Population Health

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Commentary

This interview with Veenu Aulakh, Center for Care Innovations president, touches on the organization’s approach to human-centered design and how they collaborate with patients, staff, and other stakeholders in successfully redesigning care while also telling a meaningful story to the community.

Report

These two reports provide national and state-level trends in suicide deaths from 2000 to 2017.

Report

09.2019 / By Urban Institute

This brief describes interviews with 10 Medicare Advantage plans, Medicare Advantage experts, and social service providers to discuss new benefits added under the Centers for Medicare & Medicaid Services' increased flexibility in plan year 2019.

Report

08.2019 / By Urban Institute

This report shares insights from in-depth interviews with 25 adults in immigrant families who reported that they or a family member avoided participating in safety net programs like Medicaid, SNAP, or housing assistance in 2018 because of immigration concerns.

Report

07.2019 / By Urban Institute

This brief uses the Well-Being and Basic Needs Survey to examine immigrant families’ reported avoidance of activities in various public settings.

Commentary

This analysis highlights the disparities between characteristics of populations most affected by housing affordability issues.

Brief

06.2019 /

In this blog, two former state medicaid directors demystify the distinct yet complementary roles of public health and health care — and how these state agencies can align efforts around prevention strategies to impact health and costs.

Report

This issue brief provides examples from a handful of states that have begun the work of identifying, evaluating, and reducing health disparities within their Medicaid managed care programs.

Dataset

06.2019 / By Altarum

This resource calculates the cost of lead exposure in states, and computes the economic benefits of specific policies and programs, from replacing lead drinking water service lines to eradicating lead paint hazards in older homes.

Report

05.2019 / By Urban Institute

This report examines changes in material hardship between 2017 and 2018 and finds that, despite a strong labor market, there was only modest progress in families’ ability to meet basic needs.

Report

05.2019 / By Urban Institute

This report assesses trends in self-reported measures of general health, mental health, activity limitations, and obesity by educational attainment from 1997-2017.

Brief

America’s day-to-day readiness to manage health emergencies has improved significantly over the past six years according to a nationwide index of health security.

Brief

This table highlights new programs and federal initiatives to combat the opioid crisis.

Commentary

State policymakers have more flexibility than ever to advance health-promoting policies and programs, and showcase effective strategies from which other states—and the nation as a whole—might learn. RWJF helps inform these efforts through research and analysis, technical assistance and training, and advocacy.

Graphic

This infographic shows 10 states’ guidelines for involving community members in the community health needs assessment process, as well as their enforcement levers.

Brief

States can work to make sure hospitals truly seek out and act on meaningful input from a wide range of community representatives — not just community members on a hospital’s board or leaders from high-profile community groups.

Report

In this report, ReSource Team members were interviewed on their methods for addressing the needs of extremely medically complex and socially vulnerable individuals.

Report

This issue brief explores the “next generation” practices that states are deploying to address social factors using Medicaid 1115 waivers and managed care contracts.

Report

This study analyzes three programs that use non-traditional workforce strategies to extend the reach of their clinics to better engage complex patients in their homes, at medical appointments, and other locations.

Commentary

In this interview, Carole Johnson, Commissioner of New Jersey’s Department of Human Services discusses how she is advancing the state's strategies to combat the opioid epidemic.

Report

04.2019 / By Urban Institute

This report explores the effects of Kentucky’s reinstatement of work-related time limits on the SNAP participation of able-bodied adults without dependents between January 2017 and September 2018.

Brief , Graphic

Several states are developing accountable health models to improve health and control costs by addressing health-related community needs, such as transportation, recreation, and housing. This brief examines their organizational and governance structures.

Report

Six case studies examine lessons from PHNCI Innovation Learning Community grantees, who spent eighteen months implementing public health innovations in their communities.

Commentary

This commentary explores a series of case studies and tools developed after a national scan of promising HC/CBO partnerships that examine the operational, financial, and strategic components of successful partnerships.

Report

The annual County Health Rankings measure vital health factors, including high school graduation rates, obesity, smoking, unemployment, access to healthy foods, the quality of air and water, income inequality, and teen births in nearly every county in America.

Dataset

This tool includes more than 700 measures and the most up-to-date version of 19 federal and other national measure sets and six state measure sets.

Dataset

This database includes non-HEDIS and modified HEDIS measures in use by state purchasers and regional health improvement collaboratives and associated performance levels.

