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1
Barbara Wirth MD MS
Council of State Governments Leadership Forum
Chronic Disease Policy Academy
September 19 2013
Kansas City MO
Medical Homes Building Blocks to
Health System Reform
NASHP
26-year-old non-profit non-partisan organization
Offices in Portland Maine and Washington DC
Academy members
Peer-selected group of state health policy leaders
No duesmdashcommitment to identify needs and guide work
Working together across states branches and agencies to advance accelerate and implement workable policy solutions that address major health issues
2
Where do you
want to go
Background Image by Dave Cutler Vanderbilt
Medical Center
(httpwwwmcvanderbiltedulensarticleid=216
amppg=999)
3
Patient Centered Medical Homes
Key model features
Multi-stakeholder partnerships
Qualification standards aligned with new payments
Practice teams
Health Information Technology
Data amp feedback
Practice Education
4
Graphic Source Ed Wagner Presentation entitled ldquoThe Patient-centered Medical Home Care
Coordinationrdquo Available at wwwimprovingchroniccareorgdownloadscare_coordinationppt
Practice Level Transformation
Laying the foundation Committed and aligned leadership
Effective strategy for quality improvement
Building relationships Linking patients to providers and teams
Supporting team based relationships
Changing care delivery Organized evidence-based care
Patient centered interactions
Reducing Barriers to Care Enhanced access
Care coordination
5
wwwsafetynetmedicalhomeorg
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Making medical home payments (29)
Payments based on provider qualification standards (27)
Payments based on provider qualification standards making payments in a multi-payer initiative (18)
Participating in MAPCP Demonstration (8 ME MI MN NY NC PA RI VT)
Participating in CPC Initiative (7 AR CO NJ NY OH OK OR)
Medicaid PCMH Payment Activity
AK
As of September 2013
httpwwwnashporgmed-home-map
Select Care Coordination Payments to Providers
in Multi-Payer Medical Home Initiatives
State Initiative Per member per
month range
Adjusted for Patient
Complexity or Demographic
Adjusted for Medical Home
Level
Lump Sum Payment
Financial Incentive Based
on Quality
TOTAL (n=9) $120 - $7905 7 3 2 6
Maine $695 - $700
Maryland $351 - $1154
Massachusetts $210 - $750
Michigan $450 - $650
Minnesota $1014 - $7905
North Carolina $250 - $500
Pennsylvania $210 - $850
Rhode Island $500 - $600
Vermont $120 - $239
7
Michigan Payments to Provider Organizations pass-through to practices that employ care coordinators Maine Commercial insurer PMPM rates unavailable
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
NASHP
26-year-old non-profit non-partisan organization
Offices in Portland Maine and Washington DC
Academy members
Peer-selected group of state health policy leaders
No duesmdashcommitment to identify needs and guide work
Working together across states branches and agencies to advance accelerate and implement workable policy solutions that address major health issues
2
Where do you
want to go
Background Image by Dave Cutler Vanderbilt
Medical Center
(httpwwwmcvanderbiltedulensarticleid=216
amppg=999)
3
Patient Centered Medical Homes
Key model features
Multi-stakeholder partnerships
Qualification standards aligned with new payments
Practice teams
Health Information Technology
Data amp feedback
Practice Education
4
Graphic Source Ed Wagner Presentation entitled ldquoThe Patient-centered Medical Home Care
Coordinationrdquo Available at wwwimprovingchroniccareorgdownloadscare_coordinationppt
Practice Level Transformation
Laying the foundation Committed and aligned leadership
Effective strategy for quality improvement
Building relationships Linking patients to providers and teams
Supporting team based relationships
Changing care delivery Organized evidence-based care
Patient centered interactions
Reducing Barriers to Care Enhanced access
Care coordination
5
wwwsafetynetmedicalhomeorg
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Making medical home payments (29)
Payments based on provider qualification standards (27)
Payments based on provider qualification standards making payments in a multi-payer initiative (18)
Participating in MAPCP Demonstration (8 ME MI MN NY NC PA RI VT)
Participating in CPC Initiative (7 AR CO NJ NY OH OK OR)
Medicaid PCMH Payment Activity
AK
As of September 2013
httpwwwnashporgmed-home-map
Select Care Coordination Payments to Providers
in Multi-Payer Medical Home Initiatives
State Initiative Per member per
month range
Adjusted for Patient
Complexity or Demographic
Adjusted for Medical Home
Level
Lump Sum Payment
Financial Incentive Based
on Quality
TOTAL (n=9) $120 - $7905 7 3 2 6
Maine $695 - $700
Maryland $351 - $1154
Massachusetts $210 - $750
Michigan $450 - $650
Minnesota $1014 - $7905
North Carolina $250 - $500
Pennsylvania $210 - $850
Rhode Island $500 - $600
Vermont $120 - $239
7
