Blogs / Reports
FEATURED ARTICLE
Understanding Medicaid Claims and Encounter Data and their Use in Payment Reform
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Quality and Measurement /by NASHP WritersStates across the country are fully engaged in delivery system and payment reform efforts to improve care and lower costs in their Medicaid programs. Data is a critical component of these efforts. This NASHP brief provides an introduction to two types of Medicaid utilization data—fee-for-service claims data and managed care encounter data—and, based on examples […]
All Eyes on Michigan: Will Assessments on All Health Plans Survive
/in Policy Michigan Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Quality and Measurement /by Lesa Rair and Tamara KramerOn Monday, the United States Supreme Court sent back a Michigan case for a new finding that could forbid state assessments on self funded plans. The Supreme Court told the Sixth Circuit to reconsider its ruling that a Michigan health insurance tax was not preempted by the Employee Retirement Income Security Act (ERISA) in light of the Supreme Court’s decision […]
Massachusetts Becomes First State to Pass Statewide Cap on First-Time Opioid Prescriptions
/in Policy Massachusetts Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Quality and Measurement /by NASHP WritersEarlier this year, Massachusetts Governor Charlie Baker discussed his state’s opioid epidemic during his State of the Commonwealth Address. Less than two months later, on March 14, he signed omnibus legislation designed to tackle the epidemic head-on. Chapter 52 of the Acts of 2016 contains a wide range of provisions, however one specific provision is […]
Gobeille v. Liberty Mutual: Decision
/in Policy Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Quality and Measurement /by NASHP WritersIn a 6-2 decision released today, the U.S. Supreme Court has dealt a blow to state all- payer claims databases. By upholding a lower court’s decision, the Court ruled that states may no longer require self funded plans to submit claims data – that action is preempted by ERISA. In its decision in Gobeille v. Liberty […]
Proposed Rule on Confidentiality of Substance Use Information Released
/in Policy Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Physical and Behavioral Health Integration /by NASHP WritersOn February 9th, 2016, Health and Human Services Department released long-awaited proposed rules on 42 CFR Part 2, the federal regulation that governs how federally-funded substance use disorder (SUD) programs may share health information; public comments are due on April 11th. The proposed changes to 42 CFR Part 2 would, among other things, make it […]
Engaging Self-Insured Employers in Multi-Payer Reform: Lessons from Arkansas and Walmart
/in Policy Arkansas Blogs Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health IT/Data, Health System Costs /by Ledia TaborSelf-insured employer participation in multi-payer payment reform is critical for providers to receive consistent messages across payers—an important step toward fostering widespread improvement. A recent study echoes the experience of many state-led multi-payer initiatives experiencing difficulty in engaging self-insured employers. This study looked at reforms in four states: Arkansas, Oregon, Minnesota, Vermont. Only two, Arkansas […]
2016 E-News Archive
/in Policy Blogs /by NASHP StaffJanuary 5, 2016: Delivery system & payment reform map, new states added to justice toolkit January 12, 2016: Chart on State Funding Sources, Global Budgeting Brief and more January 19, 2016: Updates on SBMs in OE3 & Advancing Pediatric Medical Homes in RI January 26, 2016: New brief on peer support for adults with SMI February 2, 2016: Blog on Global Budgeting […]
ACA’s Next Challenge: United States House of Representatives v. Burwell
/in Policy Blogs Health Coverage and Access, State Insurance Marketplaces /by Lesa RairAs we head back to court, what does a challenge to the ACA mean for the country’s Health Insurance Marketplaces? Over the past five years, the Affordable Care Act (ACA) has withstood challenges to the constitutionality of its insurance mandate, Medicaid expansion, birth control-related provisions, and questions about who can receive premium reducing tax credits. […]
Braiding and Blending Funding Streams to Meet the Health-Related Social Needs of Low-Income Persons: Considerations for State Health Policymakers
/in Policy Reports Behavioral/Mental Health and SUD, Blending and Braiding Funding, Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Equity, Health System Costs, Medicaid Managed Care, Population Health, Quality and Measurement /by Lesa RairMedicaid beneficiaries often need support outside the scope of clinical health care in order to lead healthy lives, and states are uniquely poised to provide this support by addressing the social determinants of health. While states steward a variety of funding sources that address the needs of low-income populations, too often a Medicaid beneficiary must […]
Bolstering State Efforts to Screen for Postpartum Depression
/in Policy Blogs Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Healthy Child Development, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by Lesa RairIn late January, the U.S. Preventive Services Task Force released a recommendation that clinicians screen the general adult population, including pregnant and postpartum women, for depression. Depression screening for pregnant and postpartum women is not a new idea. The Medicaid program, as a major payer of perinatal health care covering 48 percent of all U.S. […]
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