Care Coordination

The 21st Century Cures Act (“Cures”), signed into law on December 13, 2016, is being heralded as landmark legislation for biomedical innovation. Cures funds new research, streamlines the development of new drugs, and supports the interoperability of health information systems. State policymakers, however, may want to focus their attention on Cures’ myriad behavioral health provisions, […]

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  • State Financing and Delivery Innovations to Address Disparities in Uncontrolled Childhood Asthma

    The high prevalence of uncontrolled asthma among child populations served by Medicaid programs and the associated rising costs often are the impetus for states to improve the quality of care provided to children with asthma. New opportunities to comprehensively address asthma and its triggers are emerging through state and national health care delivery system and […]

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  • Enhancing Care Quality for Medicaid Beneficiaries Living with HIV/AIDS: New NASHP Case Studies

    NASHP has written two case studies for HealthHIV’s Three D HIV Prevention Program, which is supported by the Centers for Disease Control and Prevention (CDC), and provides technical assistance to better inform programmatic decisions impacting the delivery of quality HIV prevention and treatment services: New York’s experience implementing performance metrics for the HIV/AIDS population in its Medicaid managed […]

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  • Publications

    Understanding Medicaid Claims and Encounter Data and Their Use in Payment Reform

    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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  • Publications

    Braiding and Blending Funding Streams to Meet the Health-Related Social Needs of Low-Income Persons: Considerations for State Health Policymakers

    Medicaid beneficiaries often need support outside the scope of clinical health care in order to lead healthy lives, and states are uniquely poised to provide this support by addressing the social determinants of health. While states steward a variety of funding sources that address the needs of low-income populations, too often a Medicaid beneficiary must […]

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  • A Day in the Life of Local Care Coordinator Michele Brown in the CareFirst Patient-Centered Medical Home Program

    Designing a successful PCMH program involves policy decisions that create new provider and patient expectations, incentives, and infrastructure to support patient-centered care. An integral feature of the CareFirst PCMH program is the development of a care coordination infrastructure at the central, regional, and local level. Much of the work at the local level is done […]

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    February 2, 2015 | Filed under: Care Coordination

  • A Day in the Life of Community Health Nurse Emily Williamson

    Developing a coordinated care organization in northwest Oregon’s Yamhill County presented an opportunity to build an organization that reflected the community’s vision for high-quality, more efficient, integrated care for Medicaid beneficiaries. When assessing the needs of the community, it became clear to Yamhill Community Care Organization’s (YCCO’s) Clinical Advisory Panel (CAP) that a small percentage […]

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    January 26, 2015 | Filed under: Care Coordination

  • A Day in the Life of Behavioral Health Nurse Care Coordinator Amber Morgan of Hennepin Health

    Caring for the health care needs of vulnerable populations has inherent challenges. Doing this in an accountable care organization (ACO), where providers bear financial risk for meeting cost, quality, and patient satisfaction metrics, intensifies the challenges. When Hennepin Health launched in 2012 to serve as a safety-net ACO for Minnesota’s early Medicaid expansion population, it […]

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    January 5, 2015 | Filed under: Care Coordination

  • Webinars

    Care Coordination under the Medicaid Benefit for Children and Adolescents

    Tuesday, September 9, 2014: Care coordination provides a bridge across multiple systems that serve children and families, helping to ensure that a child receives additional screening, diagnosis and/or treatment as recommended by a health care practitioner. Care coordination strategies can help link providers and care settings by facilitating the arrangement of: appointments, referral forms, transportation, reminders and follow-up, and feedback reporting. This NASHP webinar provides a federal perspective from the Centers for Medicare & Medicaid Services on opportunities and promising strategies for states to coordinate care for children and adolescents enrolled in Medicaid.

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  • Publications

    Transforming the Workforce to Provide Better Chronic Care: The Role of Nurse Care Managers in Rhode Island

    Part 1 in the Transforming the Workforce to Provide Better Chronic Care: The Role of Registered Nurses series. Click to see the rest of the series. Chronic illnesses are responsible for more than three-quarters of health care spending and 7 out of 10 deaths in the United States—and nearly half of all Americans have at […]

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