Primary Care and Medical Homes

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

    A new study looks at how leading states stack up to Australia on organizing primary care. Colorado, North Carolina, and Oregon have implemented regionally based Medicaid-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations and improve the capacity of practices. Several countries with highly ranked delivery systems have implemented similar […]

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    December 8, 2015 | Filed under: Primary Care and Medical Homes, Publications
  • Publications

    Medical home initiatives across the United States are demonstrating that multipayer reform, although complex and difficult to implement, is feasible when committed stakeholders negotiate strategies that are responsive to the local context. Seventeen multipayer medical home initiatives launched between 2008 and 2014 all navigated four critical decision-making points germane to any multipayer payment model: convening […]

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    April 7, 2015 | Filed under: Primary Care and Medical Homes, Publications
  • State Health Policy Blog

    Tasmania, Australia’s only island state, encompasses an area of 26,262 square miles – an area roughly the size of West Virginia – and is home to just over half a million Australians, most of them low income. According to Tasmania Medicare Local CEO Phil Edmondson, “We are the oldest and sickest and most poorly educated […]

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  • Publications

    Federal and state policymakers are faced with the challenge of integrating services to address both the physical and behavioral health needs of the population. This brief summarizes key lessons and opportunities for federal and state alignment that surfaced during a meeting supported by The Commonwealth Fund of high-level federal and state leaders. Several case studies […]

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  • Publications

    Many factors catalyze the current trend toward primary care teams: payers’ demands for more integrated care and the varied skills such care requires; the complexity of today’s health care environment; the cost-effectiveness of using non-physician practitioners for some care; as well as insufficient numbers of primary care physicians in many areas of the country. Delivery […]

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    October 11, 2014 | Filed under: Primary Care and Medical Homes, Publications
  • Publications

    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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  • Publications

    Primary care practices transitioning to enhanced models of primary care require ongoing support to sustain their transformation efforts. Small and medium-sized practices in particular can benefit from shared resources facilitating care coordination and case management, use of data and technology, and ongoing practice improvement. This State Health Policy Briefing outlines key elements of a shared […]

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  • Publications

    Within multi-payer medical home initiatives, it is critical to develop and implement attribution and/or enrollment methodologies that assign participating patients to the practice most responsible for managing their care for two important reasons: the numbers of patients assigned to each practice influences the amount of supplemental PCMH payments paid to practices and which patients are […]

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  • Publications

    Maine was one of six states selected to participate in NASHP’s Medicaid-Safety Net Learning Collaborative. NASHP helped organize a series of web trainings for Maine’s health centers on using the Consumer Assessment for Healthcare Providers and Systems (CAHPS) patient satisfaction survey for quality improvement and staff training. CAHPS is being used in the state’s expansion […]

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    May 14, 2014 | Filed under: Medicaid, Primary Care and Medical Homes, Publications