Report

03.2019 / By ZERO TO THREE

This resource compares national and state-by-state data on the well-being of infants and toddlers, and provides national and state-level data to help advance policies to improve the lives of babies and families.

Commentary

Eight states will join Aligning Early Childhood and Medicaid, a multi-state initiative aimed at improving the health and social outcomes of low-income infants, young children, and families through cross-agency collaboration.

Brief

This brief reviews a number of Medicaid strategies states are implementing to prevent and treat substance use disorder and support long-term recovery.

Brief

This brief reviews the role that social and economic factors--such as housing, healthy food, and income--play in a “whole person” approach to health care, especially among Medicaid’s low-income enrollees.

Brief

This brief reviews the opportunities state policymakers have to affect the health—and future well-being and productivity—of their youngest residents through their Medicaid programs.

Brief

This brief reviews the growing body of research on Medicaid's health and economic impacts, including access to care; self-reported health status; preventive health screenings; delaying care because of costs; hospital and ED utilization; and mortality rates.

Commentary , Dataset

The percentage of the U.S. population that made changes to drugs due to cost has been relatively stable over time at the national level, but there are substantial differences by state and significant disparities exist between age groups and types of insurance coverage.

Brief

This brief explores opportunities to better address patients’ non-medical needs, including: identifying non-medical needs; employing non-traditional workers; partnering with community-based organizations/agencies; testing new technologies; and identifying funding.

Dataset

02.2019 / By LawAtlas

This tool facilitates use of policy surveillance and legal mapping for improving the nation’s health.

Dataset

This dataset contains local, state and national data that can identify problems and help determine best practices for health and public health programs and policies that promote optimal health.

Dataset , Report

02.2019 / By Health Impact Project

This project encourages state, local, and national level organizations to include health considerations in policy decisions across multiple sectors, such as housing, transportation, and education. Research shows that the conditions in which people live, learn, work, and play influence their health, so the project also works to create cross-sector partnerships that include the expertise of health care and public health systems.

Dataset

02.2019 / By National Equity Atlas

The National Equity Atlas is a comprehensive data resource to track, measure, and make the case for inclusive growth. It includes data on changing demographics, racial inclusion, and the economic benefits of equity—at city, region, state, and nationwide levels.

Dataset

This tool helps identify policies and programs that are a good fit for community priorities. Analysts review and assess research to rate the effectiveness of a broad variety of strategies (i.e., policies, programs, systems & environmental changes) that can affect health through changes to: health behaviors, clinical care, social and economic factors, and the physical environment.

Graphic

These infographics show how each state's overdose rates compare to the national average, provide a high-level comparison of all 50 states' overdose death rates broken down by each of the five drug types, and highlight key findings for trends in drug overdose deaths from 2000-2017,

Webinar & Presentations

This webinar by SHADAC researchers examines new measures and highlights how the estimates can be used to explore disparities between states and among sub-populations.

Report

This guide provides health departments with the key components to consider before planning the FPHS implementation process.

Dataset , Report

This report examines the country’s level of public health emergency preparedness on a state-by-state basis using 10 priority indicators.

Journal Article

01.2019 / By Urban Institute

This study analyzed linked maternal and infant Medicaid claims data and infant birth records in three states to assess treatments and outcomes on maternal and infant health.

Report

MACPAC's 2018 Medicaid and CHIP Data Book is a collection of federal and state statistics regarding the Medicaid and CHIP programs.

Brief

Adult Unhealthy Days is a new measure that provides state-level estimates of the average number of days in the past 30 days that an adult’s mental or physical health was not good.

Report

This report presents a set of policy options for how Project ECHO, a telehealth mentoring program, could be paid for through federal and state funding mechanisms.

Graphic

This infographic series examines housing affordability, both unaffordable rents overall as well as for specific populations.

Commentary

New provisional CDC data suggests opioid-related overdose deaths in the U.S. may be slowing, leveling out or dropping slightly. The opioid crisis varies across states, requiring state-level data to effectively respond.

Report

The Blueprint for Complex Care provides a strategic plan to support multidisciplinary innovations and accelerate opportunities to improve care for individuals with complex health and social needs.

Webinar & Presentations

The Senate passed H.R. 6, The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the “SUPPORT Act”) on October 3, 2018. This reviews major health provisions of the new law and implications for states.

Report

This report highlights three states – Ohio, Oregon, and Washington – work using data, expertise, and evidence to modernize their public health systems.

