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As states seek to improve quality of care and health outcomes while reducing costs, many have turned to accountable care models. One key aspect of accountable care models is that organizations or structures assume responsibility for the care and outcomes of a defined population across a continuum of care and across different parts of the health system. These models generally hold providers accountable through payments linked to value and performance measurement. This webinar will feature an overview of the opportunities in accountable care models for improving population health, as well as state examples. State officials will discuss the role of both health care financing and public health agencies; and how they are working with providers and community agencies to achieve the goals of accountable care models, particularly in improving health across whole populations.
- Moderator: José Montero, MD, MHCDS, Director, Division of Public Health Services, New Hampshire Department of Health and Human Services
- Diane Rydrych, MA, Director, Division of Health Policy, Minnesota Department of Health
- Eduardo Sanchez, M.D., M.P.H., FAAFP is Deputy Chief Medical Officer (CMO) for the American Heart Association (AHA).
- Jeanene Smith, MD, MPH, Chief Medical Officer, Oregon Health Authority
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This brief explores ways that states are sharing the responsibility of consumer assistance with the federal marketplace in three key areas: marketing and advertising initiatives, the work of navigators and other in-person assisters, and the development of a system for eligibility decision appeals. It also provides specific examples of states utilizing the Federally Facilitated Marketplace (FFM) or those partnering with it (SPM) for consumer assistance, and illustrates some of the ways that FFM and SPM states can work with their existing consumer assistance structures and with the federal government to help consumers find their way in a new coverage landscape.
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Since 2009, eight states participating in the Robert Wood Johnson Foundation’s Maximizing Enrollment program have worked to streamline eligibility and enrollment systems, policies, and procedures. States have improved customer experience and reduce unnecessary burden on eligibility staff by implementing simplification strategies at every step of the enrollment and renewal process. This Maximizing Enrollment report—the third in a series of final reports from the program—shares the participating states’ experiences in updating applications, using existing data to make eligibility determinations, simplifying renewals and transfers, making notices more readable, and improving business processes.
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by Joanne Jee
Where some may see opportunities for improved delivery and coordination of care and cost savings, others may wonder about possible disincentives for providing the full array of needed services. For more vulnerable populations, such as children and youth with special health care needs (CYSHCN), the concerns can be heightened.
By Jennifer Dolatshahi
This blog post was originally published on State Refor(u)m’s State of Implementation Blog
The Affordable Care Act (ACA) expands health insurance coverage options to millions of uninsured individuals, and makes significant changes to state eligibility and enrollment processes. Many of these changes were implemented by October 1, 2013, with the beginning of the first open enrollment period for health insurance marketplaces. This brief describes states’ experiences—including challenges and strategies to address them—during the first three months of open enrollment. These early state experiences help to document the evolution of health reform in the states and may prove instructive for states at different stages of ACA implementation as well as for planning for the next open enrollment period.
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Many states began moving forward with their plans to expand Medicaid even before the Supreme Court’s 2012 ruling on the ACA. Other states have more recently decided to pursue expansion, with a number pursuing non-traditional Medicaid alternatives. This webinar will provide a closer look at the various ways states are expanding Medicaid to those who are newly eligible for the program. State panelists will discuss issues related to the expansion, including:
- Coordination with state or federal marketplaces;
- Education and outreach efforts for newly eligible individuals;
- Benefit design and development of the Medicaid Alternative Benefit Plan;
- Provider capacity needs for new and current enrollees; and
- Implications and opportunities for delivery system reform
Please register to join us for this lively discussion.
Alan Weil, Moderator
Executive Director, National Academy for State Health Policy
Policy Specialist, National Academy for State Health Policy
Assistant Director, Arkansas Division of Medical Services, Director of Continuity of Care and Coordination of Coverage Unit
State Medicaid Director, Deputy Commissioner, State of New York Department of Health
Deputy Director, Arizona Health Care Cost Containment System
States around the country are actively working to improve service delivery under the Medicaid benefit for children and adolescents (also known as the Early and Periodic Screening, Diagnostic, and Treatment benefit or EPSDT), Medicaid’s comprehensive and preventive child health program for individuals under the age of 21. The benefit provides tens of millions of children with access to a range of preventive, screening, and treatment services, as well as vision, dental, and hearing services. The benefit is critical to early identification of health conditions, as well as to maintaining and improving the health of low-income children, making it a key priority for states as they strive to improve population health.
This webinar will draw together Medicaid officials from three states for a conversation about how they have worked to improve the Medicaid benefit for children in their states. Speakers from Iowa, the District of Columbia, and Minnesota will discuss strategies for improving access and service delivery for Medicaid-enrolled children. The conversation will have a particular emphasis on efforts in these states to better coordinate care, use public health resources to deliver benefits, collect data on and improve quality, and enhance access and delivery of behavioral health services for children. This webinar is the first in a series on the Medicaid benefit for children and adolescents: future webinars will delve more deeply into oral health, adolescent health, and care coordination.
- Eliot Fishman, Director of the Children and Adults Health Programs Group, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
- Glenace Edwall, Director of the Children’s Mental Health Division, Minnesota Department of Human Services
- Colleen Sonosky, Associate Director of the D.C. Department of Health Care Finance
- Jennifer Vermeer, Medicaid Director, Iowa Department of Human Services
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