Medicaid Managed Care
FEATURED ARTICLE
Eliminating Hepatitis C: New State Payment Models for Treatment and Emerging Evidence
/in Policy Louisiana, Washington Blogs 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 IT/Data, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Prescription Drug Pricing, Value-Based Purchasing /by Maureen Hensley-QuinnWith hepatitis C infections on the rise and curative, but expensive, prescription drugs now available, state leaders across the country are compelled to address this public health crisis, and Louisiana and Washington are developing innovative drug-purchasing strategies within their efforts. At the same time, the Patient-Centered Outcomes Research Institute (PCORI) is investing in patient-focused studies […]
Vermont Uses an Accountable Care Organization Model to Promote Developmental Screenings during Well-Child Visits
/in Policy Vermont Reports Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Safety Net Providers and Rural Health, State Insurance Marketplaces, Value-Based Purchasing /by Megan Lent and Carrie HanlonWithout early identification and treatment of development delays, children may face long-lasting and costly consequences. With more states reporting their developmental screening Child Core Set measures and new federal initiatives promoting value-based payment for children’s health, Vermont’s innovative affordable care organization’s approach can provide valuable insights. This fact sheet describes Vermont’s strategy to prioritize developmental […]
Oregon’s Accountable Health Model Addresses Health Equity and Health-Related Needs: Four Lessons from CCO 2.0
/in Policy Oregon Blogs Accountable Health, Chronic and Complex Populations, Community Benefit, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Social Determinants of Health /by Amy ClaryStates developing accountable health models often look to Oregon for inspiration. Oregon established its Coordinated Care Organizations (CCOs) in 2012, pursuant to a Medicaid Section 1115 demonstration waiver. CCOs are local networks of all types of health care providers — including physical, behavioral, and oral health providers — that the state pays a global capitated […]
States Use Policy Levers and Emerging Research to Address Antipsychotic Use in Children in Foster Care
/in Policy Reports Behavioral/Mental Health and SUD, Children/Youth with Special Health Care Needs, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, EPSDT, Health Coverage and Access, Health Equity, Health System Costs, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement /by Johanna Butler, Jennifer Reck and Maureen Hensley-QuinnState policymakers must often take action during an emerging crisis even when evidence identifying the best policy approach is not be available. This report, Evidence-Based Policymaking Is an Iterative Process: A Case Study of Antipsychotic Use among Children in the Foster Care System, explores successful state responses to dramatic increases in antipsychotic prescription rates in Medicaid-enrolled children […]
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 […]
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. 
CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports
/in Policy, Population Health California Featured News Home, Reports Housing and Health, Medicaid Managed Care, Medicaid Managed Care, Population Health /by Allie Atkeson