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Virginia’s BabyCare Program: Working to Improve Birth Outcomes through Medicaid
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Nationally, Medicaid finances 45 percent of births and is a critical resource to improve maternal health and birth outcomes and lower avoidable costs. With an increasing number of initiatives focusing on pregnant and postpartum women, such as the federal Maternal Opioid Misuse (MOM) Model, states can learn from innovative programs, including Virginia’s BabyCare initiative. This new NASHP report explores how Virginia utilizes Medicaid’s reach to improve birth outcomes through behavioral risk screening, case management services, and expanded prenatal services.
View or download: Virginia’s BabyCare Program: Working to Improve Birth Outcomes through Medicaid
To learn about other state initiatives, visit NASHP’s Healthy Child Development State Resource Center.
Maximizing Enrollment Participating State Profiles
The eight states participating in the Maximizing Enrollment program aimed to simplify and streamline enrollment and renewal policies, systems and processes for Medicaid and CHIP and prepare for ACA implementation. These state profiles offer a snapshot of the states’ work within the program by highlighting the following:
- Where states started;
- Major Simplifications Implemented as a result of Maximizing Enrollment; and
- Lessons Learned
State
| Illinois | 925 KB |
| Louisiana | 2.1 MB |
| Alabama | 2 MB |
| Massachusetts | 2.1 MB |
| New York | 2.1 MB |
| Utah | 2 MB |
| Virginia | 334.2 KB |
| Wisconsin | 2.1 MB |
Virginia – Medical Homes
In 2010, the Virginia Department of Medical Assistance Services (DMAS) began developing plans for a medical home pilot with a federally qualified health center (FQHC) in southwest Virginia. The goal of the pilot was to improve primary care delivery within the framework of an existing primary care case management (PCCM) program. The expansion of Medicaid managed care to Southwest Virginia in July 2012 required a shift in plans for the pilot. Contracts between the state’s Medicaid MCOs and DMAS now require the MCOs to partner with DMAS in developing the southwest Virginia medical home pilot. Full contract language is available online here.
Last Updated: December 2013
| Forming Partnerships |
The Virginia Department of Medical Assistance Services (DMAS) has engaged a variety of stakeholders to develop the medical home pilot, including:
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| Defining & Recognizing a Medical Home |
Definition: The Virginia Department of Medical Assistance Services’ (DMAS) contract with Medicaid managed care organizations (MCOs) identifies the following principles as “core” aspects of the medical home model:
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| Aligning Reimbursement & Purchasing | The Virginia Department of Medical Assistance Services’ (DMAS) contracted Medicaid managed care organizations (MCOs) are establishing quality benchmarks that will help determine provider rewards. The MCOs have communicated that they will base initial goals on the measures selected by DMAS for its quality improvement program. |
Health Care Price Transparency: Lessons from Three High Performing States
National media in recent months have featured the high and variable costs of common health care services. In this webinar you’ll hear from leaders in Virginia, Massachusetts, and New Hampshire on what they’ve done to address the issue and improve price transparency.
In a recent report, Catalyst for Payment Reform (CPR) and the Health Care Incentives Improvement Institute (HCI3) identified these states as among the highest performing in the nation when it comes to health care price transparency. After an overview of the issue from CPR and HCI3, the webinar’s discussion will turn to price transparency efforts in the three states, barriers they faced in reaching current levels of transparency, how challenges were managed or overcome, and other lessons for states interested in pursuing this work.
Speakers:
- François de Brantes, Executive Director, Health Care Incentives Improvement Institute
- Andréa E. Caballero, Program Director, Catalyst for Payment Reform
- Áron Boros, Executive Director, Massachusetts Center for Health Information Analysis
- Tyler Brannen, Health Policy Analyst, New Hampshire Insurance Department
- Michael Lundberg, Executive Director, Virginia Health Information
| Click to View Webinar Presentation Slides | 12.2 MB |
Virginia
NASHP’s Accountable Care Activity map is a work in progress; state activity pages will be launched in waves throughout Fall 2012.
At this time, we have no information on accountable care activity that meets the following criteria: (1) Medicaid or CHIP agency participation (not necessarily leadership); (2) explicitly intended to advance accountable or integrated care models; and (3) evidence of commitment, such as workgroups, legislation, executive orders, or dedicated staff.
If you have information about accountable care activity in your state, please email skinsler@oldsite.nashp.org.
Last updated: October 2012
State Policymakers’ Guide for Advancing Health Equity through Health Reform Implementation
The Affordable Care Act (ACA) offers states multiple policy levers to improve health status and care for racial and ethnic minority populations through delivery system reforms, public health and community interventions, and insurance coverage, as well as provisions specific to disparities reduction. This report synthesizes the experiences of teams from seven states (Arkansas, Connecticut, Hawaii, Minnesota, New Mexico, Ohio, and Virginia) that participated in a learning collaborative to advance health equity using select ACA and state policy levers. The report also presents opportunities for state and federal collaborations to strengthen these efforts, as well as important lessons for advancing health equity.
An accompanying issue brief provides a high-level summary of the full report.
| advancing.equity.health.reform.pdf | 559.2 KB |
Interagency Collaboration for Quality Care in Medicaid Managed Care for Low Income Mothers and Children
This paper reports on the experiences of two states, Colorado and Virginia, in their efforts to develop an interagency collaborative approach to the oversight of managed care entities generally, and Medicaid managed care entities in particular. The demonstration project was a year-long effort conducted by the National Academy for State Health Policy (NASHP), funded by the David and Lucile Packard Foundation, to see if by implementing an interagency approach among Medicaid, Health, and Insurance, a state could strenghten its approach to oversight of prepaid managed care organizations, particularly those serving Medicaid eligible low income women and children.
| 1997.Dec_.quality.assurance.practice.two_.state_.demonstration.interagency.collaboration.pdf | 4.9 MB |
Building Medical Homes: Lessons from Eight States with Emerging Programs
States are seeking to strengthen primary care through the medical home model to achieve better outcomes and lower costs. The eight states profiled in this report—Alabama, Iowa, Kansas, Maryland, Montana, Nebraska, Texas, and Virginia—are at different stages in the development and implementation of medical home programs. The states have drawn on both well-tested approaches and innovative tactics to help primary care providers adopt the model. As a whole, their experiences demonstrate that states can play critical roles in convening stakeholders, helping practices improve performance, and addressing antitrust concerns that arise when multiple payers collaborate.
| building.medical.homes_.emerging.states.pdf | 529.2 KB |
Using Data to Drive State Improvement in Enrollment and Retention Performance
The 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
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. 
