Posts
Simplified but not Simple: Tackling Health Reform's Eligibility and Enrollment Challenge
/in Policy Webinars /by NASHPImproving enrollment and eligibility systems is a heavy lift, but across the nation, states are developing a vision to advance efficiencies in their processes. State strategies will be varied, but the decision points are the same. How do you determine eligibility using a MAGI methodology and set eligibility system specifications to accommodate new rules? Who is in charge of eligibility decisions – Medicaid or the Exchange; states or counties? How do you work across programs to enable electronic data exchange to determine eligibility?
In the almost two years since the passage of the Affordable Care Act, the vision for a simplified, seamless eligibility and enrollment system across Medicaid, CHIP, exchanges and basic health program has been made clear. Yet, the complexities that come with simplification have also become apparent. Even as states await final proposed rules, many are moving forward in search of solutions.
This webinar will size up state progress on updating eligibility systems and profile the strategies of three early adopters. Presenters will help states identify key decision points and how to get started on tackling these challenges.
Has your state begun to develop new eligibility policies, systems and processes? Don’t let that work go uncounted! Submit documents and comments that show your state’s progress, and webinar presenter Alan Weil may highlight your work on the webinar. Start by finding your state here!
Speakers
Manu Tandon, Secretariat Chief Information Officer, Massachusetts’ Health and Human Services
Judith A. Arnold, Director, Division of Coverage and Enrollment, Office of Health Insurance Programs
Tracy Turner, Manager, Enrollment Automation and Data Integrity, Oklahoma Health Care Authority
Dustin Oxford, Manager, Enrollment Automation and Data Integrity, Oklahoma Health Care Authority
Alan Weil, Executive Director, National Academy for State Health Policy
Alice Weiss, Program Director, National Academy for State Health Policy
CHIP Dental Coverage: An Examination of State Oral Health Benefit Changes as a Result of CHIPRA
/in Policy Reports Health Coverage and Access /by Leigha Basini and Jennifer DolatshahiOral health remains a serious concern for the health and well being of children, especially those who are low-income. However, with the passage of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), all children enrolled in the Children’s Health Insurance Program (CHIP) will have a base level of dental coverage included in their benefit package. This brief provides a summary of the CHIP dental benefit changes under CHIPRA and examines the states that had voluntarily sought federal approval of current benefits, or made changes to their CHIP dental benefits as of September 2011.
Additionally, NASHP wrote a blog post about the dental brief and CHIPRA dental benefit, which is on the Georgetown Center for Children and Families’ Say Ahhh! blog.
Blog: Children’s Dental Health
By Leigha Basini
Jennifer Dolatshahi
Leigha Basini, Former Program Manager
December 2011
| Attachment | Size |
|---|---|
| NMOHPC.CHIPRA.dental.12.11.pdf | 1.64 MB |
Taking it to the Max: Eight States Improving Enrollment and Retention in Medicaid and CHIP
/in Policy Blogs Health Coverage and Access /by NASHPSarabeth Zemel
December 2011
This blog post was originally published on State Refor(u)m’s State of Implementation Blog.
Earlier this month, eight states gathered in Washington, DC for an annual meeting of grantees of the Maximizing Enrollment program, a Robert Wood Johnson Foundation initiative directed by NASHP that aims to help states improve enrollment and retention of eligible children and prepare enrollment systems for individuals eligible for public and publicly-subsidized coverage programs in 2014.
State Support for Primary Care Practice Transformation: Replication of the North Carolina Model
/in Policy Webinars Cost, Payment, and Delivery Reform /by NASHPThis webcast is an introduction to the new Infrastructure for Maintaining Primary Care Transformation (IMPaCT) initiative in North Carolina, funded by the Agency for Healthcare Research and Quality (AHRQ). It will outline the key components of North Carolina’s primary care practice transformation strategy, their interrelationship, lessons learned, the role of a state level coalition, and collaboration with area health education centers. The webcast will describe an upcoming opportunity for three states to receive technical assistance to adapt North Carolina’s model.
Speakers:
- Samuel Cykert, MD, Associate Professor of Medicine, University of North Carolina at Chapel Hill
Presentation - Darren A. DeWalt, MD, MPH, Associate Professor of Medicine, Division of General Internal Medicine, University of North Carolina at Chapel Hill
Presentation - L. Allen Dobson, Jr., MD FAAFP, Vice President, Clinical Practice Development, Carolinas HealthCare System; President, North Carolina Community Care Network, Inc.
