This brief provides an overview of the proposal developed by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) and filed on July 27th as a substitute for the American Health Care Act passed by the House to “repeal and replace” the Affordable Care Act (ACA). The proposal retains many features of the July 20th version of the Better Care Reconciliation Act (BCRA) released by Senate leadership (and rejected by the Senate on July 25th), including per capita caps on Medicaid spending and elimination of the individual and employer mandates.
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This issue brief digs into opportunities that states have to account for SDOH in Medicaid programs.
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This webinar includes an overview of the methods for gathering SDOH data, and the range of possible uses of the data by state policy makers. It also explores how states could factor SDOH into improved payment models and quality measurement activities. Lastly it describes a new payment model that Massachusetts Medicaid is using to adjust managed care payments for certain social risk factors among enrolled populations.
State Health and Value Strategies, a program of the Robert Wood Johnson Foundation, is pleased to publish the second in our series of webinars for state officials on achieving population health goals.
Driven to improve care coordination and contain costs by moving away from a volume-based payment model, an increasing number of states are implementing risk-based managed care programs to deliver long-term services and supports (LTSS). As the primary payer for LTSS, state Medicaid programs have a significant interest in ensuring that entities with which they contract deliver high quality and cost-effective care to members. This issue brief identifies ways states can learn from value-based payment models being applied elsewhere to create more accountability for the quality and cost of LTSS.
Shared Accountability Across Health and Non-Health Sectors: Opportunities to Improve Population Health
On Wednesday April 5, 2017 the State Health and Value Strategies program hosted the first in a series of three webinars aimed at helping state officials achieve population health goals. This webinar outlined opportunities for state agencies to work collaboratively to improve outcomes and reduce inefficiencies across programs serving overlapping populations.
Despite improvements that have been made over the past several decades, lead poisoning remains a serious hazard for many children in the U.S., presenting significant risks to their health and learning. More than 4 million families with children live in homes with high levels of lead, and approximately half a million under the age of five require treatment. The Children’s Health Insurance Program (CHIP) can provide critical financial support to states as they seek to implement cost-effective lead abatement activities to protect children.
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.
Social factors, including economic stability, housing, education, relationships, neighborhood, and other environmental influences, can have a significant impact on individuals’ health status. In order to make improvements to the health of both individuals and their communities, an integrated approach is critical. Policymakers need to bridge the gap between social services and health care delivery in their efforts to make these improvements, and several states have begun to develop innovative approaches toward this integration, which might provide valuable lessons for others.