As the COVID-19 crisis began to take hold, state-based marketplaces (SBMs) were quick to respond to the first nationwide public health emergency since the Affordable Care Act created new coverage options in states. Informed by conversations with seven SBMs that established an SEP—Colorado, Maryland, Massachusetts, Nevada, New York, Rhode Island and Washington—this expert perspective highlights strategies that successfully drove enrollment, including: leveraging their SBM status to quickly and efficiently operationalize customer service in a new remote environment, directly engaging with existing customers as well as reaching out broadly to new ones, and adapting outreach tactics based on new insights regarding audience needs and behaviors to reach them most effectively.
Reducing Overuse and Misuse: State Strategies to Improve Quality and Cost of Health Care
Bailit Health Purchasing—Megan Burns, Mary Beth Dyer, and Michael Bailit
Overuse and misuse of health care services are problems that affect both quality and cost of care. Experts estimate that perhaps one-third of all U.S. health care spending produces no benefit to the patient–and some of it actually results in harm. This issue brief focuses specifically on the key purchasing strategies that state Medicaid agencies and state employee health benefit purchasers can implement in order to reduce the overuse and misuse of health care services, and improve the quality and reduce the cost of care. This brief primarily focuses on actions state purchasers can take with contracted plans, providers, and other engaged purchasers to reduce overused and misused services.
Based on the issue brief, the webinar presentation focuses on actions state purchasers can take with contracted plans, providers, and other engaged purchasers to reduce misuse and overuse of health care services. Neal Kohatsu MD, MPH offers insight on overuse and misuse from his perspective as Medical Director for the California Department of Health Care Services.