Report

The Department of Homeland Security’s (DHS) proposed rule, Inadmissibility on Public Charge Grounds, proposes significant changes to how it will determine whether an immigrant is likely to become a “public charge” including, for the first time, the use of Medicaid benefits as a key factor in that analysis.This resource answers popular questions about the rule. 

Webinar & Presentations

This webinar featured speakers from AccessHealth Spartanburg in South Carolina and Petaluma Health Center in Northern California who shared strategies for addressing social determinants of health.

Report

This resource highlights articles published since January 2018 that report on the impact of Medicaid expansion in 33 states and DC, organized by health access and outcomes, economic impacts, and coverage impacts.

Brief

This State Health Policy Highlight profiles three State Health and Value Strategies issue briefs that provide states with practical approaches to improve individual and population health and create joint accountability across health care and other sectors.

Brief

This State Health Policy Highlight profiles two issue briefs and a webinar on how state Medicaid programs can address social determinants of health.

Report

10.2018 / By Urban Institute

This report explores changes in coverage type between 2013 and 2016 overall and for key demographic and income subgroups. Between 2013 and 2016, the share of Americans ages 64 and younger without health insurance fell from 17 percent to 10 percent.

Brief

10.2018 / By Urban Institute

This brief examines changes in health insurance coverage and health care access and affordability for parents and their children between 2013 and 2018 using data from the Health Reform Monitoring Survey.

Brief

Recognizing an unmet need for toiletries and household products among clients, AccessHealth Spartanburg stocks a closet where eligible clients can “shop” for items. This builds trusting relationships between clients and staff and meets basic client needs.

Dataset , Report

This report highlights the latest obesity trends as well as strategies, policies, programs, and practices that can reverse the epidemic. The report also details the level of commitment necessary to effectively fight obesity on a large scale and includes key recommendations for specific actions.

Report

09.2018 / By Urban Institute

The Well-Being and Basic Needs Survey (WBNS) monitors changes in health and well-being at a time when policymakers seek significant changes to programs that help low-income families pay for basic needs. Most indicators based on data from the WBNS are reasonably consistent with measures from larger federal surveys.

Report

09.2018 / By Urban Institute

As federal and state policymakers weigh changes to federal programs that help low-income people meet their basic needs for food, medical care and shelter, they run the risk of increasing material hardship, which could have detrimental short- and long-term impacts on children and adults.

Graphic

This chart compares the social determinants 11 states targeted in their Medicaid contracts and contract guidance documents to enhance population health, as well as how states monitored outcomes and funded these efforts.

Webinar & Presentations

This webinar is first in a two-part series exploring how providers are building on existing complex care program models to extend beyond the walls of a health system.

Dataset , Graphic

This report provides a compilation of data on equity goals and progress for 28 measures of health, socioeconomic factors, physical and social environment, and access to health care. Each measure is presented by race, ethnicity, and socioeconomic status for all 50 states, the District of Columbia, and the nation.

Report

07.2018 / By Urban Institute

The ACA has made considerable gains in health insurance coverage, but many remain uninsured. This is an update to a 2015 analysis of the characteristics of the remaining uninsured, focusing on people uninsured in 2017 as well as how the characteristics of this population have changed.

Report

This report examines the United States opioid epidemic at the state-level, analyzing trends in overdose deaths from heroin and other opioids. Using vital statistics data, it looks at which states have the highest rates of opioid-related deaths and which have experienced the largest increases in death rates.

Webinar & Presentations

This webinar provided an overview of Centers for Disease Control and Prevention's 6|18 Initiative and highlighted recent accomplishments from participating Medicaid-public health teams. The CDC 6|18 Initiative is a framework to guide Medicaid-public health collaboration.

Brief

State officials can align prevention strategies with value-based payment goals through a variety of mechanisms outlined in this brief, which draws from state-based 6|18 Initiative implementation efforts to help Medicaid and public health officials make the case for investing in prevention strategies and aligning these efforts to achieve state VBP goals.

Webinar & Presentations

Webinar discusses the status of state efforts to secure waivers to use federal Medicaid funding to provide care in Institutions for Mental Disease (IMD), including the requirements states must meet to secure an IMD waiver; the status of requests and approvals; and issues and opportunities arising as states pursue and increasingly implement the IMD waiver.

Report

This chartbook uses data from the American Community Survey (ACS) to examine health insurance coverage from 2013 to 2016 for children at the national level and in the states.

