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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

 

Public Insurance Programs and Children with Special Health Care Needs, A Tutorial on the Basics of Medicaid and the Children’s Health Insurance Program

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This tutorial on the basics of Medicaid and CHIP is a collaboration of NASHP and the Catalyst Center: Improving Financing of Care for Children and Youth with Special Health Care Needs (CSHCN). The tutorial gives a broad overview of Medicaid and CHIP, the many different populations these programs serve, the changes they are undergoing as a result of health care reform and some options to help readers think about opportunities to improve services for CSHCN through communication and collaboration with Medicaid and CHIP staff. The tutorial starts with an overview of how definitions of CSHCN may vary by agency or program, followed by eight major topic areas and then recommendations for steps Title V programs can take to build successful partnerships with public insurance programs.

Jill Rosenthal, Senior Program Director
Mary Henderson
Jennifer Dolatshahi
Catherine Hess, Managing Director for Coverage and Access
Carol Tobias
Sara Bachman
Meg Comeau
February 2012
Attachment Size
Medicaid_101_tutorial.pdf 5.69 MB

Oklahoma’s Web Portal: Fostering Care Coordination Between Primary Care and Community Service Providers

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This is the second in the series of Assuring Better Child Health and Development (ABCD) III Innovation Briefs. This new brief focuses on the web-based referral and tracking system (“web portal”) that Oklahoma has built into its pre-existing Preventive Services Reminder System. The state designed this web portal to improve care coordination for children with or at risk for developmental delays. Oklahoma is already considering ways to adapt the web portal for other services and populations.

Attachment Size
OK.Web_.Portal.pdf 248.76 KB

Toward Meeting the Needs of Vulnerable Populations: Issues for Policymakers’ Consideration in Integrating a Safety Net into Health Care Reform Implementation

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A 2011 Commonwealth Fund poll found that 98 percent of responding national health care opinion leaders believe that traditional safety net providers will still fulfill critical roles after implementation of the ACA. With the support of The Commonwealth Fund, NASHP formed the National Workgroup on Integrating a Safety Net into Health Care Reform Implementation to inform national and state policy development in addressing the roles of safety net providers in implementation of the ACA. This brief describes 10 overarching issues that the National Workgroup identified as ones that policymakers concerned with the safety net will need to consider in order to achieve health care reform goals, particularly for vulnerable populations.

safety.net_.hcr_.pdf 161.8 KB

 

Community Health Centers and State Health Policy: A Primer for Policymakers

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Although the federal health center program was initiated and still is largely implemented without significant state involvement, state governments’ relationships with these safety net providers have grown over the years as states have worked to increase coverage and access to quality care. This primer, which is an update to the 2008 publication, Federal Community Health Centers and State Health Policy: A Primer for Policymakers, provides an overview of community health centers and other types of Federally Qualified Health Centers and is intended to assist state policymakers in developing successful strategies to integrate health centers into state delivery systems and reform plans.

chc.primer.2012.2.pdf 393.8 KB

 

CHIP Dental Coverage: An Examination of State Oral Health Benefit Changes as a Result of CHIPRA

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Oral 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

Using Data to Drive State Improvement in Enrollment and Retention Performance

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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; and track the results of eligibility policy changes, including those related to the Affordable Care Act

data.drive_.state_.improvement.enrollment.retention.performance.pdf 248.3 KB

 

Building Medical Homes: Lessons from Eight States with Emerging Programs

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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

 

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