Medicaid

States are testing a myriad of models that strive to achieve the Triple Aim objectives of improved care, reduced health care costs, and better health. Though several statewide health care delivery and payment system reforms have been shown to help slow the growth of health care expenditures and improve methods for delivering health care, taken […]

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  • The newly launched National Academy for State Health Policy (NASHP) Pharmacy Cost Work Group will look beyond the strategies currently used in states to identify and develop new ideas which address the growing problem of Rx costs. The group will look broadly at states as purchasers, regulators, policymakers, and investors to develop the next generation […]

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  • Publications

    Facilitating a robust system of communication and coordination between medical and community service providers, an important goal of many health care delivery system reforms, is challenging for many states. With a variety of federal and state agencies sharing responsibility for child health and development, creating effective linkages among services is critical to optimizing outcomes. This […]

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    May 9, 2016 | Filed under: Front Page, Medicaid, Publications
  • Publications

    This issue brief, developed by NASHP and NICHQ, details the use of LARC in preventing unplanned pregnancies, the current availability and education for women, barriers to prescribing LARC, and potential Medicaid reimbursement models to improve LARC access. The issue brief was developed as part of the Collaborative Improvement and Innovation Network to Reduce Infant Mortality […]

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  • State Health Policy Blog

    Last week the Centers for Medicare and Medicaid Services (CMS) released its long-awaited final rule outlining requirements for managed care organizations in Medicaid and Children’s Health Insurance Programs (CHIP). Preliminary NASHP analyses indicate that the final rule provides states with significant flexibility in making changes designed to modernize these federal programs as part of health […]

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  • Publications

    A growing number of states are administering Medicaid managed care contracts that include both medical and dental services. In 2015, Kentucky identified dental services as one of seven key areas where the state wanted to achieve measurable improvement in its Medicaid managed care contracts. This case study examines the history of dental managed care in […]

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    April 29, 2016 | Filed under: Front Page, Kentucky, Medicaid, Oral Health, Publications
  • State Health Policy Blog

    On April 25, the Centers for Medicaid and Medicare Services (CMS) released a long-awaited final rule that updates the regulations for managed care organizations in the Medicaid and Children’s Health Insurance Programs (CHIP). These new requirements represent the first major updates to Medicaid and CHIP managed care since 2002. In the intervening years, the percentage […]

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  • Publications

    As the scope of State Medicaid agencies becomes wider and more complex, states are increasingly turning to managed care organizations (MCOs) to cover Medicaid enrollees, including those with complex needs. This shift from a fee-for-service, volume-based payment model requires states to effectively manage MCOs and other vendors. With states facing tight budgets, limited staff, and […]

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    April 19, 2016 | Filed under: Front Page, Medicaid, Ohio, Payment Reform, Publications, Tennessee
  • Publications

    States are significant purchasers of health care for Medicaid, inmates in correctional facilities, and public employees. Despite considerable efforts to maintain affordability, drug pricing continues to vex state budgets. While Medicaid is the largest single health expenditure in state budgets, spending on health care for public workers including state employees and retirees, legislators, judicial employees, […]

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  • Publications

    States across the country are fully engaged in delivery system and payment reform efforts to improve care and lower costs in their Medicaid programs. Data is a critical component of these efforts. This NASHP brief provides an introduction to two types of Medicaid utilization data—fee-for-service claims data and managed care encounter data—and, based on examples […]

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