Blogs / Reports
FEATURED ARTICLE
Managed 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 […]
New Law to Curb Opioid Abuse and Diversion Passed in Maine, Strengthens Prescription Drug Monitoring Program
/in Policy Maine Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Population Health, Prescription Drug Pricing /by Lesa RairGovernor Paul LePage signed into law “An Act to Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program” (now PL 2015, c. 488) on April 19, 2016, making Maine the second state to pass legislation on the issue this year. In March, Massachusetts passed the nation’s first law limiting first-time opioid prescriptions. Maine’s […]
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, […]
Answering the Thousand-Dollar Debt Question: An Update on State Legislative Activity to Address Surprise Balance Billing
/in Policy Reports Consumer Affordability, Cost, Payment, and Delivery Reform, Health System Costs /by NASHP WritersAs the newly insured use their coverage, increased scrutiny is being drawn toward the experiences of consumers who are receiving care. One issue of growing concern is the accumulation of medical debt, even among the insured. According to a recent study from the Kaiser Family Foundation, more than a quarter of adults in the United […]
Are States Losing Key Tools for Health Reform?
/in Policy Michigan, Vermont Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Quality and Measurement /by Lesa RairEngaged in multi-payer payment reforms? Seeking information about the cost of care? About the rate of opioid prescribing? Assessing carriers to generate needed revenue to support state activities like vaccines for children? You might soon hit a federal stoplight. The Supreme Court’s recent decision in Gobeille v Liberty Mutual, which denied the state’s ability to […]
Using CHIP and the ACA to Better Serve Children Now and in the Future
/in Policy Reports Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, Health Coverage and Access, Healthy Child Development, Maternal, Child, and Adolescent Health, Physical and Behavioral Health Integration, Population Health, State Insurance Marketplaces /by Anita CardwellStates have made great strides in providing children in families with low-to-moderate income appropriate and affordable health coverage over the past two decades through Medicaid and the Children’s Health Insurance Program (CHIP). The Affordable Care Act (ACA) created new coverage options for other populations, including parents who were previously uninsured. However, the ACA also includes […]
State Insurance Commissions are Children’s Coverage Partners Too
/in Policy Blogs CHIP, CHIP, Eligibility and Enrollment, Eligibility and Enrollment, Health Coverage and Access, Healthy Child Development, Maternal, Child, and Adolescent Health /by NASHP WritersAccording to 2014 Census data more than half (61 percent) of all children in the United States are covered by private insurance, and 43 percent have public coverage (some children with private insurance are also enrolled in Medicaid.) Over the years many efforts, including much of the children’s coverage work at NASHP, have focused on […]
Building a More Efficient Marketplace: Lessons from DC Health Link’s Experience with Open Source Code
/in Policy Reports Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health IT/Data, Health System Costs, State Insurance Marketplaces /by NASHP WritersEvery open enrollment affords the health insurance marketplaces new opportunities to introduce innovative ways to improve their systems while lowering costs. For the 2015-16 open enrollment season, DC Health Link, Washington DC’s health insurance marketplace, levied such an opportunity by transferring their marketplace onto a new open source code solution. Agile, efficient, and cost effective, […]
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. 
States’ COVID-19 Public Health Emergency Declarations and Mask Requirements
/in COVID-19 State Action Center Charts, Featured News Home, Maps COVID-19, Featured Policy Home, Health Equity, Population Health, Social Determinants of Health /by NASHP Staff and Ella Roth