Pilots in Colorado and Western Australia Integrate Paramedics into Care Team

Walkabout Medical Homes with Mary Takach: A 10-month Study of Australia
February 2015 

Reducing inappropriate utilization of the emergency department (ED) is a very common focus of health systems, payers, and practices seeking to improve health care quality and reduce costs. To help break the cycle of non-emergency ED use lists of “superutilizers” are generated from a variety of data sources and care managers are assigned to work with these patients.

Australian Policymakers Taking Cues from ‘Shark Tank’ on Disruptive Innovation

Walkabout Medical Homes with Mary Takach: A 10-month Study of Australia
January 2015 

Many people are familiar with the U.S. television show, Shark Tank, where budding entrepreneurs pitch business ideas to a panel of industry giants or “sharks,” ultimately convincing one or more of them to invest. Imagine taking a similar premise and adopting it as a strategy to surface innovations in the health policy arena. That is exactly what North Coast New South Wales (NCNSW) Medicare Local,one of 61 federally funded primary health care organizations in Australia that are charged with improving primary health care and ensuring that primary health care services are better tailored to meet the needs of local communities, did. Chief Executive Officer Vahid Saberi described sitting in an executive team meeting, discussing how to encourage ideas that address community needs when the corporate manager brought up the idea of using a reality TV format.

The Building Blocks of a Comprehensive System of Care for CYSHCN

By Felicia Heider
December 2014

Improving care for children and youth with special health care needs, also known as CYSHCN, brought together a select group of Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Coordinators and Title V children and CYSHCN directors this October as part of NASHP’s 2014 Annual State Health Policy Conference. These state leaders, who are responsible for overseeing the EPSDT benefit and CYSHCN programming, respectively, gathered to strategize on improving systems of care for CYSHCN. This daylong meeting, supported by the Lucile Packard Foundation for Children’s Health, offered attendees a unique platform for exchanging best practices and sharing the challenges and successes experienced as they work to improve care for CYSCHN. Discussions touched on an array of topics such as screening, assessment and referral, care coordination, and treatment services.

Addressing Potentially Avoidable ED Visits Among Residents of Aged Care Facilities

Walkabout Medical Homes with Mary Takach: A 10-month Study of Australia
December 2014

There are many reasons residents in aged care facilities end up in emergency departments (EDs), but a significant number of these visits, between 40 and 67 percent according to research, are potentially avoidable (NCHS, 2004; Ouslander, 2010). One reason for many unnecessary ED visits is the fact that some staff at an aged care facility may lack the basic skills for assessing and addressing conditions that could be otherwise managed there.

Using ‘Low Intensity Coaches’ Yields 60% Recovery Rates for People with Mild-Moderate Mental Health Illnesses

Walkabout Medical Homes with Mary Takach: A 10-month Study of Australia
November 2014

According to the World Health Organization, the cost of mental health problems in developed countries is estimated to be between 3% and 4% of GNP. In addition, the cost to national economies in terms of economic burden (productivity) can add up to several billion dollars more [Investing in Mental Health, 2003]. Treating mental illness at early stages before the symptoms manifest and disable is the aim of two-year pilot being tested by three primary health care organizations (PHCOs) in Australia.

What Might the Future Hold for CHIP?

By Maureen Hensly-Quinn

November 2014

As we have done for many years, with support from the David and Lucile Packard Foundation, NASHP convened the nation’s Children’s Health Insurance Program (CHIP) directors in conjunction with our recent 27th Annual State Health Policy Conference. This year the CHIP Directors’ meeting included discussions aimed at surfacing policy issues and questions that states are facing related to the future of the CHIP program and other coverage options for children. A policy café on children’s coverage during the conference also provided an opportunity for discussion on the future of CHIP among a broader range of stakeholders, including CHIP and Medicaid officials, children’s health experts, researchers, and advocates.

An Indigenous Health System’s Strategy to Develop Workforce and Tools to Connect Hard-to-Reach Populations to a Medical Home

Walkabout Medical Homes with Mary Takach: A 10-month Study of Australia
October 2014


Q. If you build a medical home, will they come?
A. It depends on the population served. For disenfranchised, complex populations, if there are no concerted efforts, the answer is a resounding no.

Enter Community Liaison Officers (CLO)—a role created by the Institute for Urban Indigenous Health (IUIH) in 2009 to connect its population of approximately 70,000 Aboriginal and Torres Strait Island people to primary health care services at one of their 18 primary care clinics in Southeast Queensland, Australia.

A Helping Hand: Support for Families in Using the EPSDT Benefit

By Mike Stanek

September 2014

The Medicaid benefit for children and adolescents (also known as the Early and Periodic Screening, Diagnostic, and Treatment benefit or EPSDT), Medicaid’s comprehensive and preventive child health component, is the backbone of public health insurance for children and youth. It provides over 44 million children with access to a range of preventive, screening, and treatment services. State Medicaid agencies are continuously developing and implementing new strategies under the EPSDT benefit to improve the care delivered to children. Sharing the tools, resources, and strategies developed by each state will enable policymakers to benefit from the work of their peers.

Organizing Delivery Systems to Better Support Primary Care: What Can States in the US Learn From and Share With Australia?

Walkabout Medical Homes with Mary Takach: A 10-month Study of Australia
September 2014

What can states with large frontier areas such as Alaska, Texas, Montana, and Arizona learn from how Australia organizes and supports primary care delivery in its vast outback? 

What do publicly financed community-based teams, networks, and organizations found in states including Vermont, North Carolina, Oregon, and Colorado have in common with the Australia government’s four-year experiment in financing and organizing local primary health care organizations nation-wide?

What lessons can states such as Massachusetts, Rhode Island, and Pennsylvania share with the Australian government on how to evolve primary care provider payments from fee for service (FFS) (yes, Australia general practitioners also get paid FFS) to blended payment models that include capitation and shared savings to better support access to medical homes?

Using Payment Policies to Support Primary Care – Behavioral Health Integration in Medicaid

By Shayla Regmi and Andrew Snyder

 August 2014

Many states are developing and implementing strategies for integrating behavioral health with primary care. Integrated care improves patients’ access to behavioral health services, attendance at scheduled appointments, satisfaction with care, and adherence to treatment. Minority populations in particular are more likely to seek mental health treatment from primary care practitioners than from mental health specialists. Medicaid payment policies, including reimbursement for behavioral health screenings, management, and referrals in primary care settings, can facilitate this integration.

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