistent public and private insurance coverage and other challenges have hindered implementation of this promising health care tool. The National Academy for State Health Policy’s (NASHP) Patient-Centered Outcomes Research Workgroup […]
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 […]
Fact and Figures: How Medicaid Covers Behavioral Health Treatment in Children
/in Policy Behavioral/Mental Health and SUD, 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, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home /by Chris KukkaMedicaid pays a large share of treatment costs for children with behavioral health conditions. In 2011, more than 4 million children enrolled in Medicaid had a diagnosed behavioral health condition. The National Academy for State Health Policy (NASHP) has developed an informational fact sheet summarizing Medicaid provisions that cover behavioral health treatment for children. The […]
State Strategies to Prevent and Respond to Disease Crises Through Medicaid and Public Health Partnerships
/in Policy California, Florida, Texas Reports Chronic Disease Prevention and Management, Community Health Workers, Health Coverage and Access, Health Equity, Population Health, Safety Net Providers and Rural Health, Social Determinants of Health, Workforce Capacity /by Tina KartikaProtecting public health in an era when infections can quickly spread from remote areas to major world cities requires creative and well-orchestrated responses from national, state, and local governments. One of the critical partnerships states can forge before, during, and after such crises is between public health and Medicaid. This report, supported by the Health […]
State Officials Work to Harness Medicaid as a Change Agent to Increase Immunization Rates
/in Policy Blogs CHIP, CHIP, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Healthy Child Development, Immunization, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Social Determinants of Health /by Megan Lent, Tina Kartika and Jill RosenthalDespite vaccines’ effectiveness in preventing infectious diseases and strong public funding for childhood immunizations, vaccination rates among children living in poverty remain stubbornly lower than for children living above poverty and who are privately insured. Recently, officials from several organizations, including the National Academy for State Health Policy (NASHP), AcademyHealth, and the Colorado Children’s Immunization […]
Federal Suspension of Risk Adjustment Payments Delivers Another Hit to State Exchanges
/in Policy Blogs Eligibility and Enrollment, Health Coverage and Access, Medicaid Expansion, State Insurance Marketplaces /by NASHP StaffThe latest challenge to the Affordable Care Act (ACA) and the stability of states’ individual markets came on July 7, 2018, when the Centers for Medicare & Medicaid Services (CMS) announced it would stop issuing risk adjustment payments pending the outcome of a challenge to the ACA program in the US District Court in New […]
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. 
Rhode Island Looks to Auto-Enrollment to Ease Transitions from Medicaid to Marketplace
/in Health Coverage and Access, Policy Rhode Island Blogs, Featured News Home State Insurance Marketplaces /by Gia Gould and Maureen Hensley-Quinn