States seeking to promote better coordination of patient care, either within Medicaid or through participation in multi-payer initiatives, will run into long-standing challenges to delivering care and promoting health in rural areas. Rural areas often experience disparities in access to care, health status, and available infrastructure relative to their urban counterparts. This brief draws from health initiatives undertaken in Alabama, Colorado, Montana, New Mexico, North Carolina, and Vermont to identify common policy considerations and action steps for coordinating care in rural areas. The brief was supported by the Robert Wood Johnson Foundation’s State Health and Value Strategies.
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The Affordable Care Act (ACA) offers states multiple policy levers to improve health status and care for racial and ethnic minority populations through delivery system reforms, public health and community interventions, and insurance coverage, as well as provisions specific to disparities reduction. This report synthesizes the experiences of teams from seven states (Arkansas, Connecticut, Hawaii, Minnesota, New Mexico, Ohio, and Virginia) that participated in a learning collaborative to advance health equity using select ACA and state policy levers. The report also presents opportunities for state and federal collaborations to strengthen these efforts, as well as important lessons for advancing health equity.
An accompanying issue brief provides a high-level summary of the full report.
State agencies identify, document, and act on data related to racial and ethnic health and health care disparities in various ways. One type of document states produce is a “report card,” or a publication that uses data from race/ethnicity-specific measures to assign letter grades that rate the state’s performance. This issue brief, prepared by NASHP for the Agency for Healthcare Research and Quality (AHRQ), focuses on New Mexico’s experience using report cards to measure racial and ethnic health disparities.
Click to download the report (PDF).
The Affordable Care Act (ACA) provides opportunities for states to make lasting and comprehensive systems change in their approaches to achieving health equity for their most vulnerable populations. Through provisions in areas such as coverage and access, prevention, care coordination, population health, and quality and efficiency, the Act offers state policymakers a broad range of policy levers for improving health care and the health status of their racial and ethnic minority populations.
With support from the Aetna Foundation, the National Academy for State Heath Policy is hosting a webinar to highlight the opportunities presented by health care reform to advance state health equity agendas. In addition to featuring national health equity experts and information on how states are using the ACA to achieve health equity, this webinar will announce the NASHP State Health Equity Learning Collaborative, an initiative to help state policymakers maintain momentum towards achieving health equity while implementing federal health care reform.
Download the RFA here!
Download the webinar slides here!
Download the prospective applicant call recording here!
- Dr. Ernest Moy, Medical Officer, Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality (AHRQ)
- Dennis Andrulis, Ph.D., Senior Research Scientist, Texas Health Institute and Associate Professor, University of Texas School of Public Health
- Diane Justice, Senior Program Director, National Academy for State Health Policy
Download the RFA here!
Health disparities cost the United States billions of dollars in direct medical expenditures in addition to the human costs. In an effort to improve quality and contain costs states are taking steps to measure these costs and address disparities. This issue brief, which features Virginia and Rhode Island, was prepared by NASHP authors Carrie Hanlon and Larry Hinkle for the Agency for Healthcare Research and Quality (AHRQ). It focuses on tools, challenges, and strategies states use to measure the costs of health disparities.
This report, prepared by NASHP for the federal Agency for Healthcare Research and Quality, summarizes how leading states analyze state and federal race/ethnicity data in strategic plans and reports aimed at reducing racial and ethnic disparities in health status and health care. It features Colorado, Connecticut, Georgia, Maryland, New Jersey, New Mexico, Rhode Island, and Utah, but also notes activity in Arizona, California, Massachusetts, Michigan, North Carolina, Ohio, and Virginia. Lessons from leading states can provide guidance for others exploring ways to launch or enhance health equity, consumer engagement, quality improvement, or cost containment initiatives.
Read full report here.
This report summarizes how leading states that participate in the Healthcare Cost and Utilization Project (HCUP) and their clients use hospital discharge data on patient race/ethnicity to inform state health care disparities reduction activities. The report features California, Florida, Massachusetts, Rhode Island, and Wisconsin HCUP Partners, but also notes activity in Connecticut, Georgia, New Jersey, and South Carolina. Partner States’ experiences demonstrate that patient race/ethnicity data are an important tool for informing state initiatives and producing policy- and practice-relevant publications to support health equity.
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