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The effective management of patients’ complex illnesses across providers, settings, and systems places extraordinary demands on primary care providers, especially those that work in resource-limited small or rural practices. Medicaid programs in some states have adopted strategies to build practice capacity to care for high-need Medicaid beneficiaries through the development of local community health teams, with members in fields such as nursing, behavioral health, pharmacy, and social work. Using data from a 2011–2012 review of state Medicaid medical home programs, we identified community health team programs in eight states that provide an array of targeted services, from care coordination to self-management coaching.
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Through Assuring Better Child Health and Development (ABCD) III, Arkansas, Illinois, Minnesota, Oklahoma, and Oregon have developed and tested models to improve care coordination for children with or at risk of developmental delay. The medical home has been a key mechanism in their improvement efforts. This brief draws from these states’ experiences to outline opportunities and lessons for state policy makers to consider in order to strengthen medical home initiatives by explicitly addressing the needs of children.
NASHP’s Accountable Care Activity map is a work in progress; state activity pages will be launched in waves throughout Fall 2012.
At this time, we have no information on accountable care activity that meets the following criteria: (1) Medicaid or CHIP agency participation (not necessarily leadership); (2) explicitly intended to advance accountable or integrated care models; and (3) evidence of commitment, such as workgroups, legislation, executive orders, or dedicated staff.
If you have information about accountable care activity in your state, please email firstname.lastname@example.org.
Last updated: October 2012
This is the second in the series of Assuring Better Child Health and Development (ABCD) III Innovation Briefs. This new brief focuses on the web-based referral and tracking system (“web portal”) that Oklahoma has built into its pre-existing Preventive Services Reminder System. The state designed this web portal to improve care coordination for children with or at risk for developmental delays. Oklahoma is already considering ways to adapt the web portal for other services and populations.
Improving enrollment and eligibility systems is a heavy lift, but across the nation, states are developing a vision to advance efficiencies in their processes. State strategies will be varied, but the decision points are the same. How do you determine eligibility using a MAGI methodology and set eligibility system specifications to accommodate new rules? Who is in charge of eligibility decisions – Medicaid or the Exchange; states or counties? How do you work across programs to enable electronic data exchange to determine eligibility?
In the almost two years since the passage of the Affordable Care Act, the vision for a simplified, seamless eligibility and enrollment system across Medicaid, CHIP, exchanges and basic health program has been made clear. Yet, the complexities that come with simplification have also become apparent. Even as states await final proposed rules, many are moving forward in search of solutions.
This webinar will size up state progress on updating eligibility systems and profile the strategies of three early adopters. Presenters will help states identify key decision points and how to get started on tackling these challenges.
Has your state begun to develop new eligibility policies, systems and processes? Don’t let that work go uncounted! Submit documents and comments that show your state’s progress, and webinar presenter Alan Weil may highlight your work on the webinar. Start by finding your state here!
Manu Tandon, Secretariat Chief Information Officer, Massachusetts’ Health and Human Services
Judith A. Arnold, Director, Division of Coverage and Enrollment, Office of Health Insurance Programs
Tracy Turner, Manager, Enrollment Automation and Data Integrity, Oklahoma Health Care Authority
Dustin Oxford, Manager, Enrollment Automation and Data Integrity, Oklahoma Health Care Authority
Alan Weil, Executive Director, National Academy for State Health Policy
Alice Weiss, Program Director, National Academy for State Health Policy
This report summarizes early findings from the current Assuring Better Child Health and Development (ABCD III) learning collaborative of five states. Arkansas, Illinois, Minnesota, Oklahoma, and Oregon are testing models to strengthen linkages and care coordination between pediatric primary care providers and community-based providers of early intervention, mental health, public health, and early care and education services. The states’ early experiences piloting communication tools, facilitating data sharing, implementing quality improvement processes, and involving families are relevant for efforts to engage multi-sector stakeholders to improve state policy, primary care practice, and population health.
States participating in the Assuring Better Child Health and Development (ABCD) III initiative are implementing new strategies to improve care coordination and service linkages to support healthy child development. A number of early lessons have emerged from the initiative with implications for young children and other populations. This webinar, supported by The Commonwealth Fund, will feature presentations from the five states in the ABCD III Learning Collaborative. Each state will discuss its interventions, lessons, and implications for broader state agendas, including medical homes and health reform. The state lessons are the subject of a forthcoming NASHP paper.
- Sheena Olson, Assistant Director, Medical Services, Arkansas Division of Medical Services
- Julie Doetsch, Manager, Child Health Section, Illinois Department of Healthcare and Family Services
- Meredith Martinez, Maternal and Child Health Policy Specialist, Maternal and Child Health Assurance, Minnesota Department of Human Services
- Terrie Fritz, External Relations Coordinator, Oklahoma Health Care Authority
- Charles Gallia, Senior Policy Advisor, Division of Medical Assistance Programs, Oregon Health Authority
- Carrie Hanlon, Policy Specialist, National Academy for State Health Policy
- Jill Rosenthal, Program Director, National Academy for State Health Policy
Federal and state governments play a significant role in strengthening the delivery of primary care, however current efforts have disproportionally been focused on large or multi-specialty practices. This report examines the roles states are playing to reorganize the delivery of primary and chronic care to produce more efficient and effective care, particularly in small practices. Through short case studies developed via interviews with state officials and physicians the authors highlight several state-based initiatives that seek to create high performing health systems by targeting local and regional strengths. Additionally, authors identified five themes critical to enacting strategic delivery system reforms.
The five states participating in the third Assuring Better Child Health and Development (ABCD) learning consortium have gone through an extensive planning process to set the stage for implementation of interventions to improve coordination among providers serving children in pilot communities. This document describes 1) how Arkansas, Illinois, Minnesota, Oklahoma, and Oregon are building on existing local partnerships and assets to organize community pilots, and 2) preliminary lessons that have emerged from these states, including new federal opportunities to bolster community partnerships that will improve service linkages for children.