With states increasingly moving to develop population-based payment arrangements with provider organizations, the critical role of safety-net providers has become a challenging consideration for states. While safety-net providers typically lack the capital, experience, and/or scale to operate as an Accountable Care Organization (ACO), their role in state Medicaid programs underscores their integral role in the implementation of a population-based payment strategy with ACOs.
Developing a State-based Quality Measurement Program Using an Episode-of-Care Framework: Recommendations for State Purchasers
In attempting to move toward value-based payments, there exist the inherent challenges posed by the availability of data. States wishing to accelerate the transformation of the existing delivery system into one that delivers high quality and affordable health care have to take action to develop a comprehensive data collection and reporting mechanism. Such an approach can be taken using episodes of medical care as the central unit of measure.
Federally Qualified Health Centers (FQHCs) traditionally provide health care services primarily to low-income individuals who are covered by Medicaid or who are uninsured. As state Medicaid programs increase their focus on value-based payment, it is important to consider how FQHCs may participate in payment reform strategies. This brief provides an overview of FQHC cost reporting, delves into state payment reform strategies that Include FQHCs, and offers considerations for states and FQHCs alike.
In October, SHVS hosted a webinar on improving care for Medicaid beneficiaries experiencing homelessness, introducing a new issue brief and toolkit for states and featuring presentations by a panel of experts from a state Medicaid agency, a Medicaid managed care plan, and a Medicaid provider – all working to link Medicaid services with housing to improve care for homeless Medicaid beneficiaries.
Nationwide on a given night in January 2014, more than 578,000 people were homeless, and one third of these people were sleeping on the streets, in cars, or other places not meant for human habitation. Over the course of a year, about 1.42 million people used a shelter or transitional housing program for homeless individuals or families. Homeless people often have significant health and behavioral health needs that can be very difficult to manage without stable housing, and many people who experience homelessness are Medicaid beneficiaries. As purchasers of health care, state Medicaid agencies have critical roles to play in the delivery of more appropriate and cost-effective care for people with complex health and behavioral health care needs who experience homelessness.
State health care purchasers are increasingly shifting toward value-based purchasing (VBP) strategies that reward providers for value or outcomes as a means of improving care, improving health and reducing overall costs. This webinar examines how states are currently advancing payment reform in their managed care provider networks by moving away from fee-for-service (FFS) and identifies key considerations for states interested in implementing VBP strategies in this environment. Representatives from Arizona and Tennessee share ground-level experiences in adopting VBP strategies in their Medicaid managed care programs.
This suite of issue briefs is geared toward states interesting in value-based purchasing for health care. Part 1 deals with strategic considerations, Part 2 offers an implementation guide, while Part 3 includes a planning template for state purchasers.
Individual and Family Engagement in the Medicaid Population: Emerging Best Practices and Recommendations
In this issue brief, The Institute for Patient- and Family-Centered Care (IPFCC) outlines action-oriented recommendations and strategies to support enhanced individual and family engagement efforts in Medicaid. Research shows that engaged individuals and families actively working with their health care teams have better outcomes, often choose less expensive options when participating in shared decision-making, and express greater satisfaction with their health care experiences.
Approaches to the Integration of Services for Individuals with Intellectual and Other Developmental Disabilities
Based on interviews conducted with I/DD staff in six states, this paper highlights approaches to integrating services within the Medicaid program for individuals with I/DD, and lessons learned from states with integration activities underway.
Tailored to the needs of state officials and other stakeholders involved in measure set creation, this webinar addresses strategies for developing and maintaining aligned quality measure sets.