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Developing and Implementing the Section 2703 Health Home State Option: State Strategies to Address Key Issues

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The health home state option provides an enticing opportunity for states to better coordinate care for Medicaid enrollees with serious mental illness or chronic health issues. This NASHP report identifies strategies from the first four states with approved state plan amendments (MO, NY, OR, and RI) to address five key considerations that states will likely face during the development and implementation of the health home option. The five issues discussed in this paper are: coordination with existing programs, financing/payment, integrating behavioral and physical health care, sharing health data, and evaluation considerations. The Commonwealth Fund provided support for the development of this report.

health.home_.state_.option.strategies.section.2703.pdf 538.2 KB

 

Payment Reform and the Safety Net Webinar

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Medicaid payment reform is needed to drive delivery system change. Moving to value-based purchasing strategies, particularly for patients with complex health needs, makes sense. Historically, however, few Medicaid programs have succeeded inmoving safety net providers away from volume-based reimbursement. This Medicaid-only webinar discussed options and possibilities for safety net providers to participate in value-based payment models. Oregon’s Medicaid Director described how safety net providers fit into the state’s new Coordinated Care Organization program, as well as the development of a new alternative payment methodology (APM) for federally qualified health centers (FQHCs). Senior staff from the Center for Medicaid and CHIP Services, CHIP, and Survey & Certification (CMCS) at the Centers for Medicare & Medicaid Services (CMS) followed with remarks on state flexibility to pursue new value-based purchasing strategies, especially through State plan amendments and 1115 waivers.
 
Presenters:
Carol Backstrom (CMS)
Judy Mohr-Peterson and Don Ross (Division of Medical Assistance Programs, Oregon Health Authority
 
This event inspired a blog post by NASHP’s Jason Buxbaum on State Refor(u)m, an online network for state health policymakers. The post, “Helping FQHCs Get Off the Treadmill,” discusses Oregon’s proposed alternative payment methodology (APM) for FQHCs.
 

Quality Improvement Techniques to Improve Care Coordination: An Assuring Better Child Health and Development (ABCD) Webinar

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State health agencies can catalyze the development of systems to improve care coordination between primary care and community service providers. This NASHP webinar, sponsored by The Commonwealth Fund, focuses on lessons from ABCD III states as they developed quality improvement (QI) projects in partnership with physicians and community organizations to improve care coordination for children at risk for developmental delay.  Topics include the state’s role in QI partnerships to design and spread improvements and incentives for physician participation, including maintenance of certification credit.
Speakers:
Juanona Brewster, Director, Early Childhood Development; Illinois Chapter, American Academy of Pediatrics
Presentation
Susan Castellano, Acting Director, Performance Measurement and Quality Improvement Division, Minnesota Department of Human Services
Presentation
Charles Gallia, Senior Policy Advisor, Oregon Department of Human Services
Presentation
Jill Rosenthal, Program Director
Presentation
 

Transitioning to Managed Care: Medicaid Managed Care in Mental Health

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This report reflects the discussion of nine states participating in “Transitioning to Managed Care: Medicaid Managed Care in Mental Health.” The symposium was funded by the Henry J. Kaiser Family Foundation and the federal Health Care Financing Administration (HCFA).

1997.Jun_.kaiser.hcfa_.transitioning.managed.care_.medicaid.mental.health.pdf 1.7 MB

 

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

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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 457.6 KB

 

Improving Care Coordination and Service Linkages to Support Healthy Child Development: Early Lessons and Recommendations from a Five-State Consortium

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This report summarizes early findings from the current Assuring Better Child Health and Development (ABCD III) learning collaborative of five states. Arkansas, Illinois, Minnesota, Oklahoma, and Oregon are testing models to strengthen linkages and care coordination between pediatric primary care providers and community-based providers of early intervention, mental health, public health, and early care and education services.  The states’ early experiences piloting communication tools, facilitating data sharing, implementing quality improvement processes, and involving families are relevant for efforts to engage multi-sector stakeholders to improve state policy, primary care practice, and population health.

improving.care_.support.healthy.child_.development.pdf 532.6 KB

 

Coordinating Care for Young Children and Beyond: Early Lessons and Implications from Leading States

