All payer claims databases (APCDs) and multi-payer claims databases are a source of information that, when used effectively, can provide insight into how states’ health care systems are functioning and facilitate data-driven decision-making. This issue brief looks at the progress states and community organizations have made in using their APCDs and other multi-payer claims databases for various strategic purposes, and offers considerations for states that are seeking to optimize their own claims databases to achieve health care system performance improvement goals. The State Health Policy Highlight, Achieving Transparency and Value Using Multi-Payer Claims Databases, provides an overview of how states are leveraging their claims databases and reviews the lessons experienced states and community organizations have to offer other states seeking to optimize their own databases.
On Wednesday, March 27, 2019 at 3:00 p.m. ET, State Health and Value Strategies, in partnership with the Peterson Center on Healthcare, will host a webinar on the ways in which several states and one community organization are using their multi-payer claims databases. More states are leveraging multi-payer claims databases to better understand how their health care systems are operating and implementing data-driven decision-making. States may not be aware, however, of the strategies other states and organizations are adopting to leverage claims databases to support health care transformation goals. During the webinar, presenters from the state of Vermont and Rhode Island, as well as the Washington Health Alliance, will discuss how they are employing claims databases to enhance the value of care and will share lessons learned for those seeking to optimize their own databases.
Using Hospital Admission, Discharge, and Transfer (ADT) Data to Coordinate Care: Lessons from Tennessee and Washington
On September 6, 2018, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar on effective use of admissions, discharge, and transfer (ADT) data. Considered to be the most relevant real-time electronic data for health care providers, ADT data, if used effectively, can help states improve overall health of their populations. This webinar featured the use of ADT data feeds to coordinate care for patients with behavioral health and other complex care issues by two states, Tennessee and Washington. Presenters provided an overview of their respective state programs, including operational and financing strategies, linkages to quality metrics and outcomes, and alignment with other statewide payment and delivery system efforts. Presenters also shared lessons learned and advice to states.
Data Points to Consider When Assessing Proposals to Cap Federal Medicaid Funding: A Toolkit for States
Key leaders in Congress and high-ranking members of the Trump Administration are proposing major changes to Medicaid financing through the adoption of a block grant or per capita caps. To assist states in assessing the potential implications of proposals to cap federal Medicaid funding, the State Network team at Manatt Health has developed a toolkit providing state-by-state data on Medicaid enrollment and expenditure trends—factors that are central to establishing the amount each state would be allocated under various capped funding proposals.
Recent proposals for the incoming Congress and presidential administration to repeal the Affordable Care Act (ACA) have also included calls for an overhaul of the current Medicaid program financing structure. Such a change, aimed at reducing federal Medicaid spending, would have significant implications for state Medicaid programs. A new webinar examined these proposals and the potential impact that they could have on states.
Section 1115 waivers allow states to waive certain Medicaid statutory requirements in order to advance state policy priorities and test innovations in their Medicaid programs, provided that they are budget neutral and “further the goals of the Medicaid program.” Since 2014, seven states have used 1115 waivers to implement alternative Medicaid expansions, and these waivers are likely to be leveraged by states in the next four years to advance changes to Medicaid. This issue brief, developed by Manatt Health, provides an overview of the features of these alternative Medicaid expansion waivers.
Shared Measurement and Joint Accountability Across Health Care and Non-Health Care Sectors: State Opportunities to Address Population Health Goals
Health care leaders are well-positioned to use cross-sector approaches to drive improvements in population health in collaboration with state leaders. Through the use of joint measurement and accountability tools, policymakers can help to improve health outcomes to an extent not possible through isolated, medical-centric efforts. This issue brief, developed by Dana Hargunani, MD, MPH, outlines how state agencies can use shared measurement and joint accountability across sectors as tools for improving population health outcomes.
The Buying Value Measure Selection Tool: Strategies for Selecting Measures and Developing Aligned Measure Sets
The “Buying Value Measure Selection Tool” was developed to assist state agencies, private purchasers and other stakeholders in creating aligned measure sets, and was first released in 2014. A recent webinar explained this tool and recent updates for state officials and other stakeholders involved in developing and maintaining aligned quality measure sets for health care entities and programs including for health plans, accountable care organizations, and patient-centered medical homes.
Medicaid expansion under the Affordable Care Act (ACA) has had a positive impact for states, both in terms of the number of people covered and the budget savings and revenue gains that they have realized as a result. A series of recent reports demonstrates the economic impact in states that have expanded Medicaid. A new webinar examined potential repeal of Medicaid expansion under the ACA, and what this would likely mean for states.
Medicaid expansion has generated significant savings and new revenues for states, which they have used to finance spending priorities and to offset state Medicaid costs. States that have expanded Medicaid received over $60 billion in federal funds in 2015 and covered approximately 11 million newly eligible people. This tool, developed by Manatt Health, is designed to help states document the impacts of Medicaid expansion on state budgets, including revenue generation and reductions to state general fund spending on Medicaid and other health related programs and services. This tool can be used to demonstrate the impact of expansion as the incoming administration and the new Congress develop proposals to repeal the Affordable Care Act (ACA), potentially including the Medicaid expansion.