Report

Informed by more than 30 key informant interviews representing programs in 19 states and a small group convening, this report offers a national analysis to uncover opportunities to facilitate state-level, cross-sector strategies that promote health beyond the traditional health care levers.

Report

This issue brief provides an overview of hospital global budgeting, which represents a middle-ground approach between the narrow bundling of services and global capitation that transfers higher levels of financial risk to a hospital. It provides a brief overview of hospital global budgets for state health officials interested in whether global budgets may be an option for their state.

Graphic

According to 2016 data from the National Survey of Children’s Health, 33.9 percent of children nationwide had trouble affording nutritious meals.

Graphic

According to 2016 data from the National Survey of Children’s Health, 14.4 percent of children nationwide lived in working poor households. Of these, roughly one-third resided in ten states: Mississippi, New Mexico, Arizona, New York, Arkansas, Michigan, Nevada, Alabama, Louisiana, and Texas. 

Graphic

SHADAC is highlighting state-specific findings from the 2016 National Survey of Children’s Health (NSCH) on measures that illustrate where states are closer to achieving a Culture of Health and where improvements can be made. As additional years of NCSH data are released, trends will be monitored in these indicators to track progress in developing a culture of health over time.

Journal Article

The six household surveys documented in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP).

Report

An annual assessment of the nation and each state’s day-to-day readiness for managing health emergencies improved significantly over the past five years, though deep regional differences remain. The 2018 National Health Security Preparedness Index found the United States scored a 7.1 on a 10-point scale for preparedness—nearly a 3 percent improvement over the last year, and a nearly 11 percent improvement since the Index began five years ago.

Brief

In Morrison County, Minnesota, an innovative state approach to improve population health is also helping combat the opioid crisis and save money. The Unity Accountable Community for Health (ACH) initiative has saved the state’s Medicaid program $3.8 million over three years by reducing claims for prescription opioid and related drugs.

Journal Article

This paper examines a 2008 survey of adults enrolled in Minnesota's public health care programs to study the effect of barriers to health care access and the magnitude of those barriers on health care utilization. The authors found that multiple types of barriers are associated with delayed and foregone care, with system-level barriers and discrimination having the greatest effect on health care seeking behavior.

Report

Six case studies on innovations in public health, including: Boston's PHC Bridges Sectors to Combat Overdoses; Chicago's DPH Sees the Future Thanks to Predictive Analytics; Hennepin County Uses Automation in Databook Development; Douglas' CHD Brings STD Testing to Youth-Friendly Locations; Portsmouth's HD Uses CASPER to Collect Neighborhood Data; and Check Out a Book, Check Out a Blood Pressure Kit.

Brief

This issue brief summarizes key features of the February 9, 2018 10-year CHIP extension. CHIP covers nearly 9 million children and is a key contributor to record-low levels of uninsurance among children.

Dataset , Report

The County Health Rankings is an annual county-by-county assessment that shows where we live matters to health. This year, we bring new analyses that show meaningful health gaps persist not only by place, but also among racial and ethnic groups. These gaps are largely the result of differences in opportunities in the places where we live. And, these differences disproportionately affect people of color.

Brief

The nation’s opioid epidemic claimed more than 42,000 lives in 2016, and more than 2 million people in the United States have an opioid use disorder (OUD). Yet, only 1 in 5 people suffering from an OUD receive treatment. In this issue brief, data from three states—New Hampshire, Ohio and West Virginia—highlight Medicaid’s role as the linchpin in states’ efforts to combat the opioid epidemic.

Journal Article

This article explores efforts by nine state Medicaid and public health agency teams to implement 6|18 interventions related to asthma control, tobacco cessation, and unintended pregnancy prevention. It was published in the Journal of Public Health Practice and Management and covers Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina.

Brief

This brief compares the health topics each governor addressed in their 2018 State of the State remarks.

Webinar & Presentations

This eLearning series will teach you about: Innovation and Public Health; Foundational Public Health Services: An Overview; Connecting the Dots of Emerging National Public Health Initiatives; and Policy, Systems, and Environmental Change to Drive Innovation in Public Health.

Report

This report examines the issue that with no individual mandate and expanded non-comprehensive coverage, the divisions between states will deepen, and market conditions will deteriorate for unsubsidized farmers and others seeking coverage in states that don’t protect their risk pool.

