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Engineering an Exchange: A Look at State Blueprints and Decisions

By December 14, 2012, each state establishing a state-based exchange will submit a blueprint to HHS, capturing the most detail yet available regarding keys aspects of the exchanges. States participating in a partnership exchange must submit their blueprints before February 15, 2013. In this webinar, we heard from three state leaders: Peter Lee of California and Colleen Burns of Illinois, who provided inside looks at their blueprints and at the policy decisions and visions behind them. And panelist Norm Thurston of Utah, a state that has not yet declared its intent, described factors the state is considering in coming to its decision, and what choices state leaders have made so far.

Speakers:

(Moderator) Elizabeth Cronen,
Community Manager, National Academy for State Health Policy
Sarabeth Zemel, Program Manager, National Academy for State Health Policy
Rachel Dolan, Policy Analyst, National Academy for State Health Policy
Peter Lee, Executive Director, California Health Benefit Exchange
Colleen Burns, Special Counsel for Health Policy, Illinois Department of Insurance
Norm Thurston, Health Reform Implementation Coordinator, Utah Department of Health Care Finance

Coordinating Services With and For Persons with Disabilities: A Challenge for State Government

This paper reflects the conversations and considerations of a focus group of 18 individuals representing persons with disabilities and their advocates and State and Federal officials. Convened to review the National Academy for State Health Policy’s recent publication, A Guide to Federal Programs for People With Disabilities, the group was invited to muse about how State governments could re-engineer themeselves to improve our policies and practices affecting persons with disabilities. The result of those conversations is this paper, which sets forth a framework for re-thinking policy for persons with disabilities and strengthening State’s capacities to work closely with consumers to forge more comprehensive and coordinated care for persons with disabilities and their families. This paper is not a comprehensive analysis of models and their strengths and weaknesses; rather, it is a first step to convene consumers and policymakers to envision a new and better way of doing business together. Much more analysis and demonstration is needed, but this paper presents the range of possibilities available if Federal programs serving persons with disabilites could be better coordinated or consolidated.

1995.Aug_.coordinating.services.persons.disabilities.challenge.pdf

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Shared Decision Making: Advancing Patient-Centered Care through State and Federal Implementation

March 16, 2012/in Policy Reports Cost, Payment, and Delivery Reform /by NASHP Staff

Shared decision making (SDM)—a process that engages patients in a dialogue with their providers to help them select health care options that conform to their values and preferences—is receiving increased attention as a tool for improving quality and patient satisfaction, and addressing unwarranted variation in care. Building on NASHP’s analyses of state health system improvement initiatives, this report reviews the definition, process, and rationale for SDM and potential roles of states in promoting SDM. The report and a companion document highlight state legislative, regulatory, and other approaches in Maine, Minnesota, Oregon, Vermont, and Washington. The report discusses the challenges of implementation, state strategies to overcome challenges, policy options states have pursued, and lessons from their experience.

shared.decision.making.report.pdf

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Building a Consumer-Oriented Health Insurance Exchange: Key Issues

March 5, 2012/in Policy Reports /by NASHP, Sarabeth Zemel, Anne Gauthier and Abigail Arons

As states develop insurance exchanges, their decisions have profound implications for consumers. This report covers three main areas where consumers intersect with the exchange. First are ways consumers participate in exchange governance, such as directly serving on exchange governing boards. Second is consumer input into exchange policy and implementation decisions, and the various avenues states are using to gather this input, such as workgroups, town hall meeting participation, and surveys. Third is the early planning for the consumer-serving functions of the exchange, such as navigator programs and the web portal.

Building_a_Consumer_Oriented_Exchange_final.pdf

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Sustaining Support for Exchange Directors: Models, Options, and Lessons

January 23, 2012/in Policy Reports /by Sarabeth Zemel, Anne Gauthier and Abigail Arons

Electronic Release of Clinical Laboratory Results: A Review of State and Federal Policy

February 17, 2010/in Policy Reports /by NASHP Staff

State and national initiatives to promote health information exchange (HIE) are gaining momentum in the wake of the American Recovery and Reinvestment Act of 2009 (ARRA), which provides over $40 billion to promote health information technology. States face particular challenges in promoting HIE for clinical laboratory results. This paper is intended to provide policymakers with useful background on:
• Policy issues related to sharing lab results with providers and patients;
• The pertinent laws and how they are interpreted by various states;
• How the Clinical Laboratory Improvement Amendments (CLIA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) laws relate to each other; and
• Opportunities for reviewing, reinterpreting, and updating laws to fit with new electronic health information infrastructures and policies.
The California HealthCare Foundation provided generous support for the development of this paper.

Electronic Lab Results Exchange Policy

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Opportunities and Recommendations for State-Federal Coordination to Improve Health System Performance: A Focus on Patient Safety

January 7, 2010/in Policy Reports /by NASHP Staff

NASHP convened a roundtable of state and national health policy leaders in October 2009 to discuss opportunities for states and the federal government to develop congruent policies to promote patient safety. This brief summarizes recommendations that emerged from that meeting. Participants identified four criteria to use in selecting issues for state-federal coordination: (1) degree of readiness for change, (2) symbolic value and potential to send broad messages about priorities, (3) potential to avoid harm from non-aligned policies, and (4) potential for cost savings. Considering these criteria, participants recommended three topics as especially worthy of future dialogue: reducing healthcare-associated infections (HAIs), decreasing preventable hospital readmissions, and avoiding hospitalizations for ambulatory care-sensitive (ACS) conditions.

Patient Safety Brief

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