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States participating in the Assuring Better Child Health and Development (ABCD) III initiative are implementing new strategies to improve care coordination and service linkages to support healthy child development. A number of early lessons have emerged from the initiative with implications for young children and other populations. This webinar, supported by The Commonwealth Fund, will feature presentations from the five states in the ABCD III Learning Collaborative. Each state will discuss its interventions, lessons, and implications for broader state agendas, including medical homes and health reform. The state lessons are the subject of a forthcoming NASHP paper.
Speakers:

  • Sheena Olson, Assistant Director, Medical Services, Arkansas Division of Medical Services
  • Julie Doetsch, Manager, Child Health Section, Illinois Department of Healthcare and Family Services
  • Meredith Martinez, Maternal and Child Health Policy Specialist, Maternal and Child Health Assurance, Minnesota Department of Human Services
  • Terrie Fritz, External Relations Coordinator, Oklahoma Health Care Authority
  • Charles Gallia, Senior Policy Advisor, Division of Medical Assistance Programs, Oregon Health Authority
  • Carrie Hanlon, Policy Specialist, National Academy for State Health Policy
  • Jill Rosenthal, Program Director, National Academy for State Health Policy
early.lessons.agenda.pdf 297 KB

 

Improving the Quality of Care and Coordination of Services for Young Children—ABCD, CHIPRA and Beyond!

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Early identification of delays and linkage to appropriate services can improve coordination among pediatric primary health care providers and providers of mental health, early intervention, child welfare, and early care and education services and influence the course of young children’s healthy development. States are using a variety of mechanisms to develop and test interventions to improve linkages between primary care and other child and family service providers. This webinar will highlight how Illinois, Oregon, South Carolina, and Vermont are using ABCD III (Assuring Better Child Health and Development) and/or CHIPRA quality grants to build on and align current efforts, such as medical home initiatives, health information technology or exchange, performance measurement, and health reform, to transform the delivery of care to children covered by Medicaid and CHIP. This event is sponsored by The Commonwealth Fund and builds upon a session held during the NASHP Annual Conference in October 2010.
 

Panelist Discussion 

  • How is your state promoting children’s healthy development by improving linkages to services?
  • How is your state using the CHIPRA grant and ABCD project to improve care coordination and linkages to services for young children? Where is the synergy between the two projects?
  • How is your state engaging the provider community to support state agency‐led efforts to improve care coordination and linkages to assure better child health and development? What do these efforts look like in real time—how does QI truly happen at the practice level?
  • How is your state using HIT/HIE to support efforts to improve care coordination and linkages to services?

 
Moderator: 
Jill Rosenthal, NASHP
Panel: 
Scott Allen, Executive Director, Illinois Chapter, American Academy of Pediatrics
Juanona Brewster, Director, Early Childhood Development Projects Illinois Chapter, American Academy of Pediatrics
Russell Frank, CHIP Director, Department of Vermont Health Access
Charles Gallia, Senior Policy Advisor, Division of Medical Assistance Programs, Oregon Health Care Authority
Felicity Meyers, Deputy Director, South Carolina Department of Health and Human Services

 

State Strategies to Improve Quality and Efficiency: Making the Most of Opportunities in National Health Reform

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There is an acknowledged need for extensive reform to the health care delivery system in the United States. The Patient Protection and Affordable Care Act offers unprecedented opportunities to transform care delivery, with numerous provisions that support systemic improvements. States have an imperative to greatly improve system efficiency if they are to effectively and sustainably implement the law’s changes, particularly mandatory coverage expansion. This report examines specific Affordable Care Act provisions that support state system improvement goals and profiles efforts in 10 states: Colorado, Kansas, Maine, Massachusetts, Minnesota, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington. The report highlights the opportunities and challenges that federal health care reform will bring and offers suggestions for how state and national leaders can streamline implementation.

state.strategies.improve.quality.efficiency.pdf 580.5 KB

 

Linking Children to Services: Building on Community Assets to Pilot Test Improvement Strategies

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The five states participating in the third Assuring Better Child Health and Development (ABCD) learning consortium have gone through an extensive planning process to set the stage for implementation of interventions to improve coordination among providers serving children in pilot communities. This document describes 1) how Arkansas, Illinois, Minnesota, Oklahoma, and Oregon are building on existing local partnerships and assets to organize community pilots, and 2) preliminary lessons that have emerged from these states, including new federal opportunities to bolster community partnerships that will improve service linkages for children.

linking.children.to_.services.pdf 251.3 KB

 

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