- ACA Implementation & State Health Reform
- Coverage and Access
- Federal/State Issues
- Medicaid and CHIP
- Population and Public Health
- Providers and Services
- Acute Care
- Assisted Living
- Behavioral Health
- Case Management
- Child Development Services
- Chronic Care Management
- Community Health Centers
- Developmental Screening
- Early Childhood Services
- Emergency Care
- EPSDT
- Family Planning
- Federally Qualified Health Centers
- Home & Community Based Services
- Hospitals
- Long Term Services & Supports
- Medical Homes & Health Homes
- Mental Health
- Nursing Homes
- Oral Health
- Preventive Care
- Primary Care
- Safety Net Providers
- Quality, Cost, and Health System Performance
- ACOs
- Adverse Event Reporting
- Care Transitions
- Comparative Effectiveness
- Cost Sharing
- Delivery System Reform
- Fraud and Abuse
- Health Care Workforce
- Health Information Technology
- Managed Care
- Medical Homes & Health Homes
- Medical Malpractice
- Patient Safety
- Payment Reform
- Performance Measurement
- Provider Payment Policy
- Quality Oversight
- Specific Populations
- Adolescents
- Childless Adults
- Children
- Children with Special Health Care Needs
- Dual Eligibles
- Elders
- Families
- Low Income People
- Parents
- People with Chronic Conditions
- People with Developmental Disabilities
- Transitional Youth
- Vulnerable Populations
- Young Adults
- Youth
- Youth in Foster Care System
- Youth in Juvenile Justice System
State Innovations to Transform and Link Small Practices
Federal and state governments play a significant role in strengthening the delivery of primary care, however current efforts have disproportionally been focused on large or multi-specialty practices. This report examines the roles states are playing to reorganize the delivery of primary and chronic care to produce more efficient and effective care, particularly in small practices. Through short case studies developed via interviews with state officials and physicians the authors highlight several state-based initiatives that seek to create high performing health systems by targeting local and regional strengths. Additionally, authors identified five themes critical to enacting strategic delivery system reforms.
December 2010
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Evaluating the Patient-Centered Medical Home: Potential and Limitations of Claims-Based Data
This State Health Policy Briefing summarizes the advantages and disadvantages of using claims-based data to evaluate patient-centered medical home initiatives. A Medicaid-based medical home initiative in Oklahoma and a multi-payer medical home pilot in Rhode Island are highlighted. Both states are using a mixture of claims-based data and supplementary resources like patient or provider surveys and data collected from electronic medical records to evaluate their medical home programs. Understanding the potential uses and limitations of both claims data and other data sources that can aid evaluators will help states to design appropriate evaluative criteria for their medical home programs.
September 2010
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A Tale of Two Systems: A look at State Efforts to Integrate Primary Care and Behavioral Health in Safety Net Settings
Integrated behavioral health and primary care occurs when behavioral health specialty and general medical care providers work collaboratively to address patients' physical and behavioral health needs. Federal community health centers are uniquely positioned to partner with the community mental health system to deliver integrated care, and to address behavioral health issues as part of a comprehensive medical home. This report focuses on how Tennessee and Missouri - two states that NASHP works with under our National Cooperative Agreement with the federal Health Resources and Services Administration, Bureau of Primary Health Care (HRSA/BPHC) - have approached integration and provides lessons for states seeking to integrate health care delivery systems.
May 2010
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State Multi-Payer Medical Home Initiatives and Medicare’s Advanced Primary Care Demonstration
In September 2009, the U.S. Secretary of Health and Human Services announced that Medicare will join selected state-based, multi-payer medical home initiatives in an Advanced Primary Care (APC) demonstration. States have welcomed this announcement viewing Medicare as a valuable potential strategic stakeholder, yet are concerned that the proposed APC criteria may be too narrow to fit many current initiatives. This paper builds from a December 2009 research scan and webcast that looks at a broad range of state multi-payer initiatives and compares some of these criteria against the proposed APC criteria.
February 2010
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State Strategies for Care Coordination, Case Management, and Linkages for Young Children: A Scan of State Medicaid. Title V, And Part C Agencies
NASHP conducted this scan of states in order to better identify and understand what states are doing through variously funded early child health and development agencies to promote better care coordination, case management, and linkages to services for young children. The scan was designed to elicit strategies used by the three state agencies to improve healthcare and community linkages in three areas: within primary care practices; between primary care practices and other child and family service providers; and through systems or statewide strategies. This paper describes state models that may help policy makers become more aware of the potential resources and tools available to promote healthy development for young children and can provide states with strategies to more effectively coordinate resources and achieve better outcomes for their children.
December 2009
Engaging Primary Care Medical Providers in Children’s Oral Health
Access to dental care in the U.S. is a severe problem for young children, underscored by the fact that only a quarter of all children under six had a dental visit in 2004. In an effort to address these access issues, many states have begun reimbursing medical providers for delivering basic oral health services to children. This issue brief provides an update to the 2008 State Health Policy Monitor, The Role of Physicians in Children’s Oral Health, which highlighted state efforts to increase access to preventive dental care through the use of medical providers. Currently, 34 state Medicaid programs reimburse primary care providers for performing preventive oral health care services on children, including nine new state programs since last year’s study. These preventive oral health care services include the application of fluoride varnish, anticipatory guidance/caregiver education, risk assessment, and an oral examination/screening.
September 2009
The National Research Council/Institute of Medicine’s Adolescent Health Services: Highlights and Considerations for State Health Policymakers
In May 2006, the National Research Council/Institute of Medicine’s (NRC/IOM’s) Board on Children, Youth and Families (BCYF) convened the Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Healthy Development. With funding from The Atlantic Philanthropies, the committee conducted a study of health services for adolescents ages 10-19 in the United States and issued a report, Adolescent Health Services: Missing Opportunities. The National Academy for State Health Policy has written this paper based upon that report to highlight aspects of the publication most relevant for and applicable to state policymakers, who play an important role in improving adolescent health.
September 2009
Building Medical Homes in State Medicaid and CHIP Programs
With 47 million uninsured Americans, double digit inflation in medical spending and health outcomes that lag far behind other nations, comprehensive health care reform that addresses access, cost and quality issues is a national priority. A primary care oriented system may have benefits for population health, equity in health and cost containment and has been shown to reduce racial and ethnic disparities, and result in significantly lower health care costs and improved life expectancy diseases for those with chronic diseases.
June 2009
The Role of Federally Qualified Health Centers in State-led Medical Home Collaboratives
The medical home is a model of care that is taking root in both public and private payer programs in an effort to improve quality, control costs and increase both patient and provider satisfaction. Since 2006, more than 30 states have been leading efforts to advance medical homes in their Medicaid and Children’s Health Insurance Program (CHIP). Several states are leading multi-payer medical home collaboratives to spread this model in the private sector.
June 2009
