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Creating the Perfect Storm for Community-Based Prevention

by Jill Rosenthall and Manel Kappagoda of ChangeLab Solutions
April 2014

The United States ranked 15th among affluent countries in life expectancy in 1980. By 2009, it had dropped to 27th place. Our fragmented health care delivery and public health systems, and the lack of coordination between the two, has resulted in an imbalance of high health spending and poor health outcomes.

 

 A recent report by the Robert Wood Johnson Foundation’s Commission to Build a Healthier America, confirms what we already know: dramatically changing these statistics requires a combined approach that comprises investment in health care delivery and expanding “our focus to address how to stay healthy in the first place.”

 

Medicaid Managed Care for Children and Youth with Special Health Care Needs

by Joanne Jee
February 2014

Where some may see opportunities for improved delivery and coordination of care and cost savings, others may wonder about possible disincentives for providing the full array of needed services. For more vulnerable populations, such as children and youth with special health care needs (CYSHCN), the concerns can be heightened. 

 

Ringing in a New Year for Children’s Coverage

By Carla Plaza
January 2014

The start of a new year is a time for reflection and making resolutions. A new year also brings renewed hope, and in 2014, many individuals and families will have access to health insurance coverage, perhaps for the first time. Given all the attention to enrollment and coverage due to the roll out of the Affordable Care Act (ACA), we here at NASHP also hope to continue to help states make progress in reducing the number of uninsured children.
 

2013: Exchanges and More

Neva KayeBy Neva Kaye
December 2013

The health policy community has been paying rapt attention to the challenges and successes of implementing the state and federal health insurance exchanges (aka marketplaces).  But states have a much broader agenda for improving coverage, promoting access to services, and improving the delivery of care.  In NASHP’s final blog of the year we draw attention to the many accomplishments that have occurred outside the spotlight.

 

How Do I Enroll Thee? Let States Count the Ways…

By Alice Weiss
November 2013

 

While open enrollment for health insurance exchanges is well underway, major changes to enrollment processes won’t begin for all states until January 1, 2014, when the Affordable Care Act’s Medicaid and Children’s Health Insurance Program (CHIP) eligibility requirements go into effect.  These new requirements, like the “no wrong door” enrollment process, standard income determination rules, and electronic verification, apply to all states, regardless of their decision to host an exchange or expand Medicaid.  To prepare, state officials have been working around the clock. 

Lessons in Primary Care Extension from Four States

By Larry Hinkle
October 2013

Many states are testing primary care extension as a strategy for supporting continuous quality improvement in practice. Primary care extension is based on the model of the Agricultural Extension Service. In health care this model applies scientific research and new knowledge to practices through provider education – often led by other providers or specially trained practice facilitators.
 

School-Based Health Care for Adults, Too

By Andy Snyder

September 2013

It’s the start of the school year, and some school-based health centers (SBHCs) are busy providing health services not just to students, but to adults as well. The School-Based Health Alliance reports that the number of school-based health centers that provide care to students’ families, school faculty, and the wider community is increasing.  As states look for ways to increase their capacity for primary care and ensure access to those who will be newly insured, innovative efforts in Oregon and Los Angeles show how states and communities can leverage SBHCs to expand access to care for adults. 

 

Blazing the Trail into the Digital Age

By Barbara Wirth

August 2013

 

Information drives change, and, in today’s digital age, the transformation of the health care system is increasingly linked to the use of health information technology (HIT). The days of hand-written notes, manual chart reviews and paper bills sent to payers by a health care provider practice are all but gone.  States increasingly need to collect accurate, timely and actionable measurements electronically and use that data to advance the triple aim of improving patient experience, improving health outcomes for the population and managing health care costs.  

The HIT Trailblazer Project highlighted the challenges for states in creating the state-level HIT infrastructure that would align HIT with these goals for health care transformation. Sponsored by the Office of the National Coordinator for Health Information Technology (ONC), Deloitte Consulting LLP, and Research Triangle Institute International (RTI), eight states – Arkansas, California, Maine, Massachusetts, Michigan, Minnesota, Oregon and Rhode Island - received support to ‘blaze a trail’ forward into this complex and fragmented field.  The challenges ahead are numerous.

Partnering for Kid’s Coverage – It’s Never too Late

By Carla Plaza

July 2013

Over the last couple of years, we’ve heard and learned much about states’ efforts to implement the Affordable Care Act (ACA). However, we have heard less about the continuing efforts and successes of states in covering more children. NASHP’s Children in the Vanguard project, supported by The Atlantic Philanthropies, brought together a diverse group of states—California, Colorado, Maryland, Mississippi, New Jersey, North Carolina, Ohio, Oklahoma, and Oregon—to focus on children’s coverage during this incredibly busy time. Participating state teams of state officials and advocates developed complementary strategies and engaged in peer learning opportunities to improve the enrollment of children in health insurance coverage and to address the needs of children and youth in implementing the ACA.

Care Coordination: If we don't measure it, does it exist?

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?

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