Medicaid Managed Care Contract Language: Health Disparities and Health Equity
This document provides excerpts of health disparities and health equity contract language from Medicaid Managed Care (MMC) contracts from eight states—Kentucky, Michigan, Minnesota, North Carolina, Ohio, Oregon, Virginia, Washington—and the District of Columbia as well as the contract for California’s Health Exchange, Covered California. The criteria for inclusion in this compendium were contracts that explicitly addressed health disparities and/or health equity. Website links to the full contracts are included where available.
Buying Value: Measures that Matter for Quality and Equity
On Monday, September 28, State Health and Value Strategies hosted a webinar on the Buying Value suite of resources to support state use of performance measures as they assess and improve value with managed care plans and accountable provider entities. Buying Value consists of two free Excel-based tools. The Buying Value Measure Selection Tool assists states, employers, consumer organizations and providers in creating and maintaining aligned quality measure sets. The Buying Value Benchmark Repository is a database of non-HEDIS measures in use by state purchasers and regional health improvement collaboratives, and associated performance data for benchmarking purposes.
Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis
This issue brief describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities in five areas: coverage, enrollment, benefits, models of care, and quality improvement. In some cases, the Medicaid agency will be responsible for implementing these policies; in other cases, the Medicaid agency can lead collaboration with other state agencies such as the public health department or the state marketplace.
How States Can Use Measurement as a Foundation for Tackling Health Disparities in Medicaid Managed Care
Many people in America face segregation, social exclusion, encounters with prejudice, and unequal access and treatment by the health care system, all of which can impact health. Medicaid programs serve a disproportionate share of populations that are negatively impacted by health disparities. This new State Health and Value Strategies (SHVS) issue brief provides examples from a handful of states that have begun the work of identifying, evaluating, and reducing health disparities within their Medicaid managed care programs. Additionally, it offers an approach for other states interested in measuring disparities in health care quality in Medicaid managed care as a step towards achieving health equity, such that all Medicaid managed care enrollees have a fair and just opportunity to be as healthy as possible.
Leveraging Multi-Payer Claims Databases for Value
On Wednesday, March 27, 2019, State Health and Value Strategies, in partnership with the Peterson Center on Healthcare, hosted 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, discussed 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.
Measure Selection, Alignment and Performance Benchmarking: A New Resource for States
On October 12, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar, facilitated by experts at Bailit Health, on a new suite of publicly available resources that support states in their measure selection, alignment and performance benchmarking efforts. The Buying Value Benchmark Repository builds upon the Buying Value Measure Selection Tool and is a downloadable database of non-HEDIS and modified HEDIS measures that states and regional health improvement collaboratives are using for reporting, payment or other purposes. During the webinar technical experts from Bailit Health provided an overview of the repository and discussed how states can both utilize the tool and contribute measures to it. The webinar also reviewed the resources available through Buying Value to support measurement selection. These resources are publicly available to download and use, and the Measure Selection Tool can be customized to support measure alignment and selection processes.
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.
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.
Integrating Health Care and Social Services: Moving from Concept to Practice
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.
Tricky Problems with Small Numbers: Methodological Challenges and Possible Solutions for Measuring PCMH and ACO Performance
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.