As the list of nationally recommended newborn screenings continues to grow, health departments are called to do more with increased costs. How do states make decisions about what they will cover? What are the ethical, scientific, and legal issues they consider? Where will states find funding for testing as well as support for treating identified conditions? Will state advisory group recommendations be included, and how do these recommendations shape state benefit packages?
Expanding Newborn Screening: Issues That Influence State Decisions
Tuesday, October 6, 2009
Coordinating Community Care and Navigating Passages between Home and Hospitals
Tuesday, October 6, 2009
Increasing attention is being placed on coordinating care for persons with multiple chronic and long term care needs. Medicare chronic care demonstrations have highlighted challenges to successfully coordinating community care and decreasing hospitalizations. However, evaluations of these efforts have also identified key elements that produced positive outcomes. These will be presented along with the experiences of two states that have strengthened their case management systems to improve coordination of long term supports and reduce use of hospital and nursing facility care.
Improving Managed Care Quality and Accountability Using State Regulatory Strategies
Tuesday, October 6, 2009
Most states now contract with managed care plans to provide Medicaid services for many Medicaid beneficiaries. How can state regulatory agencies and Medicaid agencies work together to get the most from their health care dollars? What tools can regulators employ to help states monitor the activities of managed care plans? We will look at regulatory strategies that states can use to improve quality, coordinate care, and improve health outcomes.
Partnering with the Private Sector in State Medical Homes Initiatives
Tuesday, October 6, 2009
Successful state medical home initiatives have all involved public-private partnerships in order to change behavior and practices at the consumer, provider, and payer level. This session will look at different state models that explore how partnerships formed and the critical factors for success including how to use payment incentives to drive change. Examples from states will include Oklahoma, which through extensive provider outreach and input has developed medical home criteria that they hope will inform private sector participation; Rhode Island, which through partnerships with health plans and physicians is seeking to change provider behavior; and Pennsylvania, which through partnerships with commercial payers is seeking to penetrate the entire state to spur access to high functioning medical home practices.
