- 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
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Toward Meeting the Needs of Vulnerable Populations: Issues for Policymakers’ Consideration in Integrating a Safety Net into Health Care Reform Implementation
A 2011 Commonwealth Fund poll found that 98 percent of responding national health care opinion leaders believe that traditional safety net providers will still fulfill critical roles after implementation of the ACA. With the support of The Commonwealth Fund, NASHP formed the National Workgroup on Integrating a Safety Net into Health Care Reform Implementation to inform national and state policy development in addressing the roles of safety net providers in implementation of the ACA. This brief describes 10 overarching issues that the National Workgroup identified as ones that policymakers concerned with the safety net will need to consider in order to achieve health care reform goals, particularly for vulnerable populations.
January 2012» -
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» -
Reducing Racial and Ethnic Disparities Through Health Care Reform: State Experience
The Patient Protection and Affordable Care Act of 2010 (ACA) provides an opportunity for states to reduce racial and ethnic disparities in health and health care. As states roll out health care reform implementation, they can use disparities data to inform their actions. This issue brief was prepared by NASHP for the Agency for Healthcare Research and Quality (AHRQ). It provides examples of how states can integrate health equity into health care reform and insurance exchange implementation.
August 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 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» -
Enhanced Pregnancy Benefit Packages: Worth Another Look
Through their Medicaid programs, states may offer specialized pregnancy benefits to women that target risks contributing to poor pregnancy outcomes. Though such benefits are categorized as “optional” Medicaid services, they are seen by many as critical to optimizing maternal health and positive birth outcomes. These enhanced pregnancy benefits support women in having healthy pregnancies and contribute to improved infant and maternal health. Congress gave states the option to offer enhanced pregnancy benefits to pregnant women on Medicaid in 1985, and many states quickly took advantage of this opportunity, adding comprehensive non-clinical and medical pregnancy services to their Medicaid benefit packages. The use of enhanced pregnancy benefits peaked in 1993 when forty-four states provided at least one enhanced pregnancy benefit through Medicaid.January 2010 -
Increasing Access to Dental Care in Medicaid: Targeted Programs for Four Populations
Poor access to oral health care and low utilization of oral health services by publicly insured people have been persistent problems that states and their Medicaid programs have grappled with for decades. However, there are groups of Medicaid enrollees – such as young children, pregnant women, people with developmental disabilities, and people living in rural areas – who face particular oral health challenges. These populations can benefit from interventions targeted specifically at their needs. This policy briefing, which is drawn from a literature review and interviews with stakeholders across the country, describes strategies that several states have used to better address the oral health needs of these groups by doing the following:March 2009 -
Chronic Homelessness and High Users of Health Services: Report from a Meeting to Explore a Strategy for Reducing Medicaid Spending While Improving Care
There is evidence that homeless people, especially the chronically homeless, incur high health care costs, much of which may be paid for with Medicaid funds. There is also evidence that health care costs are reduced when homeless people with intensive medical needs enter supportive housing, which combines affordable, stable housing with care workers who assist residents in managing health, mental health, substance abuse, and employment issues. This evidence provides an opportunity for states to reduce Medicaid costs by increasing their investment in housing. In April 2007, a small group of homeless and housing advocates, state health care leaders, and managed care providers met to explore this opportunity.January 2008 -
Medically Needy: An Option Worth Revisiting?
Medicaid medically needy programs allow states the option to expand Medicaid coverage to people with high medical expenses and who otherwise would be ineligible due to income or resource limits. To qualify, individuals “spend down” into Medicaid coverage by paying out-of-pocket medical expenses to lower their income to a predetermined level. Currently, 33 states and the District of Columbia operate medically needy programs. In 2003, more than 3.4 million people – 6.3 percent of the Medicaid population – received coverage through a medically needy program at an annual cost of $27 billion -- 9 percent of total Medicaid expenditures. These programs also allow states to expand Medicaid benefits to certain populations otherwise neligible for Medicaid, notably young adults ages 19 to 21.December 2007