Michigan Payments to Provider Organizations pass-through to practices that employ care coordinators Maine Commercial insurer PMPM rates unavailable
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Where do you
want to go
Background Image by Dave Cutler Vanderbilt
Medical Center
(httpwwwmcvanderbiltedulensarticleid=216
amppg=999)
3
Patient Centered Medical Homes
Key model features
Multi-stakeholder partnerships
Qualification standards aligned with new payments
Practice teams
Health Information Technology
Data amp feedback
Practice Education
4
Graphic Source Ed Wagner Presentation entitled ldquoThe Patient-centered Medical Home Care
Coordinationrdquo Available at wwwimprovingchroniccareorgdownloadscare_coordinationppt
Practice Level Transformation
Laying the foundation Committed and aligned leadership
Effective strategy for quality improvement
Building relationships Linking patients to providers and teams
Supporting team based relationships
Changing care delivery Organized evidence-based care
Patient centered interactions
Reducing Barriers to Care Enhanced access
Care coordination
5
wwwsafetynetmedicalhomeorg
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Making medical home payments (29)
Payments based on provider qualification standards (27)
Payments based on provider qualification standards making payments in a multi-payer initiative (18)
Participating in MAPCP Demonstration (8 ME MI MN NY NC PA RI VT)
Participating in CPC Initiative (7 AR CO NJ NY OH OK OR)
Medicaid PCMH Payment Activity
AK
As of September 2013
httpwwwnashporgmed-home-map
Select Care Coordination Payments to Providers
in Multi-Payer Medical Home Initiatives
State Initiative Per member per
month range
Adjusted for Patient
Complexity or Demographic
Adjusted for Medical Home
Level
Lump Sum Payment
Financial Incentive Based
on Quality
TOTAL (n=9) $120 - $7905 7 3 2 6
Maine $695 - $700
Maryland $351 - $1154
Massachusetts $210 - $750
Michigan $450 - $650
Minnesota $1014 - $7905
North Carolina $250 - $500
Pennsylvania $210 - $850
Rhode Island $500 - $600
Vermont $120 - $239
7
Michigan Payments to Provider Organizations pass-through to practices that employ care coordinators Maine Commercial insurer PMPM rates unavailable
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Patient Centered Medical Homes
Key model features
Multi-stakeholder partnerships
Qualification standards aligned with new payments
Practice teams
Health Information Technology
Data amp feedback
Practice Education
4
Graphic Source Ed Wagner Presentation entitled ldquoThe Patient-centered Medical Home Care
Coordinationrdquo Available at wwwimprovingchroniccareorgdownloadscare_coordinationppt
Practice Level Transformation
Laying the foundation Committed and aligned leadership
Effective strategy for quality improvement
Building relationships Linking patients to providers and teams
Supporting team based relationships
Changing care delivery Organized evidence-based care
Patient centered interactions
Reducing Barriers to Care Enhanced access
Care coordination
5
wwwsafetynetmedicalhomeorg
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Making medical home payments (29)
Payments based on provider qualification standards (27)
Payments based on provider qualification standards making payments in a multi-payer initiative (18)
Participating in MAPCP Demonstration (8 ME MI MN NY NC PA RI VT)
Participating in CPC Initiative (7 AR CO NJ NY OH OK OR)
Medicaid PCMH Payment Activity
AK
As of September 2013
httpwwwnashporgmed-home-map
Select Care Coordination Payments to Providers
in Multi-Payer Medical Home Initiatives
State Initiative Per member per
month range
Adjusted for Patient
Complexity or Demographic
Adjusted for Medical Home
Level
Lump Sum Payment
Financial Incentive Based
on Quality
TOTAL (n=9) $120 - $7905 7 3 2 6
Maine $695 - $700
Maryland $351 - $1154
Massachusetts $210 - $750
Michigan $450 - $650
Minnesota $1014 - $7905
North Carolina $250 - $500
Pennsylvania $210 - $850
Rhode Island $500 - $600
Vermont $120 - $239
7
Michigan Payments to Provider Organizations pass-through to practices that employ care coordinators Maine Commercial insurer PMPM rates unavailable
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Practice Level Transformation
Laying the foundation Committed and aligned leadership
Effective strategy for quality improvement
Building relationships Linking patients to providers and teams
Supporting team based relationships
Changing care delivery Organized evidence-based care
Patient centered interactions
Reducing Barriers to Care Enhanced access
Care coordination
5
wwwsafetynetmedicalhomeorg
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Making medical home payments (29)
Payments based on provider qualification standards (27)
Payments based on provider qualification standards making payments in a multi-payer initiative (18)
Participating in MAPCP Demonstration (8 ME MI MN NY NC PA RI VT)
Participating in CPC Initiative (7 AR CO NJ NY OH OK OR)
