State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This webinar includes an overview of the methods for gathering SDOH data, and the range of possible uses of the data by state policy makers. It also explores how states could factor SDOH into improved payment models and quality measurement activities. Lastly it describes a new payment model that Massachusetts Medicaid is using to adjust managed care payments for certain social risk factors among enrolled populations.
State Health and Value Strategies, a program of the Robert Wood Johnson Foundation, is pleased to publish the second in our series of webinars for state officials on achieving population health goals.
Driven to improve care coordination and contain costs by moving away from a volume-based payment model, an increasing number of states are implementing risk-based managed care programs to deliver long-term services and supports (LTSS). As the primary payer for LTSS, state Medicaid programs have a significant interest in ensuring that entities with which they contract deliver high quality and cost-effective care to members. This issue brief identifies ways states can learn from value-based payment models being applied elsewhere to create more accountability for the quality and cost of LTSS.
Shared Accountability Across Health and Non-Health Sectors: Opportunities to Improve Population Health
On Wednesday April 5, 2017 the State Health and Value Strategies program hosted the first in a series of three webinars aimed at helping state officials achieve population health goals. This webinar outlined opportunities for state agencies to work collaboratively to improve outcomes and reduce inefficiencies across programs serving overlapping populations.
Despite improvements that have been made over the past several decades, lead poisoning remains a serious hazard for many children in the U.S., presenting significant risks to their health and learning. More than 4 million families with children live in homes with high levels of lead, and approximately half a million under the age of five require treatment. The Children's Health Insurance Program (CHIP) can provide critical financial support to states as they seek to implement cost-effective lead abatement activities to protect children.
Shared Measurement and Joint Accountability Across Health Care and Non-Health Care Sectors: State Opportunities to Address Population Health Goals
Health care leaders are well-positioned to use cross-sector approaches to drive improvements in population health in collaboration with state leaders. Through the use of joint measurement and accountability tools, policymakers can help to improve health outcomes to an extent not possible through isolated, medical-centric efforts. This issue brief, developed by Dana Hargunani, MD, MPH, outlines how state agencies can use shared measurement and joint accountability across sectors as tools for improving population health outcomes.
The Buying Value Measure Selection Tool: Strategies for Selecting Measures and Developing Aligned Measure Sets
The "Buying Value Measure Selection Tool" was developed to assist state agencies, private purchasers and other stakeholders in creating aligned measure sets, and was first released in 2014. A recent webinar explained this tool and recent updates for state officials and other stakeholders involved in developing and maintaining aligned quality measure sets for health care entities and programs including for health plans, accountable care organizations, and patient-centered medical homes.
Social factors, including economic stability, housing, education, relationships, neighborhood, and other environmental influences, can have a significant impact on individuals' health status. In order to make improvements to the health of both individuals and their communities, an integrated approach is critical. Policymakers need to bridge the gap between social services and health care delivery in their efforts to make these improvements, and several states have begun to develop innovative approaches toward this integration, which might provide valuable lessons for others.
Tricky Problems with Small Numbers: Methodological Challenges and Possible Solutions for Measuring PCMH and ACO Performance
With health care providers increasingly being rewarded based on changes in cost of care, it is critical that sufficient statistical safeguards are in place to ensure that payment arrangements fairly reflect provider performance rather than random variation in medical utilization. The underlying changes in cost of care for populations served by patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) are difficult to accurately assess when there are a small number of attributed patients.
Changes in population-based payment models in health care delivery have spurred enhanced efforts toward closer integration between state purchasers of health care and state, county, and local public health officials. This issue brief, developed by Bailit Health Purchasing LLC and Dr. Karen Hacker, investigates approaches that state agencies might employ in order to better integrate public health and health care delivery as a means of improving health and the value of health care, and it is organized according to seven features of integration. The issue brief is accompanied by three case studies providing additional detail to some of the examples cited in the brief.