Value-Based Purchasing
FEATURED ARTICLE
Medicaid Alternative Payment Models for Prescription Drugs: Do They Add Value for States?
/in Policy Oklahoma Webinars Administrative Actions, Cost, Payment, and Delivery Reform, Health System Costs, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by NASHP WritersWednesday, Dec. 12, 2018 2-3 pm (EST) Listen to the Webinar. Download the Slides. As states struggle with the increasing cost of prescription drugs, they are testing various alternative payment models (APMs). The Oklahoma Health Care Authority is a national leader with four alternative payment models in the form of direct contracts with pharmaceutical manufacturers. […]
Q&A: How Rhode Island Tackles Social Determinants of Health through its Accountable Entity Model
/in Policy Rhode Island Blogs Accountable Health, Blending and Braiding Funding, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Equity, Health System Costs, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by Elinor HigginsAcross the country, states are launching new payment models that reward quality, promote care integration, improve access, and address the social determinants of health (SDOH) in an effort to improve population health. One of these ground-breaking initiatives is Rhode Island’s Accountable Entity (AE) Program, created to improve the health of Rhode Islanders enrolled in Medicaid […]
Oklahoma Signs the Nation’s First State Medicaid Value-Based Contracts for Rx Drugs
/in Policy Oklahoma Blogs Administrative Actions, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health System Costs, Population Health, Prescription Drug Pricing, State Rx Legislative Action, Value-Based Purchasing /by Jennifer ReckOn the heels of Oklahoma’s first-in-the-nation, value-based purchasing deal to improve adherence to an antipsychotic drug, the state’s Medicaid agency just signed its second value-based contract for a prescription drug used to treat serious bacterial skin infections. While several private insurers have initiated value-based contracting, which links payments to a drug’s effectiveness and outcome, Oklahoma […]
Conference Presentations 2018
/in Policy Annual Conference, Blogs Behavioral/Mental Health and SUD, Blending and Braiding Funding, Care Coordination, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, Healthy Child Development, HIV/AIDS, Housing and Health, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Population Health, Prescription Drug Pricing, Primary Care/Patient-Centered/Health Home, Safety Net Providers and Rural Health, Social Determinants of Health, State Insurance Marketplaces, State Rx Legislative Action, Value-Based Purchasing /by NASHP StaffBelow is a full list of the Conference speaker presentations.
How States Address Social Determinants of Health in their Medicaid Contracts and Contract Guidance Documents
/in Policy Colorado, Delaware, Massachusetts, Michigan, Minnesota, New York, Oregon, Rhode Island, Vermont, Washington Charts Behavioral/Mental Health and SUD, Blending and Braiding Funding, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Health IT/Data, Healthy Child Development, Housing and Health, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by Tina KartikaTo encourage investments in population health, states are increasingly using levers available in their managed care and value-based contracts to address social determinants of health, such as housing and employment. With support from the Robert Wood Johnson Foundation, the National Academy for State Health Policy examined Medicaid contracts and contract guidance documents in 11 states […]
Washington’s Medicaid Chief Examines the Future of Medicaid and Health Reforms
/in Policy Washington Blogs Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Population Health, Quality and Measurement, State Insurance Marketplaces, Value-Based Purchasing /by NASHP WritersMaryAnne Lindeblad oversees Washington State’s Apple Health (Medicaid) program, which serves more than 1.8 million residents. She also chairs the National Academy for State Health Policy’s executive committee and is a National Association of Medicaid Directors board member. Lindeblad took time recently to talk to NASHP about the future of Medicaid and health care reform. […]
An Early Look at Vermont’s Value-Based, Multi-Payer “Next Gen” Model, Designed to Lower Costs and Improve Population Health
/in Policy Vermont Reports Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Population Health, Quality and Measurement, State Insurance Marketplaces, Total Cost of Care Benchmark, Value-Based Purchasing /by NASHP WritersBy Robin Lunge, JD, MHCDS Robin Lunge is a member of Vermont’s Green Mountain Care Board, which regulates health insurance rates, hospital budgets, and accountable care organizations. In this brief, she explores how the state’s transformation from a fee-for-service payment system to a value-based, multi-payer model designed to curb health care spending and improve care […]
The Roadmap Ahead: New York’s Value-Based Payments Reward Communities and Providers for Addressing the Social Determinants of Health
/in Policy New York Blogs Accountable Health, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health, State Insurance Marketplaces, Value-Based Purchasing /by Amy ClaryMedicaid payment models in many states are shifting away from rewarding providers for the quantity of care they provide to models that reward high-quality, coordinated care that addresses some of the broader social factors that influence health and well-being. One example is New York’s Value-Based Payment (VBP) Roadmap, which rewards Medicaid providers and community-based organizations […]
Ohio Implements Value-Based Payment Reform to Improve Population Health
/in Policy Ohio Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health IT/Data, Health System Costs, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Quality and Measurement, Social Determinants of Health, State Insurance Marketplaces, Value-Based Purchasing /by NASHP WritersGreg Moody, director of Ohio’s Office of Health Transformation, has quietly spearheaded one of the most effective redesigns of a state health care payment system in the country, generating cost savings and improving public health by showing providers how the cost and quality of their care compares with their peers. This value-based cost-savings and quality improvement […]
Leveraging State Purchasing Power to Stabilize the Individual Insurance Market: Washington State Leads the Way
/in Policy Washington Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Medicaid Expansion, Medicaid Managed Care, State Insurance Marketplaces, Value-Based Purchasing /by NASHP WritersWashington state has enacted a groundbreaking law to help stabilize its individual insurance market and prevent “bare counties,” areas of the state without an insurance option on its exchange. Sponsored by longtime National Academy for State Health Policy (NASHP) member, state Rep. Eileen Cody, HB 2408 requires insurance plans covering state or school employees to offer at least […]
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 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 […]