Report

Studies show that health disparities are often passed down from socially disadvantaged parents to their children and grandchildren. Poor children begin life on an uneven playing field; they face greater challenges than their healthier, more advantaged classmates; and they often struggle as adults to accumulate wealth to share with—and bequeath to—their children. State and federal health policymakers play a crucial role in breaking this cycle of poverty and inequity so that all can live healthy, prosperous lives.

Report

This report highlights policy levers, performance measurement strategies, and sustainable financing options that states can use to support accountable health structures.

Journal Article

This article details a qualitative analysis that (1) identified facilitators and barriers to utilizing a community health worker (CHW) model among patient-centered medical homes (PCMHs) in Minnesota; and (2) defined roles played by the CHW workforce within the PCMH team. Four themes emerged as facilitators and barriers: the presence of leaders with knowledge of CHWs who championed the model; a clinic culture that favored piloting innovation vs. maintaining established care models; clinic prioritization of patients' nonmedical needs; and leadership perceptions of sustainability.

Brief

As Congress barrels toward the end of the year, several bills are in play that will have major and almost immediate ramifications for health insurance markets. They include: Tax Cuts and Jobs Act (H.R. 1); The Alexander-Murray insurance market stabilization bill; The Nelson-Collins reinsurance program bill; and the temporary elimination of the health insurance tax (H.R. 4620).

Brief

More than 200 state health officials crowded into a NASHP annual conference session to learn about strategies to improve population health and reduce costs while simultaneously transforming their state’s health care finance and delivery models.

Report

States and the federal government have invested in programs that help low-income and vulnerable populations find housing and access health care and supportive services. However, those programs often remain siloed, with health and housing sectors frequently working independently toward similar goals. These resources support policymakers working to break down those silos to better deploy state resources through an aligned health and housing agenda.

Report

As states transform their health systems, many are turning to community health workers (CHWs) to improve health outcomes and access to care, address social determinants of health, and help control costs of care. While state definitions vary, CHWs are typically frontline workers who are trusted members of and/or have a unique and intimate understanding of the communities they serve. These resources support state efforts to incorporate CHWs into their health and health equity improvement work.

Report

This report examines how organizations participating in Transforming Complex Care (TCC), a multi-site national initiative funded by RWJF, are assessing and addressing social determinants of health for populations with complex needs. It reviews key considerations for organizations seeking to use SDOH data to improve patient care.

Report

As the opioid and mental health crises continue to gain national attention, local leaders are stepping up to implement programs to address the prevalence and impact of untreated serious mental illness (SMI) and substance use disorders (SUD). This report explores how cities and counties have launched local initiatives to address the human and economic impact of untreated SMI and SUD.

Brief

The Administration signaled a willingness to give states more flexibility to address health and prevention in new and innovative ways under Section 1115 of the Social Security Act, allowing the Department of Health and Human Services to approve experimental and innovative projects that promote the goals of Medicaid. This comes at a pivotal time when many states are developing new ways to improve health care, reduce costs, and address health-related social needs such as housing.

Report

This report provides an annual update to comparisons of uninsurance estimates from four federal surveys:
-The American Community Survey (ACS)
-The Current Population Survey (CPS)
-The Medical Expenditure Panel Survey - Household Component (MEPS-HC)
-The National Health Interview Survey (NHIS)

Graphic

This map highlights state activity to integrate Community Health Workers (CHWs) into evolving health care systems in key areas such as financing, education and training, certification, and state definitions, roles and scope of practice. The map includes enacted state CHW legislation and provides links to state CHW associations and other leading organizations working on CHW issues in states.

Graphic

This chart summarizes major provisions included in the 2010 Affordable Care Act, provisions included in the American Health Care Act passed by the House on May 4, 2017, as well as preliminary analysis of the Senate Better Care Reconciliation Act (BCRA) discussion draft as amended on June 26, 2017, and then revised on July 13, 2017 and July 20, 2017.

Report

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. Social determinants include a broad array of social and environmental risk factors such as poverty, housing stability, early childhood education, access to primary care, access to healthy food, incarceration and discrimination. This report digs into opportunities that states have to account for SDOH in Medicaid programs.

Report

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 report digs into opportunities that states have to account for SDOH in Medicaid programs.

Brief

Low-income and vulnerable populations often need services and supports outside the scope of a single state agency to live healthy lives. In some states, braiding or blending funding streams lends programs a measure of flexibility, efficiency, and resiliency. Some states are considering whether innovative funding models could help them address the health-related social needs of vulnerable residents.

