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#NASHPCONF20 Highlighted States’ Creativity in Addressing Equity, Bolstering Health Care, and Preserving Safety Nets during COVID-19

Last week, over 1,000 state health policy leaders and others from every state joined the National Academy for State Health Policy’s (NASHP) first-ever virtual state health policy conference to discuss a path forward during an unrelenting pandemic and profound budget challenges. As one state official noted, “This was a chance to lift my eyes from the day-to-day challenges and look at the big picture.”

Several common themes emerged from the discussions. First, we saw the resiliency and creativity of state policymakers as they struggle with the day-to-day challenges of addressing the pandemic and safeguarding public health. We saw their insistence that action must replace words to address the horrific racial disparities in health care.

During the sessions, attendees reinforced the need for data and evidence to inform policies and for continued vigilance to ensure health care is available and affordable for all. Frustrated by the lack of federal action, particularly around costs, states are exploring new models to make prescription drugs affordable now and new initiatives to benchmark total cost-of-care spending, limit cost growth, and address health care consolidation.

The NASHP conference reinforced how much the work state leaders do every day matters. They make the right things happen that support our heroic frontline workers, they work hard behind the scenes to ensure health care is safe, accessible, and affordable, and they quietly keep things running while chaos and crisis make headlines.

The pandemic has challenged state leaders to find new ways to deliver care to those with substance use disorders, children with special health care needs, and others who rely on home- and community-based services. State officials shared their strategies to:

  • Support essential health workers who provide critical care;
  • Deploy state employees to staff hotlines to bolster contact tracing and provide other support to populations at high risk of infection; and
  • Continue regulatory flexibility to support telehealth to allow states to determine appropriate utilization and reimbursement strategies.

The conference gave leaders an opportunity to brainstorm about the pandemic’s impact on nursing home and other congregate care facilities and the need to re-double efforts to build more robust home- and community-based care options. Throughout the conference, attendees noted that many of these issues are not new – but the urgency now to address them will stimulate action.

In his opening day remarks, Massachusetts Gov. Charlie Baker praised the work of states and noted that the pandemic challenges state policymakers to find new ways to change how health care is delivered and to recognize that health care must also address the social determinants of health.

A striking theme throughout the three-day conference was the emergence of new partnerships and the breaking down of silos within state government to allow staffs from different agencies to quickly join forces in a common effort to make needed changes. Collaboration replaced competition as states faced both the pandemic and its devasting impact on state budgets – a trend speakers hoped would survive the pandemic.

We hope state leaders who are working under extraordinary pressure during this unique period in our nation’s history were a bit re-energized as they returned to work, knowing new challenges lie ahead. This pandemic will pass and in its wake will be innovation and creativity that will inform future policy. Getting there isn’t easy, but the NASHP conference reinforced how much the work state leaders do every day matters. They make the right things happen that support our heroic frontline workers, they work hard behind the scenes to ensure health care is safe, accessible, and affordable, and they quietly keep things running while chaos and crisis make headlines. They hold firm to their values and tell truth to power no matter what the consequences.

We hope to meet in person at next year’s conference in Washington, DC with tales to tell of how you made progress on equity, ensured that the safely net was there in tough budget times, and how you managed to pull out from the shadows of a long pandemic. Be well, take care of yourselves, and thank you for your continued leadership and devotion to the important work you do.

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