Health Coverage and Access
FEATURED ARTICLE
Strategies to Increase Access to Long-Acting Reversible Contraception (LARC) in Medicaid
/in Policy Reports Essential Health Benefits, Health Coverage and Access, Health Equity, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Population Health /by Tamara KramerThis issue brief, developed by NASHP and NICHQ, details the use of LARC in preventing unplanned pregnancies, the current availability and education for women, barriers to prescribing LARC, and potential Medicaid reimbursement models to improve LARC access. The issue brief was developed as part of the Collaborative Improvement and Innovation Network to Reduce Infant Mortality […]
Updated HHS Guidance on Improving Health Care Access for Justice-Involved Individuals
/in Policy Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Quality and Measurement, Social Determinants of Health /by Anita CardwellLast Thursday, the Department of Health and Human Services (HHS) released new guidance to clarify and update policies related to how states can improve access to Medicaid coverage and services for incarcerated individuals transitioning back into communities. Based on data from a newly published HHS report, currently 2.2 million individuals are incarcerated and an additional […]
Early Highlights of What the Final Managed Care Rule for Medicaid and CHIP Could Mean for Children with Chronic and Complex Health Care Needs
/in Policy Blogs Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Population Health /by Karen VanLandeghem and Tamara KramerLast week the Centers for Medicare and Medicaid Services (CMS) released its long-awaited final rule outlining requirements for managed care organizations in Medicaid and Children’s Health Insurance Programs (CHIP). Preliminary NASHP analyses indicate that the final rule provides states with significant flexibility in making changes designed to modernize these federal programs as part of health […]
Gobeille v. Liberty Mutual Update: Developments We are Watching
/in Policy Florida, Michigan Blogs Essential Health Benefits, Health Coverage and Access, Health IT/Data, Medicaid Expansion, State Insurance Marketplaces /by Tamara KramerEarlier this year, the U.S. Supreme Court’s decision in Gobeille v. Liberty Mutual dealt a blow to the 18 existing state-run all-payer claims databases (APCDs) by holding that ERISA prevents states from compelling self-funded insurers to report to their data systems. In response to the Court’s decision, a number of state APCDs and/or payers have […]
Webinar: A Conversation with State Officials on Medicaid Dental Managed Care
/in Policy Arizona, Kentucky, Pennsylvania Webinars Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Oral Health /by NASHP StaffManaged Care for Medicaid Dental Services: Insights from Kentucky
/in Policy Kentucky Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Managed Care, Oral Health /by Najeia MentionA growing number of states are administering Medicaid managed care contracts that include both medical and dental services. In 2015, Kentucky identified dental services as one of seven key areas where the state wanted to achieve measurable improvement in its Medicaid managed care contracts. This case study examines the history of dental managed care in […]
Early Highlights of CMS’s Final Managed Care Rule for Medicaid and CHIP
/in Policy Blogs CHIP, CHIP, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health System Costs, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care /by Tamara KramerOn April 25, the Centers for Medicaid and Medicare Services (CMS) released a long-awaited final rule that updates the regulations for managed care organizations in the Medicaid and Children’s Health Insurance Programs (CHIP). These new requirements represent the first major updates to Medicaid and CHIP managed care since 2002. In the intervening years, the percentage […]
Managing Medicaid Managed Care: New State Strategies to Promote Accountability and Performance
/in Policy Ohio, Tennessee Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Medicaid Expansion, Medicaid Managed Care, Quality and Measurement, State Insurance Marketplaces, Value-Based Purchasing /by Sarabeth Zemel, Alice Weiss and Neva KayeAs the scope of State Medicaid agencies becomes wider and more complex, states are increasingly turning to managed care organizations (MCOs) to cover Medicaid enrollees, including those with complex needs. This shift from a fee-for-service, volume-based payment model requires states to effectively manage MCOs and other vendors. With states facing tight budgets, limited staff, and […]
States and Prescription Drugs: An Overview of State Programs to Rein in Costs
/in Policy Reports Administrative Actions, Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Prescription Drug Pricing, State Rx Legislative Action /by Ellen SchneiterStates are significant purchasers of health care for Medicaid, inmates in correctional facilities, and public employees. Despite considerable efforts to maintain affordability, drug pricing continues to vex state budgets. While Medicaid is the largest single health expenditure in state budgets, spending on health care for public workers including state employees and retirees, legislators, judicial employees, […]
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