Brief

06.2017 / By Urban Institute

Mental health and substance use coverage could roll back to pre-Affordable Care Act (ACA) levels if the American Health Care Act (AHCA) becomes law. Analysis finds the AHCA could limit access to mental health treatment.

Report

The Partnership for Healthy Outcomes set out to capture and analyze the lessons emerging in this dynamic space, as organizations explore partnerships to achieve greater outcomes together than they could on their own. A national request for information asked specifically about partnerships between health care organizations and CBOs. It produced a wealth of data from a wide range of partners in a wide variety of partnerships.

Brief

This blog examines three potential changes to state public health programs, based on insights in the proposed White House budget for FY 2018. The budget is expected to change in Congress; however, it is important for states to consider what the administration’s priorities could mean for public health. It proposes some targeted infrastructure investments and proposes to reduce funding for public health infrastructure and services.

Brief

State health policymakers are increasingly acknowledging housing as a key component of health and are weaving housing strategies into their broader health system transformations. States have powerful levers at their disposal and a range of funding streams that they can bring to bear to support integrated health and housing, while local public housing authorities also play a large role in community efforts to house vulnerable, low-income households.

Webinar & Presentations

This webinar profiles Louisiana’s Permanent Supportive Housing program and  Virginia’s Children’s Services Act, and examines their use of blended or braided funding to help meet the health-related social needs of vulnerable low-income populations.

Report

This report examines the United States opioid epidemic at the state-level, analyzing trends in overdose deaths from heroin and other opioids, such as prescription painkillers. Using vital statistics data, it looks at which states have the highest rates of opioid-related deaths and which have experienced the largest increases in death rates.

Brief

Under the authority of Section 1115 demonstrations, some states have implemented DSRIP programs to improve care, improve health, and lower costs. DSRIP programs restructure Medicaid funding into a pay-for-performance arrangement in which providers earn incentive payments outside of capitation rates for meeting certain metrics or milestones based on state-specific needs and goals, which are used to measure success.

Report

This report explores Louisiana’s permanent supportive housing program. The program, administered jointly by the state’s Medicaid agency and housing authority, is a cross-agency partnership that braids funding to serve vulnerable cross-disability populations, address homelessness, reduce institutionalizations, and save money for the state.

Brief

Medicaid can play a unique and critical role in responding to public health emergencies and health crises. This brief explores the role Medicaid has played in responding to events such as the opioid and HIV/AIDS epidemics, the 2001 World Trade Center attacks, the Flint, Michigan lead contamination crisis, and Hurricane Katrina.

Report

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 report identifies ways states can learn from value-based payment models being applied elsewhere to create more accountability for the quality and cost of LTSS.

Report

04.2017 / By Urban Institute

In this report, researchers estimate the impact of the ACA Medicaid expansion on uninsured rates of poor, childless adult citizens, by age, gender, race, income, education, and health.

Brief

While the focus of debate regarding repeal of the Affordable Care Act (ACA) has been on Marketplaces and the Medicaid expansion, myriad other provisions of the ACA are at risk of repeal—including those that streamline Medicaid eligibility and enrollment systems and implement a national, simplified standard for income eligibility. As of January 2016, 37 states are able to complete an eligibility determination in real time, defined as less than 24 hours, and among these, 11 states report that at least half of their applicants receive an eligibility determination in real time. The future of the ACA’s streamlined eligibility and enrollment-related provisions and the system improvements states have invested in to implement them are the subject of this issue brief.

Commentary

State and federal policymakers increasingly acknowledge that health is difficult to achieve and maintain for people without a stable home. Numerous studies show that housing and housing supports can help vulnerable populations improve and maintain health while lowering hospital and other costs for state and local governments. This commentary outlines three tips for state policymakers.

Report

This report identifies solutions that could be developed, and implemented at the local or community level to advance health equity.

Brief

CHIP can provide critical financial support to states as they seek to implement cost-effective lead abatement activities to protect children. This issue brief describes the CHIP State Plan option, which does not require a waiver, and the opportunity it provides for states to make significant tangible reductions in lead exposure and improvements to children’s health. The brief includes specific examples in case studies from Michigan and Maryland.

Brief

When it comes to prevention, identification, and mitigation of public health crises, states are at the forefront. These crises require a multi-sector state agency approach as often they disproportionally impact disadvantaged communities and are linked with challenging social determinants of health.