Presentation - David Meyers, MD, FAAFP, Director, Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality
Presentation - Denise Levis Hewson, RN, BSN, MSPH, Director of Clinical Programs and Quality Improvement, Community Care of North Carolina
Presentation - Jill Rosenthal, MPH, Program Director, National Academy for State Health Policy.
Presentation
Using Data to Drive State Improvement in Enrollment and Retention Performance
/in Policy Webinars Health Coverage and Access /by NASHPThe Maximizing Enrollment program has worked intensively with eight states to help them increase their use of Medicaid and CHIP enrollment and retention data to monitor and improve their performance outcomes. This issue brief presents recommendations from Maximizing Enrollment and Mathematica Policy Research for twelve core measures that states may want to consider implementing as they plan for new eligibility and enrollment rules and systems to:
- Monitor and improve their program’s performance
- Track the results of eligibility policy changes, including those related to the Affordable Care Act
To read the full report please click here.
To view or download the slides from the webcast click here.
Moderator:
Catherine Hess, Managing Director, National Academy for State Health Policy; Co-Director, Maximizing Enrollment
Presenters:
Chris Trenholm, Senior Economist and Associate Director for Heath Research, Mathematica Policy Research, Inc.
Rebecca Mendoza, Director, Division of Maternal and Child Health in the Virginia Department of Medical Assistance Services
Building Electronic Information-Sharing Systems to Support Care Coordination in Illinois
/in Policy Reports Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Maternal, Child, and Adolescent Health /by NASHP and Larry HinkleThis is the first in a series of Assuring Better Child Health and Development (ABCD) III Innovation Briefs. This brief focuses on electronic information-sharing systems that Illinois is building or adapting to improve care coordination for children with or at risk of developmental delays. Illinois is poised to improve care coordination by implementing an electronic referral initiation and feedback system. These system changes have implications for information sharing to support care coordination statewide and for other populations.
Larry Hinkle
November 2011
| Attachment | Size |
|---|---|
| ABCD.III_.Innovation.Brief_.1.pdf | 275.6 KB |
Looking into the Crystal Ball: Preparing for the Essential Health Benefits
/in Policy Webinars /by NASHPNASHP executive director Alan Weil will moderate a panel of state officials and experts on issues related to benefit design and the Essential Health Benefits. Presenters will identify how states can get started on benefit design, and three panelists will provide context and insights on interpreting the upcoming HHS guidance on the EHB package.
Moderator: Alan Weil, Executive Director, National Academy for State Health Policy
Panelists:
Chris Koller: Health Insurance Commissioner, Rhode Island
Carolyn Ingram: Senior Vice President, Center for Health Care Strategies
John Lewis: Principal Analyst, California Health Benefits Review Program
Ben Steffen: Acting Executive Director, Maryland Health Care Commission
Pediatric Medical Necessity: EPSDT, CHIP, and Children’s Health Coverage in the Era of Health Reform
/in Policy Webinars Health Coverage and Access, Maternal, Child, and Adolescent Health /by NASHPThis state-only webinar presented by NASHP with support from the Commonwealth Fund and the David and Lucile Packard Foundation for EPSDT and CHIP program administrators provided participants with an opportunity to learn more about the concept and legal definitions of pediatric medical necessity and to talk with their peers about implementation of pediatric necessity within Medicaid/EPSDT and CHIP programs. It also addressed working with stakeholders to develop the pediatric medical necessity definition.
Moderated by Neva Kaye, Senior Program Director, and Catherine Hess, Senior Program Director, National Academy for State Health Policy.
Agenda
The speakers were:
- Anne Markus, PhD, JD, Assistant Dean for Academic Affairs and Associate Professor of Health Policy at George Washington University
A Legal and Policy Overview on Pediatric Medical Necessity - Cathy Caldwell, Director of the Bureau for Children’s Health Insurance in the Alabama Department of Public Health
Pediatric Medical Necessity and CHIP
- Marti Cote, RN, Social Services Program Specialist at the Nevada Division of Health Care Financing and Policy
Lessons from Nevada
- David Kelly, MD, MPA, Medical Director of the Pennsylvania Office of Medical Assistance Programs
Pediatric Medical Necessity in EPSDT
Using Report Cards to Measure Racial and Ethnic Health Disparities: State Experience
/in Policy Reports Population Health /by NASHPState agencies identify, document, and act on data related to racial and ethnic health and health care disparities in various ways. One type of document states produce is a “report card,” or a publication that uses data from race/ethnicity-specific measures to assign letter grades that rate the state’s performance. This issue brief, prepared by NASHP for the Agency for Healthcare Research and Quality (AHRQ), focuses on New Mexico’s experience using report cards to measure racial and ethnic health disparities.
Click to download the report (PDF).
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