Medicaid PCMH Payment Activity
AK
As of September 2013
httpwwwnashporgmed-home-map
Select Care Coordination Payments to Providers
in Multi-Payer Medical Home Initiatives
State Initiative Per member per
month range
Adjusted for Patient
Complexity or Demographic
Adjusted for Medical Home
Level
Lump Sum Payment
Financial Incentive Based
on Quality
TOTAL (n=9) $120 - $7905 7 3 2 6
Maine $695 - $700
Maryland $351 - $1154
Massachusetts $210 - $750
Michigan $450 - $650
Minnesota $1014 - $7905
North Carolina $250 - $500
Pennsylvania $210 - $850
Rhode Island $500 - $600
Vermont $120 - $239
7
Michigan Payments to Provider Organizations pass-through to practices that employ care coordinators Maine Commercial insurer PMPM rates unavailable
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Making medical home payments (29)
Payments based on provider qualification standards (27)
Payments based on provider qualification standards making payments in a multi-payer initiative (18)
Participating in MAPCP Demonstration (8 ME MI MN NY NC PA RI VT)
Participating in CPC Initiative (7 AR CO NJ NY OH OK OR)
Medicaid PCMH Payment Activity
AK
As of September 2013
httpwwwnashporgmed-home-map
Select Care Coordination Payments to Providers
in Multi-Payer Medical Home Initiatives
State Initiative Per member per
month range
Adjusted for Patient
Complexity or Demographic
Adjusted for Medical Home
Level
Lump Sum Payment
Financial Incentive Based
on Quality
TOTAL (n=9) $120 - $7905 7 3 2 6
Maine $695 - $700
Maryland $351 - $1154
Massachusetts $210 - $750
Michigan $450 - $650
Minnesota $1014 - $7905
North Carolina $250 - $500
Pennsylvania $210 - $850
Rhode Island $500 - $600
Vermont $120 - $239
7
Michigan Payments to Provider Organizations pass-through to practices that employ care coordinators Maine Commercial insurer PMPM rates unavailable
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Select Care Coordination Payments to Providers
in Multi-Payer Medical Home Initiatives
State Initiative Per member per
month range
Adjusted for Patient
Complexity or Demographic
Adjusted for Medical Home
Level
Lump Sum Payment
Financial Incentive Based
on Quality
TOTAL (n=9) $120 - $7905 7 3 2 6
Maine $695 - $700
Maryland $351 - $1154
Massachusetts $210 - $750
Michigan $450 - $650
Minnesota $1014 - $7905
North Carolina $250 - $500
Pennsylvania $210 - $850
Rhode Island $500 - $600
Vermont $120 - $239
7
Michigan Payments to Provider Organizations pass-through to practices that employ care coordinators Maine Commercial insurer PMPM rates unavailable
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Multi-disciplinary teams Expanding PCMH to make room for new services
Key model features
Practice teamsmdashoften shared among practices
Payments to teams and qualified providers
Patients and families ldquoon the teamrdquo
Teams are based in a variety of settings
8
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Shared Practice Team Programs (9 AL ME MI MN MT NY NC OK VT)
Planning Activity (3 IA MD RI)
Medicaid Supporting Shared Practice Team
Models
AK
As of September 2013
Mary Takach and Jason Buxbaum 2013 ldquoCare Management for Medicaid Enrollees Through Community Health Teamsrdquo The Commonwealth Fund
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Building ldquoHealth Homerdquo Neighborhoods
using ACA Sec 2703
10
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Medical Homes vs Health Homes
Medical Homes
Designed for everybody
Primary care provider-led
Primary care focus
No enhanced federal Medicaid match
2703 Health Homes
Designed for eligible individuals with a serious mental illness andor specific chronic physical conditions
Primary care provider is key but not necessarily the lead
Focus on linking primary care with behavioral health and long-term care
Eight-quarter 90 percent federal Medicaid match
Significant increase in financial support to providers
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
DE
RI
NJ CT
MA
HI
Approved State Plan Amendment(s) (12)
Planning Grant (17)
ACA Section 2703 Health Home Activity
AK
As of June 2013
httpwwwnashporgmed-home-map
Note States with stripes have both
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Integratedaccountable care health
system models
Key model features
High-performing primary care providers
Emphasis on coordination across providers in the health care system
Shared goals amp risk
Population health management tools
Health information technology amp exchange
Engaged patients
13
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
14 httpwwwnashporgstate-accountable-care-activity-map
State lsquoAccountable Carersquo Activity Map
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
State Innovation Models (SIM) Initiative
WA
OR
TX
CO
NC
LA
PA
NY
IA
VA
NE
OK
AL
MD
MT
ID
KS
MN
NH
ME
AZ
VT
MO CA
WY
NM
IL
WI
MI
WV
SC
GA
FL
UT NV
ND
SD
AR
IN OH
KY
TN
MS
AK
DE
RI
NJ CT
MA
HI
Model Testing Grants (6)
Model Pre-Testing Grants (3)
