2015 Roundtables

Wednesday, October 21, 2015

Interoperability and Privacy and Security Policy: How States Can Share Health Information to Improve Health Outcomes

This workshop will focus on how state statutes and regulations can break down false barriers to health information sharing and can influence health information interoperability at the legal, policy, and technical levels.  Specifically, the workshop will cover opt-in versus opt-out approaches, basic choice/computable privacy, and how states can take the lead in addressing misconceptions related to the sharing of health information.  Attendance is limited to current state officials only.

Expert Resources: Lucia Savage, JD, Chief Privacy Officer, U.S. Department of Health and Human Services (HHS), Office of the National Coordinator (ONC), Office of the Chief Privacy Officer, and Devi Mehta, JD, MPH, Privacy Policy Analyst, U.S. Department of Health and Human Services (HHS), Office of the National Coordinator (ONC), Office of the Chief Privacy Officer

States and the Health Care Payment Learning and Action Network (LAN)
The mission of the LAN is to accelerate the health care system’s transformation to alternative payment models by combining the innovation, power and reach of the public and private sectors with the goal of better care, smarter spending and healthier people.  A majority of states have officials participating in the LAN and so far, seven have officially committed to ambitious goals for the amount of public and private payment that rewards quality and value rather than fee-for-service payment.  Join LAN Project Leader Anne Gauthier to learn about LAN activities and how your states can be more involved, and to hear from selected states on their specific payment reform progress and lessons, all in an informal interactive conversation.

Expert Resource: Anne Gauthier, Project Leader, Health Care Payment Learning and Action Network, the MITRE Corporation

Adult Medicaid Quality Grants: Measuring and Improving the Quality of Care
CMS project officers will share strategies used by Grantees to develop and implement quality improvement projects, build staff capacity, and use data for monitoring and improving access and quality of care in Medicaid.  State achievements and lessons learned from the Adult Medicaid Quality Grants Program will also be discussed.

Expert Resources: Virginia (Gigi) Raney, LCSW, Health Insurance Specialist, Centers for Medicare & Medicaid Services, and Deirdra Stockmann, PhD, Health Insurance Specialist, Centers for Medicare & Medicaid Services

Making ACA Coverage a Reality – A National Examination of Provider Network Monitoring Practices by States and Health Plans
In an examination of state and health plan provider network monitoring and compliance practices, findings confirm which network monitoring strategies are common or less common across Medicaid and Marketplace programs, frequent challenges, recent strategies to manage this complex task, and examples of where health plans exceed state requirements in their efforts to accommodate enrollee access to care. Findings will inform state and health plan provider network monitoring practices. This study was conducted by Health Management Associates under a grant from the Robert Wood Johnson Foundation.

Expert Resource: Karen Brodsky, Principal, Health Management Associates

Medicaid/Behavioral Health Data Integration To Answer Key Policy Questions

A Medicaid/Behavioral Health Data Integration pilot is being initiated by several states.

Key policy questions that only an integrated State Medicaid & specialty State Behavioral Health Agency (SBHA) data system could answer.

What are:

Total State government expenditures for mental health services (combining SBHA and Medicaid expenditures) and what are the changes (service patterns, funding resources, etc.) over a specified time period?

  •   Overall health care costs of BH clients (combining Medicaid primary health care expenditures to SBHA client information) and what are the changes (service patterns, funding resources, etc.) over a specified time period?
  •   Crisis Services and Emergency Room Usage by BH clients?
  •   30 day hospital readmissions and how do they relate to other services?
  •   Many others

Tell us your key policy topics and learn from others.

Expert Resource: Tim Knettler, MBA, CAE, Executive Director/CEO, (NRI) National Association of State Mental Health Program Directors Research Institute

Research Results from the HCCI/NASHP State Health Policy Grant Program

This roundtable features the work of four research teams representing the Health Care Cost Institute (HCCI)/ National Academy for State Health Policy (NASHP) State Health Policy Grant Program. These research teams have utilized a large, national dataset comprised of healthcare claims data to study changes and reforms in state health policies. These innovative research projects cover various topics of interest to healthcare and state policy stakeholders including, scope of practice laws, integrated behavioral and primary healthcare, provider consolidation, and direct access to care laws.

Expert Resource: Dr. Amanda Frost, Senior Researcher at the Health Care Cost Institute

How States Can Buck the High Drug Spending Trend

State budgets are under tremendous pressure, and new, costly prescription drugs have put additional burdens on Medicaid, state employee, and prison budgets. While new medications play a critical role in helping to prevent, manage and even cure disease, states also have to consider their costs and overall value. This Roundtable will discuss strategies and solutions for states as they consider drug costs for all areas of the budget.

Expert Resources: TBD

Exploring State Choices in Benefit Design for Medicaid Expansion Populations

The Affordable Care Act has given states substantial flexibility, as well as new requirements, for designing benefit packages for their Medicaid expansion populations. States have taken different approaches toward developing these Alternative Benefit Plans (APBs) — for example, adopting their exact or modified State Plan benefits, or basing the benefits on commercial marketplace-style coverage. This roundtable will discuss the choices states have made in creating ABPs and policy implications of those decisions.

Expert Resource: Colin Planalp, Research Fellow at the State Health Access Data Assistance Center (SHADAC)

Medicaid’s Interactions with Disability Insurance Programs in a Coverage Expansion Era

For many low-income adults with disabilities, states’ expansion of Medicaid coverage offers a direct avenue to Medicaid enrollment previously only available through Supplemental Security Income (SSI) receipt. Using data from the Social Security Administration (SSA), Mathematica is estimating the impact of states’ Medicaid expansion decisions on the volume of SSI applications.  Nearly all states provide supplemental payments to SSI recipients. If increased Medicaid availability makes low-income adults with disabilities less likely to enroll in SSI, states’ net costs to expand Medicaid may be lower than previously estimated.

Expert Resource: Maggie Colby, Associate Director and Senior Health Researcher, Mathematica Policy Research

To Enroll or Not to Enroll? What Makes the Difference
This interactive discussion will focus on both enrollment patterns and consumer experience of Americans in health insurance exchanges during the second open enrollment period. Drawing from findings from the Commonwealth Fund’s Affordable Care Act Tracking Survey, this roundtable will provide insight into what works to get those that are eligible but unenrolled into a plan and how to target outreach efforts. The impact of navigators and other factors will also be discussed to identify policy solutions for further reducing the number of uninsured Americans.

Expert Resource: Rachel Nuzum, MPH, Vice President, Federal and State Health Policy

Cross-Agency Connections for Individuals with Behavioral Health and Corrections Involvement

Adults with mental health and/or substance use disorders are not only some of the highest-cost enrollees in state health systems, they are also very prevalent in the corrections population. Coordination across systems is necessary to ensure that people’s needs are met, and that care is continued and coordinated as people move through various settings. This discussion will focus on building bridges across multiple systems to address the needs of people with serious mental illness and substance use disorders both before and after incarceration.

Expert Resource: Maria Schiff, Director, State Health Care Spending, The Pew Charitable Trusts