- 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
- Child Development Services
- Chronic Care Management
- Community Health Centers
- Developmental Screening
- Early Childhood Services
- EPSDT
- Family Planning
- Federally Qualified Health Centers
- Home & Community Based Services
- 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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Policies and Strategies to Make Medicaid Managed Care Work for FQHCs: Experiences from Two States
State policies have a strong influence on the ability of Federally Qualified Health Centers (FQHCs) to participate in managed care arrangements. The 2000 Institute of Medicine report, “America’s Health Care Safety Net: Intact but Endangered,” examined the impact of Medicaid managed care on the future integrity and viability of safety net providers, such as community health centers. The report warned federal and state policy makers that managed care policies need to explicitly take into account the unique mission of safety net providers, reflected through fair rates and policies, lest the safety net structure be significantly weakened.March 2009 -
SCHIP Delivery Systems
This State Health Policy Monitor provides an overview of the delivery systems and payment structures states use for their State Children’s Health Insurance Programs (SCHIP). States generally choose from among: • Contractor-based managed care delivery, • Primary care case management (PCCM), and • Traditional fee-for-service arrangements. A NASHP survey in 2005 found that approximately 70 percent of all children enrolled in SCHIP were in managed care plans, and nearly 90 percent of SCHIP programs using managed care contracted with one or more plans that primarily serve the commercial market.October 2007» -
Medicaid Managed Care: Looking Forward, Looking Back
This paper tracks changes and trends in Medicaid managed care between 1990 and 2002. The report is based on six NASHP surveys of state Medicaid managed care programs (conducted in 1990, 1994, 1996, 1998, 2000, and 2002). The surveys gathered information on the scope and operation of both risk and primary care case management (PCCM) programs. The report also looks ahead and includes a discussion with state officials of trends that may continue and factors that may impact the future of Medicaid managed care. Contents Key Findings Introduction to the Data Marketplace Enrolled Populations Contractor Type and Covered Services Selection and Payment Access to Care Quality Looking Ahead Conclusion Appendix: 2002 Survey InstrumentJune 2005» -
ERISA Update: The Supreme Court Texas Decision and Other Recent Developments
This brief explores the U.S. Supreme Court’s June 2004 decision that ERISA preempts the Texas HMO liability law, as well as the decision’s effects on other state health plan liability laws. The brief also examines implications of ERISA preemption for state health insurance regulation, “pay or play” health coverage laws, and premium assistance programs.August 2004» -
State Budget Cuts and Medicaid Managed Care: Case Studies of Four States
Based on information gathered from survey data and interviews with stakeholders in four states (Florida, Massachusetts, Michigan, and Oregon), this report examines the impact of Medicaid budget cuts on states’ Medicaid managed care programs.June 2004» -
Perspectives on Using a Rapid Monitoring System: A Report from the Effective Managed Behavioral Healthcare Program Monitoring Summit
This report looks at eight key findings of a group of state policy makers and other experts convened to discuss their experience in operating an Early Warning System (EWS) or a similar system. An EWS uses a limited set of measures and administrative processes to oversee the managed care behavioral health system and provide real-time, performance-based information to state, federal, and local governments; consumers; families; providers; advocates; and other key stakeholders.September 2002» -
Medicaid Managed Care Policies Affecting Safety-Net Providers and the People They Serve – Volume III: Finance
This report is the third of three in a series that uses findings from a literature review and an all-state survey conducted by NASHP in the fall of 2000 to examine Medicaid managed care policies related to safety-net providers and the people they serve. This third report examines state Medicaid managed care policies regarding aspects of financing of particular concern to safety-net providers.November 2001» -
Medicaid Managed Care Policies Affecting Safety-Net Providers and the People They Serve – Volume I: Eligibility and Access Policies
This report is the first of three in a series that uses findings from a literature review and an all-state survey conducted by NASHP in the fall of 2000 to examine Medicaid managed care policies related to safety-net providers and the people they serve. This first report examines state Medicaid policies regarding the inclusion of safety-net providers in Medicaid managed care and access for people served by these providers.November 2001» -
Medicaid Managed Care Policies Affecting Safety-Net Providers and the People They Serve – Volume II: Monitoring Functions and Quality
This report is the second of three in a series that uses findings from a literature review and an all-state survey conducted by NASHP in the fall of 2000 to examine Medicaid managed care policies related to safety-net providers and the people they serve. This second report examines state Medicaid managed care policies regarding managed care monitoring functions and quality issues of particular concern to safety-net providers.November 2001» -
Building Quality in Medicaid Managed Care: What Policy Makers Need to Know (and Do!)
This report is designed to help policy makers sift through the complex responsibilities states assume as purchasers, regulators, and partners of health plans. Written in plain, jargon-free language, the report both clarifies state responsibilities for quality care and identifies the tools available to policy makers to help meet those responsibilities.February 1998»