Report

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 report outlines how state agencies can use shared measurement and joint accountability across sectors as tools for improving population health outcomes. 

Report

This report describes six potential integration strategies that state agencies might employ to better integrate social services and health care delivery. For each, the report contains examples from several states that have utilized these strategies in their own efforts to increase integration.

Brief

High-profile diseases such as Ebola and Zika grab headlines, but state health policymakers know that emergency preparedness begins long before the first news stories—or symptoms—appear. At the nexus of federal policy and local concern, state health policymakers are well-positioned to lead prior to, and during, health emergencies.

Webinar & Presentations

Increasingly, health departments are serving as leaders in communities to address the root causes of health inequities. This requires changing systems and policies, and working with non-traditional partners to ensure that all people have the opportunity to attain their highest level of health. On December 12, 2016, PHNCI explored the stories of two health departments working to transform communities such that zip codes do not dictate health outcomes. 

Brief

Stark health disparities make it difficult to move the needle on health outcomes and costs and reflect the fact that states face a variety of political and resource constraints when it comes to implementing health equity initiatives. While disparities still exist, all states have opportunities to advance health equity through a range of approaches, from incremental targeted programs to integration in broad health reform initiatives.

Brief

Leaders from across state governments, in both the executive and legislative branches, convened to help identify cross-cutting issues that provide opportunities to advance health reform and transform our health system to one that lowers cost, rewards value, and improves health. This brief presents key opportunities before the new administration that could maintain and accelerate state-based reforms.

Brief

To help better prevent and control costly conditions such as chronic diseases and break the cycle of poor health, states are experimenting with mechanisms to incentivize healthy behaviors and personal responsibility for wellness. In October 2016, leaders from Connecticut, Idaho, and Indiana shared their experiences along with the unique approaches their states are taking to address this issue.

Brief

State agencies across the country, from Medicaid to public health, to social services and corrections, are deeply engaged in multi-sector initiatives to reduce infant mortality. And for good reason: the United States ranks 25th among industrialized countries in infant mortality with a disproportionate number of being African Americans.

Report

10.2016 / By Urban Institute

This report is a detailed analysis of state rankings on 39 health outcomes, and correlations between those health outcomes and 123 determinants of health spanning five domains: health care, health behaviors, social and economic factors, the physical and social environment, and public policies and spending.

Brief

As public health departments adapt to meet the growing and changing needs of their communities, several national initiatives emerged to serve as pathways for health departments to be conveners, providers, and strategists to improve health and well-being. PHNCI, a division of the PHAB, was created to act as a national convener to incubate and share innovative ideas that help improve public health practice and serves as the hub for 21st century health. As part of PHNCI’s aim to provide strategic coordination at the national level, this brief provides an overview of national initiatives and their connections to accreditation.

Report

In an era of public health system transformation, public health departments around the nation are adapting — or “modernizing” — to meet the growing and changing needs of their communities. To help states navigate the challenges inherent in public health system transformation, three grantee states are participating in a learning community supported by PHNCI. The three states — Ohio, Oregon and Washington — are working to test and implement the systems transformations required to provide the foundational public health services statewide and ensure that all residents have equitable access to public health.

Report

PHAB is the nonprofit accrediting body for Tribal, state, local, and territorial public health departments. In 2015, PHAB launched PHNCI, a new division established to identify, implement, and spread innovations in public health practice to help meet the health challenges of the 21st century in communities nationwide. This report explains the alignment between version 1.5 of the accreditation standards and measures and version 1.0 of the foundational capabilities as part of the foundational public health services framework.

Brief

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 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.

Brief

As state Medicaid programs increase their focus on value-based payment, it is important to consider how FQHCs may participate in payment reform strategies. Through their focus on improved health outcomes, patient satisfaction, and access to appropriate care, alternative payment methodologies can benefit FQHCs, the state purchaser, and most importantly Medicaid beneficiaries. This brief describes a number of state-level payment reform strategies that include FQHCs and offers strategies and considerations for states and FQHCs alike.

Report

This report stems from technical assistance provided to California’s Department of Health Care Services (DHCS). The technical expert facilitated webinars and meetings with DHCS staff and medical directors of contracted MCOs, in order to share information about housing resources and emerging practices for improving care and achieving savings by linking more Medicaid beneficiaries with permanent supportive housing.

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