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- Managed Care
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Using Report Cards to Measure Racial and Ethnic Health Disparities: State Experience
State agencies identify, document, and act on data related to racial and ethnic health and health care disparities in various ways. One type of document states produce is a “report card,” or a publication that uses data from race/ethnicity-specific measures to assign letter grades that rate the state's performance. This issue brief, prepared by NASHP for the Agency for Healthcare Research and Quality (AHRQ), focuses on New Mexico’s experience using report cards to measure racial and ethnic health disparities.
Click to download the report (PDF).
September 2011 -
Using Geographic Information to Target Health Disparities: State Experience
This brief describes how two states, Rhode Island and Virginia, have used particular data collection techniques along with Geographic Information Systems (GIS) to analyze and map race and ethnicity data. Virginia uses GIS with multi-level spatial analysis, while Rhode Island uses GIS in conjunction with Community Based Participatory Research (CBPR). This brief, prepared by NASHP for the Agency for Healthcare Research and Quality (AHRQ), also discusses how both states utilize these techniques to target interventions aimed at reducing disparities. View the full report here.
September 2011» -
Assessing the Costs of Racial and Ethnic Health Disparities: State Experience
Health disparities cost the United States billions of dollars in direct medical expenditures in addition to the human costs. In an effort to improve quality and contain costs states are taking steps to measure these costs and address disparities. This issue brief, which features Virginia and Rhode Island, was prepared by NASHP authors Carrie Hanlon and Larry Hinkle for the Agency for Healthcare Research and Quality (AHRQ). It focuses on tools, challenges, and strategies states use to measure the costs of health disparities.
June 2011» -
State Documentation of Racial and Ethnic Health Disparities to Inform Strategic Action
This report, prepared by NASHP for the federal Agency for Healthcare Research and Quality, summarizes how leading states analyze state and federal race/ethnicity data in strategic plans and reports aimed at reducing racial and ethnic disparities in health status and health care. It features Colorado, Connecticut, Georgia, Maryland, New Jersey, New Mexico, Rhode Island, and Utah, but also notes activity in Arizona, California, Massachusetts, Michigan, North Carolina, Ohio, and Virginia. Lessons from leading states can provide guidance for others exploring ways to launch or enhance health equity, consumer engagement, quality improvement, or cost containment initiatives.
Read full report here:
January 2011 -
State Strategies to Improve Quality and Efficiency: Making the Most of Opportunities in National Health Reform
There is an acknowledged need for extensive reform to the health care delivery system in the United States. The Patient Protection and Affordable Care Act offers unprecedented opportunities to transform care delivery, with numerous provisions that support systemic improvements. States have an imperative to greatly improve system efficiency if they are to effectively and sustainably implement the law’s changes, particularly mandatory coverage expansion. This report examines specific Affordable Care Act provisions that support state system improvement goals and profiles efforts in 10 states: Colorado, Kansas, Maine, Massachusetts, Minnesota, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington. The report highlights the opportunities and challenges that federal health care reform will bring and offers suggestions for how state and national leaders can streamline implementation.
December 2010» -
State Uses of Hospital Discharge Databases to Reduce Racial and Ethnic Disparities
This report summarizes how leading states that participate in the Healthcare Cost and Utilization Project (HCUP) and their clients use hospital discharge data on patient race/ethnicity to inform state health care disparities reduction activities. The report features California, Florida, Massachusetts, Rhode Island, and Wisconsin HCUP Partners, but also notes activity in Connecticut, Georgia, New Jersey, and South Carolina. Partner States’ experiences demonstrate that patient race/ethnicity data are an important tool for informing state initiatives and producing policy- and practice-relevant publications to support health equity.
September 2010» -
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» -
Collaborating with Health Centers to Leverage HIT for System Improvement
Early in 2010, NASHP hosted a webinar that brought together individuals from Massachusetts, Oregon, and Tennessee with experience in collaborating with health centers around Health Information Technology (HIT) activities to discuss ways in which state agencies and federally qualified health centers (FQHCs) are working together to use HIT and health information exchange (HIE) funding opportunities from the American Recovery and Reinvestment Act (ARRA) to achieve mutual goals for health system improvements. This briefing draws from and builds on this webinar to offer an overview of opportunities, explore these states’ experiences, and provide concluding observations. This brief was developed through a National Cooperative Agreement (NCA) sponsored by the Health Resources and Services Administration’s (HRSA) Bureau of Primary Health Care (BPHC).April 2010» -
Enhancing Clinical Information in Statewide Hospital Administrative Data: Project Summary and Lessons Learned
This report, developed by Thomson Reuters and NASHP, is based on lessons from the AHRQ-sponsored Adding Clinical Data project, which awarded Pilot or Planning contracts to the Healthcare Cost and Utilization Project (HCUP) Partner organizations in Florida, Minnesota, Virginia, and Washington to explore feasible, practical solutions to adding clinical data to administrative discharge records. Adding present on admission coding and laboratory results to existing administrative datasets is seen as a practical, effective, and cost-effective method to produce more accurate and expanded quality assessments of hospitals; it will also provide the evidence base for quality improvement efforts.January 2010» -
Nonpayment for Preventable Events and Conditions: Aligning State and Federal Policies To Drive Health System Improvement
NASHP synthesized background information about state and federal policies that deny or reduce payment for adverse events. In October 2009, NASHP convened high-level state and national leaders to discuss 1) issues related to nonpayment of adverse events and 2) priority issues for state/federal dialogue. This report examines policies implemented by the Medicare program and state agencies in twelve states (Colorado, Kansas, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New York, Oregon, Pennsylvania and Washington). Key lessons are included. Participants see aligning federal and state nonpayment policies as one area in which future alignment between federal and state policies can advance health system reform.December 2009»
