Round tables

Wednesday, October 19th
12:45PM-2:15PM
Lunch Roundtables:
Lunch Roundtables provide an opportunity for informal conversation on a specified topic. Each roundtable is hosted by an expert resource on the subject and facilitated by a NASHP representative. Roundtables are currently being vetted and additional offerings will be added to the agenda soon.
 
What Did States Achieve in the Balancing Incentive Program:
Authorized by the ACA, 21 states participated in the Balancing Incentive Program, which provided enhanced FMAP to support structural changes in states’ LTSS systems and rebalancing of Medicaid LTSS expenditures. In addition to implementing structural changes, states were required to increase Medicaid spending on HCBS. In this roundtable, researchers will discuss findings from the ASPE-sponsored BIP evaluation. State officials will have an opportunity to share their experiences and discuss their plans to sustain rebalancing efforts.
Expert Resources: Joshua M. Wiener, PhD, Distinguished Fellow, Aging, Disability and Long-Term Care, RTI International.
 
Spark: New Community Responses to the Healthcare Needs of Justice-Involved Populations:
Join the discussion to learn how states and counties are addressing the behavioral and medical needs of individuals who are Medicaid eligible and involved with correctional systems. This conversation will touch on a variety of topics, including prevention, early behavioral health intervention, care coordination, and Medicaid coverage upon leaving the correctional setting. Come and ignite the conversation with your ideas on what a shared accountability model looks like in your community.
Expert Resources: Leslie Schwalbe, Senior Vice President, State and Local Government Programs, Optum and Brent Kelsey, Assistant Director for Substance Abuse Services, Utah Division of Substance Abuse and Mental Health.
 
Inviting States’ Input on Critical Payment Reform Efforts:
States are deeply engaged in the triple aim of improving patient care, improving population health, and reducing costs. In March, 2015, HHS launched the Health Care Payment Learning and Action Network (LAN), with the goal of having at least 30% of U.S. health care payments linked to quality and value through Alternative Payment Models (APMs) in 2016 and 50% in 2018. As a public-private effort involving diverse stakeholders across health care, to date over 6,000 individuals are participating in the LAN. In this session, the LAN’s Project Leader Anne Gauthier will describe LAN activities and invite feedback to strengthen states’ engagement. She will be joined by at two state officials who have been involved in LAN activities. Anne and the state officials will highlight the LAN’s Framework for categorizing APMs and provide a high level overview of the LAN’s draft recommendations for population-based payment models. They will also delve into the LAN’s clinical episode payment draft recommendations for elective joint replacement, maternity and cardiac care episode bundles, and will solicit input from participants.
Expert Resources: Anne Gauthier, Project Leader, Health Care Payment Learning and Action Network, MITRE Brooks Daverman, Tennessee Division of Health Care Finance and Administration and LAN Clinical Episode Payment Work Group Member MaryAnne Lindeblad, Medicaid Director, Washington State Healthcare Authority.
 
Discussing the Importance of Conflict-Free Assessments in Long-Term Care:
This roundtable will facilitate conversations on the importance of conflict-free assessments in determining the needs for long-term care program participants. We will particularly highlight: Preadmission Screening & Resident Review (PASRR) I and II assessments; Level of Care assessments; and Intellectual & Developmental Disability (IDD) assessments like the Supports Intensity Scale® (SIS®) and Inventory for Client and Agency planning (ICAP).
Expert Resource: Nancy Shanley, Vice President, MAXIMUS
 

Care Over Cure: State Policy Supporting Palliative and End of Life Care:
Patient-centered palliative and end of life care is an emerging policy area that requires attention to speed state policy development. This round table discussion is an opportunity to brainstorm and to share examples of current state activity as well as provider and consumer-led activity, to flesh out a state policy agenda on this topic. Areas covered may include advance care planning, cost savings, quality measures, patient/family/consumer/provider engagement, and care delivery models. We can also explore the role of state policy levers such as legislation, regulatory and/or licensing authority, and purchasing power, to support palliative and end of life care.

 

Women’s Health Policy: What are Opportunities and Emerging Issues for States?
This roundtable will explore policy opportunities and emerging issues in women’s health to help states meet health care cost, quality and access goals.  Most state initiatives or programs for women focus on maternity and perinatal care, although public health agencies also often focus on preventable and costly chronic diseases women face overall, from cancer and depression to heart disease and diabetes, or issues such as smoking, substance use and intimate partner violence.  What are your state’s policy priorities in women’s health? What promising practices or emerging needs do you see? Are there opportunities for cross-agency collaboration to maximize resources and impact?  Join colleagues to discuss these and other questions about women’s health policy.

Expert Resource: Carrie Hanlon, Project Director, NASHP

 
State-only Roundtable: HHS Request for Information on Payment and Delivery System Reforms 
CMS released a request for information (RFI) to solicit stakeholder feedback on state-based payment and delivery system reforms to help shape future federal-state initiatives. Since 2013 through the State Innovation Model (SIM) initiative, CMS has supported states in exploring payment and delivery reforms. There are also states engaged in the Delivery System Reform Incentive Payment program (DSRIP) and some states are actively working to build and use all payer claims databases (APCDs) to support reforms. HHS is now seeking input on how to evolve such efforts that both leverage lessons learned and consider how to implement models under the Medicare Access and Reauthorization Act (MACRA). NASHP wants to support sharing states’ perspectives in responding to this RFI. So, we are convening a state-only roundtable discussion to facilitate a discussion among you and your state official peers that will focus on the questions posed in the RFI. NASHP anticipates writing a short piece to highlight themes and take-aways from this discussion, but we will not attribute specific details to any individual or state.
 

Ending the Surprise Party! Ideas to Limit Out-of-Network Billing
State are increasingly taking up the issue of surprise billing by out-of-network providers practicing at network facilities, and air ambulance providers.  This roundtable is an opportunity to discuss the steps state policymakers are taking to address these issues.  What are the pros and cons of state efforts?   How do states create a policy agenda to solve this multi-faceted problem?  How can states overcome barriers to action?  We’ll delve into these questions and others as they arise.

Expert Resource: Emily Donaldson, Director, State Research and Policy, Blue Cross Blue Shield Association

Serving Underserved and Vulnerable Populations
Program Examples: Ohio QIT and Enrolling Individuals into an MCO
The importance of establishing linking underserved populations to available programs cannot be overstated. It depends on effective outreach strategies, coordinated stakeholder engagement, robust systems, and culturally sensitive communication techniques. Two examples where we have put all of these strategies in place are the Ohio QIT Program and our Enrollment of Inmates into an MCO. The program is designed to identify, educate and assist individuals receiving long-term care services whose income exceeds the Medicaid eligibility limit, to establish a Qualified Income Trust (QIT) in order to maintain Medicaid eligibility. Experience working with low income, older adults and people with disabilities who receive long-term care services is vital. We implemented an initiative to identify and enroll inmates due for release from Ohio Rehabilitation and Corrective facilities into a Medicaid managed care MCO to ensure continuity of care and satisfaction with the selected MCO. The Program involved coordination with correctional facilities, Ohio State stakeholders, and sensitive education to offenders.