Payment and Delivery Reform
FEATURED ARTICLE
New Federal “No Surprises Act” Extends Medical Billing Protections Beyond State Reach
/in Policy Blogs, Featured News Home Consumer Affordability, Cost, Payment, and Delivery Reform, Health System Costs, Hospital/Health System Oversight, Quality and Measurement /by Christina CousartThe “No Surprises Act,” the most comprehensive federal legislation enacted to date designed to prohibit surprise medical bills, is part of the recently enacted Consolidated Appropriations Act of 2021.
States Quickly Retool Strategies to Maximize Vaccination Coverage
/in COVID-19 Blogs, Featured News Home Cost, Payment, and Delivery Reform, COVID-19, Health Coverage and Access, Health Equity, Population Health, Quality and Measurement, Quality and Measurement, Social Determinants of Health, Workforce Capacity /by Ariella Levisohn, Rebecca Cooper and Jill RosenthalFaced with limited vaccine supplies, a slow rollout of federal funds, and new federal guidelines allowing vaccination of those 65 and older, states face distribution challenges as they quickly evaluate which mass immunization practices are most effective.
Texas Improves Access to Routine Oral Health Services for Very Young Children
/in Policy Texas Child Oral Health, Chronic Disease Prevention and Management, Consumer Affordability, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Oral Health, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Quality and Measurement, Social Determinants of Health /by Veronnica ThompsonThough largely preventable, tooth decay (caries) is the most common chronic disease in US children, affecting approximately 23 percent of children ages 2 to 5.[1],[2] Texas’s First Dental Home and its enhanced bundled payment has increased access to preventive dental service and improved the oral health of Medicaid-enrolled children ages 6 to 35 months. Providing […]
Michigan Medicaid Addresses Social Determinants of Oral Health through Dental and Medical Contracts
/in Policy Michigan Blogs, Featured News Home Child Oral Health, CHIP, Consumer Affordability, Cost, Payment, and Delivery Reform, EPSDT, Health Coverage and Access, Health Equity, Health System Costs, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Oral Health, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Social Determinants of Health, Workforce Capacity /by Ariella LevisohnInequities in dental care are prevalent across the United States, with significant disparities based on age, race, ethnicity, and socioeconomic status. Economic factors, such as ability to pay for dental insurance, and social factors such as food insecurity and access to nutritious food options also play a large role in oral health outcomes. In Michigan, […]
State Approaches to Reimbursing Family Caregivers of Children and Youth with Special Health Care Needs through Medicaid
/in Policy Children/Youth with Special Health Care Needs, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, COVID-19, EPSDT, Health Equity, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health, State Resources, The RAISE Family Caregiver Resource and Dissemination Center /by Olivia Randi, Eskedar Girmash and Kate HonsbergerState Legislative Action to Lower Pharmaceutical Costs
/in Prescription Drug Pricing Maps Cost, Payment, and Delivery Reform, Health System Costs, Legislative Tracker, Prescription Drug Pricing, State Rx Legislative Action Prescription Drug Pricing /by NASHP StaffStates Use Appendix Ks to Provide Innovative Flexibilities for Medicaid Enrollees and Caregivers during COVID-19
/in Policy Connecticut, Georgia, Washington Blogs, Featured News Home Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, COVID-19, Long-Term Care, Medicaid Managed Care, Population Health, State Resources, The RAISE Family Caregiver Resource and Dissemination Center /by Salom Teshale, Paige Spradlin, Wendy Fox-Grage and Kitty PuringtonDuring the COVID-19 pandemic, states have used the Appendix K Emergency Preparedness and Response authority to amend Medicaid 1915(c) home- and community-based services (HCBS) waivers and quickly provide more flexible services and supports to Medicaid enrollees and, indirectly, their caregivers.
State Use of Patient-Centered Outcomes Research in Telehealth Policymaking
/in Policy Featured News Home, Reports Chronic Disease Prevention and Management, Consumer Affordability, Cost, Payment, and Delivery Reform, COVID-19, Health Equity, Health System Costs, Population Health, Quality and Measurement, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by Amanda Attiya, Christina Cousart and Maureen Hensley-QuinnThe adoption and use of telehealth have exploded across states, spurred by the COVID-19 pandemic, the need for social distancing, and swift federal and state action to enable how telehealth is delivered and covered by insurers. These changes will have a lasting impact on how health care is delivered, affecting payers, medical providers, and patients […]
Resources for States to Address Health Equity and Disparities
/in Policy Toolkits Accountable Health, Chronic Disease Prevention and Management, Community Benefit, Cost, Payment, and Delivery Reform, Featured Policy Home, Health Coverage and Access, Health Equity, Population Health, Social Determinants of Health Health Equity /by NASHP WritersMany states are transforming their health care delivery systems to improve health and control costs. Reducing health disparities — and addressing their social and economic causes — is at the heart of many of these efforts.
Medicaid Supports for Family Caregivers
/in Policy Featured News Home, Reports Children/Youth with Special Health Care Needs, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Council Meeting Materials and Resources, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health, State Resources, The RAISE Family Caregiver Resource and Dissemination Center /by Neva Kaye and Salom TeshaleFamily caregivers help Medicaid enrollees safely stay in their own homes, prevent or delay hospital and nursing facility stays, and provide personal care services that Medicaid agencies would otherwise need to pay for. However, there are strong indications that family caregivers need additional supports, which would benefit the Medicaid enrollees in their care. Recognizing family […]
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
State Delivery System and Payment Reform Map
/in Policy Maps Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health System Costs, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Value-Based Purchasing Cost, Payment, and Delivery Reform /by NASHP