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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.

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Date Created: Jan 12, 2017
Document Type

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.

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Date Created: Jan 9, 2017
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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.

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Date Created: Dec 5, 2016
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With health care providers increasingly being rewarded based on changes in cost of care, it is critical that sufficient statistical safeguards are in place to ensure that payment arrangements fairly reflect provider performance rather than random variation in medical utilization. The underlying changes in cost of care for populations served by patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) are difficult to accurately assess when there are a small number of attributed patients.

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Date Created: Apr 26, 2016
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Changes in population-based payment models in health care delivery have spurred enhanced efforts toward closer integration between state purchasers of health care and state, county, and local public health officials. This issue brief, developed by Bailit Health Purchasing LLC and Dr. Karen Hacker, investigates approaches that state agencies might employ in order to better integrate public health and health care delivery as a means of improving health and the value of health care, and it is organized according to seven features of integration. The issue brief is accompanied by three case studies providing additional detail to some of the examples cited in the brief.

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Date Created: Mar 30, 2016
Document Type

With states increasingly moving to develop population-based payment arrangements with provider organizations, the critical role of safety-net providers has become a challenging consideration for states. While safety-net providers typically lack the capital, experience, and/or scale to operate as an Accountable Care Organization (ACO), their role in state Medicaid programs underscores their integral role in the implementation of a population-based payment strategy with ACOs.

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Date Created: Jan 26, 2016
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In attempting to move toward value-based payments, there exist the inherent challenges posed by the availability of data. States wishing to accelerate the transformation of the existing delivery system into one that delivers high quality and affordable health care have to take action to develop a comprehensive data collection and reporting mechanism. Such an approach can be taken using episodes of medical care as the central unit of measure.

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Date Created: Dec 22, 2015
Document Type

Federally Qualified Health Centers (FQHCs) traditionally provide health care services primarily to low-income individuals who are covered by Medicaid or who are uninsured. As state Medicaid programs increase their focus on value-based payment, it is important to consider how FQHCs may participate in payment reform strategies. This brief provides an overview of FQHC cost reporting, delves into state payment reform strategies that Include FQHCs, and offers considerations for states and FQHCs alike.

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Date Created: Dec 14, 2015
Document Type

State health care purchasers are increasingly shifting toward value-based purchasing (VBP) strategies that reward providers for value or outcomes as a means of improving care, improving health and reducing overall costs. This webinar examines how states are currently advancing payment reform in their managed care provider networks by moving away from fee-for-service (FFS) and identifies key considerations for states interested in implementing VBP strategies in this environment. Representatives from Arizona and Tennessee share ground-level experiences in adopting VBP strategies in their Medicaid managed care programs.

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Date Created: Jun 9, 2015
Document Type

This suite of issue briefs is geared toward states interesting in value-based purchasing for health care. Part 1 deals with strategic considerations, Part 2 offers an implementation guide, while Part 3 includes a planning template for state purchasers.

Date Created: Jan 22, 2015