State roles

As states assess the challenges and opportunities presented by federal health reform legislation, there is a natural tendency to focus on the most immediate issues, but it is equally important that states begin planning for the many aspects of implementation that occur in later years.  This State Health Policy Briefing identifies and describes ten aspects of federal health reform that states must get right if they are to be successful in implementation.  States that pursue the ten critical elements identified in this brief will have the greatest chance of achieving the goals embodied in the federal health reform law.  

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.

This NASHP-led, Commonwealth Fund-supported report highlights ten leading state quality improvement partnerships, broad-based, public-private partnerships that strive for long-term, statewide, and systemic quality improvement. This report describes the state partnerships' origins, internal processes, accomplishments, and lessons learned, as well as their five strategies for achieving quality improvement. The factors and policies that influence the 10 featured state partnerships offer key insights for achieving systemic improvement in health care quality and performance. The report features state partnerships in Colorado, Kansas, Maine, Massachusetts, Minnesota, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington.

The recent growth of retail clinics across the United States presents opportunities and challenges for states working to address access, costs, and quality issues within their health delivery systems.  With more than 1,000 sites in 37 states, the emergence of retail clinics as an alternate provider has shaken up traditional health care models and can no longer be viewed as a passing trend for the following reasons: • Retail clinics are accessible. They are usually found in suburban settings within a drug store, grocery store, or mass merchandise store. They are open during evening and weekend hours, without waits or appointments. • Retail clinic services often cost less. Because clinics are mostly staffed by lower cost providers such as nurse practitioners and have lower overhead costs, prices for services can be substantially less than alternatives such as an emergency room or urgent care center.