Blogs

By Carrie Hanlon

June 2013

It has been said (perhaps first by William Bruce Cameron), “Not everything that can be counted, counts, and not everything that counts can be counted.” When it comes to state policy for health system performance improvement, a more accurate axiom might be, “What gets measured gets done”.  Leaders rely on evidence that a health care policy, process or program is meeting its goals—containing costs, producing better health outcomes and/or improving quality of care.  Anecdotal evidence can be powerful, but data also are an influential tool in policymaking. Through research for a forthcoming report on NASHP’s ABCD III project, it became clear there are many state and federal delivery reform and performance improvement initiatives expecting or requiring care coordination, but we aren’t measuring care coordination across primary medical and community (non-medical) settings. How do we know if it’s happening?

By Sarah Kinsler

May 2013

Momentum is building at the state level for multi-payer payment and delivery system transformation. Across the country, states like Maine, Arkansas, and Oregon are partnering with commercial insurers and other stakeholders to pursue Triple Aim goals. NASHP’s new Multi-Payer Resource Center, supported by The Commonwealth Fund, will help them succeed.

By Maureen Hensley-Quinn

April 2013

As state and federal government officials race to meet Affordable Care Act (ACA) implementation deadlines much of their attention has been focused on adults who will be newly eligible for health coverage.  Health insurance exchanges (exchanges) or marketplaces need to be prepared to serve children’s needs as well.  The Children’s Health Insurance Program (CHIP), an already established and tested program, could be used to help states meet ACA requirements for exchanges while establishing good coverage for children.  A recent issue brief and compendium released by the National Academy for State Health Policy (NASHP) explores how CHIP could inform children’s coverage provided through exchanges. 

By Scott Holladay

March 2013

The goal of evidence-based supported employment is to place individuals with serious mental illness in real, competitive jobs. This evidence–based practice (EBP) is highly effective, resulting in competitive employment at nearly three times the rate of other vocational services.[1] Studies comparing supported employment with day treatment have shown similar results.[2] Despite this strong evidence, the practice has been slow to take hold, but 17 states are now using Medicaid to expand its availability. As a major payer for behavioral health services, Medicaid support is crucial to implementation of EBPs.

By Alice M. Weiss, J.D.

February 2013

As states embark on the final stretch before new Patient Protection and Affordable Care Act (ACA) coverage options begin in 2014, most are finding their sprint has turned into more of an obstacle course, with late-breaking guidance posing new hurdles and surprises around every bend. Given all this, you would think states might be ready to slow their pace, and yet when I spoke with state officials at NASHP’s final Maximizing Enrollment grantee meeting, all reported they are committed to reaching the finish line in their work to streamline eligibility and enrollment systems and processes. There were a bunch of common themes, even though the states were coming from different political tracks and starting blocks. I wanted to share out some key ideas I heard about how state work is progressing, challenges states are facing, and lessons learned to help other states and those working with them as we begin this final lap.

By Mike Stanek

January 2013

States are at the forefront of efforts to design and implement innovative payment and delivery mechanisms that encourage accountability for costs and quality in health care delivery. Bolstered by state legislative mandates, as well as provisions in the Affordable Care Act to re-orient federal health spending to promote accountable care, states are developing a variety of initiatives to improve value—achieving better health outcomes at lower cost—and foster accountability for the value of care provided.

By Larry Hinkle

December 2012

Many state officials are turning their attention to the most neglected leg of the Triple Aim: improving the health of populations, which along with improving the experience of care, and reducing per capita costs of health care, is essential for system transformation efforts. The critical need to integrate population health strategies into systems transformation was a central theme that emerged during the presentations and discussions of a National Academy for State Health Policy Preconference: Improving Population Health Outcomes: Creating a Truly Comprehensive System.

By Jennifer Dolatshahi

November 2012

All children enrolled in Medicaid are entitled to dental benefits as part of the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT), but only 40 percent of enrolled children had a dental visit in 2010. Access to dental care remains an issue for children, and states report that most dentists treat few or no Medicaid or Children’s Health Insurance Program (CHIP) enrollees, although both programs cover dental services. The health care safety net is small and fragmented when it comes to oral health, and provided dental care to only 10 percent of children in Medicaid in 2009.

By Neva Kaye

October 2012

The Assuring Better Child Health and Development Initiative (ABCD) was formed in 2000 with a focus on supporting young children’s healthy development because there was strong evidence and growing recognition that early intervention can change the trajectory of a child’s life. Children at risk for developmental delay were not being identified as early as they could be and, even after identification, many children waited too long to receive services. The American Academy of Pediatrics was also near release of a statement that made explicit recommendations about surveillance and use of standardized screening tools to help identify developmental delays. The time was right for states to engage with this critical issue.

By Katharine Witgert

September 2012

It’s back-to-school time in many families, but kids – and moms – can benefit from teaching and learning much earlier in life, too. Home visits to new and expectant mothers help ensure that both mothers and children receive needed health services and can improve health and life outcomes in cost-effective ways. The Affordable Care Act (ACA) raised the profile of home visiting through the Maternal Infant and Early Childhood Home Visiting (MIECHV) program. Funding from MIECHV allows all 50 states to test home visiting models and expand those that meet standards of effectiveness. MIECHV’s $1.5 billion funding is available for five years. Medicaid is onepossible source of funding to help bring evidence-based home visiting programs to scale and ensure their long-term sustainability.