Model Design Grants (16)
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
Oregon Coordinated Care Organizations
(CCOs) Payment Model
Authorized by the legislature in 2012 via SB 1580
15 CCOs are operating in communities in Oregon
Each CCO receives a fixed global budget for physicalmental (ultimately dental care) for each Medicaid enrollee
CCOs must have the capacity to assume risk
Implement value-based alternatives to traditional FFS reimbursement methodologies
CCOs to coordinate care and engage enrollees amp providers in health promotion
Meet key quality measurements while reducing spending growth by 2 over the next 2 years
wwworegongovohaohpbpageshealth-reformccosaspx
16
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
What have we learned What role can you play
Embedded nurse care managers = secret sauce
Practice transformation takes time and resources
Data challenges are significant
States have demonstrated a commitment and a unique role in advancing primary care
Models are not static status quo not an option
Legislation works leadership cannot be underestimated
Cost savings are uncertain for now budget neutrality is often the goal
Public-private partnerships are critical
Time is now
18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
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18
Please visit
wwwnashporg
www nashporgmed-home-map
wwwnashporgstate-accountable-care-activity-map
wwwstatereforumorg
wwwpcpccnet
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
bullHome | bullAbout NASHP | bullNewsroom | bullE-News signup | bullEmployment |
bullContact Us
Search this site
bullChronic amp Long Term Care bullComprehensive Health Reform bullCoverage amp Access bullHealth System Improvement
bullSpecific Services amp Populations
bullABCD Resource Center bullMaximizing Enrollment for Kids bullMedicaid and the DRA bullPatient Safety Toolbox
bullState Quality Improvement Partnership Toolbox
bullNASHP Projects amp Programs bullNASHP Publications by Category bullNASHP Publications by Date bullNASHP Authors Publications
bullNASHP Publications by Related Topics
bullPreconference Sessions bullConference Sessions bullConference Speakers
bullSession Speakers
New NASHP Publications bullA State Policymakersrsquo Guide to Federal Health Reform - Part I Anticipating How Federal Health Reform will Affect State Roles Many critical aspects of federal health reform will be implemented by the states Through program design regulations policies and practices state decisions and actions already play a profound role in shaping the American health care system Both the House and Senate reform proposals would dramatically change the federal structure within which state health policy operates Part I of this State Policymakersrsquo Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles Download the file Policymakers Guide Part 1 November 2009 bullState Policymakersrsquo Priorities for Improving the Health System This State Health Policy Briefing presents the issues identified by NASHPrsquos state leadership as their most significant priorities for improving their health systems As Academy members discussed their priorities a set of broader themes emerged These larger policy goals are Connect People to Needed Services Promote Coordination and Integration in the Health System Improve Care for Populations with Complex Needs Orient the Health System toward Results Increase Health System Efficiencies This briefing also provides a more detailed list of statesrsquo priorities presented in four major categories of state health policy Coverage and Access Health Systems Improvement Special Services and Populations and Long Term and Chronic Care Download the file Policymakers Priorities November 2009 bullSupporting State Policymakersrsquo Implementation of Federal Health Reform States will have enormous short-term and long-term needs for assistance as they grapple with federal health reform legislation Significant federal and private resources to support state-level implementation will be necessary Implementation support must be defined and coordinated quickly Technical assistance must be provided in a manner that corresponds with state needs State officials should be involved in the design of technical assistance so that it is most effective given varied state circumstances needs and capacities Technical assistance should inspire innovation among leaders even as it helps all states meet minimum standards of performance Download the file Supporting Implementation of Federal Reform
November 2009
Will Medicare Join State Multi-Payer Medical Home Initiatives A Conversation with States Regarding Medicarersquos Proposed Advanced Primary Care Demonstration
ABCD III Using Data Integration and Information Technology to Improve Care Coordination for Young Children
bullRWJF Blog Preparing for health reform in the states with Alan Weil
For More Information
Searchform-f8cf0search_theSearchform-f8cf0search_the
