This report explores flu vaccination rates across multiple years for U.S. adults across the 50 states and the District of Columbia as a proxy to identify population subgroups that may be harder to reach with a COVID-19 vaccine.
This webinar features experts reviewing the provisions of the No Surprises Act and implications for states, providing an overview of the next steps for implementing the federal balance billing protections and what the law will mean for state-level protections.
This commentary explores Michigan’s efforts in improving access and adherence to asthma medications and devices, as well as promoting the use of evidence-based interventions to improve access to important asthma devices and services.
This report uses data from the most recent wave of the Coronavirus Tracking Survey to assess food insecurity and other key indicators of material hardship and well-being among families with young children.
This commentary examines unique strategies states are developing to support the health needs of children and youth with special health care needs who lack access to their usual school-based physical, developmental, and mental health supports.
This report examines the impact of COVID-19 on essential and nonessential workers needing to work in person at even higher risk for contracting COVID-19 and the need for policies and systems to protect and support them.
This report draws on interviews with maternal care stakeholders and available literature and reports to assess if and how our current data systems provide the information needed to track inequities in maternal health outcomes.
This brief explores the key challenges faced by the rural ambulatory safety net in delivering primary care and behavioral health services since COVID-19 and the policy changes that have been implemented in response.
This report seeks to identify ways in which the opioid crisis is affecting children in families touched by drug use; how parents or caregivers could be better supported; and how service providers and systems could better support families.
This commentary explores recent federal efforts to expand private insurance coverage of a COVID-19 vaccine, and provides a roadmap for states to close remaining coverage gaps that could inhibit vaccine uptake.
This commentary examines the impact that recent postal delays, COVID-19-related housing and economic crises, and natural disasters have had on state Medicaid and Children’s Health Insurance Program agencies.
This report provides perspectives from organizations across the country that serve immigrant families and shares their view on what response efforts have done to support immigrant families during the COVID-19 pandemic.
This commentary examines the characteristics of hospitals that received and did not receive the first round of high-impact COVID-19 payments to examine how well the Depart of Health and Human Services (DHHS) targeted the $12 billion to hospitals in early hot spots.
This commentary explores how states have been required to make numerous changes to their eligibility and enrollment systems, operations, and policies, in order to comply with the enhanced Federal Medicaid Assistance Percentages.
This commentary recommends specific steps for state Medicaid programs to ensure state residents receive needed services during the COVID-19 pandemic, with a specific focus on Medicaid managed care organization (MCO) enrollees.
This commentary features a conversation with health leaders in Colorado about how their agencies partnered to support families with young children during the COVID-19 pandemic, as well as the challenges they faced.
This commentary discusses the decision to shift COVID-19 data reporting from the Centers for Disease Control and Prevention to the Department of Health and Human Services, and subsequent warnings from state officials.
This commentary discusses how state Medicaid, children’s health insurance programs, and health insurance marketplaces prepare for an expected increase in demand due to COVID-19, an economic downturn and ensuing budget crises, and unpredictable federal relief efforts.
This webinar highlighted how states should adapt their strategies during COVID-19 as they plan their open enrollment outreach and education campaigns, and how to ground these efforts in terms of audience targeting and messaging.
This report uses a microsimulation model to incorporates data on employment losses by industry, state, and demographic characteristics, allowing researchers to simulate employment losses and associated health insurance coverage.
This commentary provides updated interactive maps that explore the current status of all 50 states and the District of Columbia’s reporting of COVID-19 case and death data breakdowns by age, gender, race, ethnicity, and health care workers.
In this webinar, experts present key findings from a new COVID-19 state resource guide on federal and state Medicaid flexibilities and how they are being deployed to help ensure access to long-term services and supports.
This chart describes each state’s dates for phased COVID-19 reopenings and any delays or reclosings resulting from the recent resurgence of infections, and indicates which states currently have statewide mask requirements.
This report uses new data from the first wave of the Urban Institute’s Coronavirus Tracking Survey to examine health care affordability problems and avoidance of care due to concerns about exposure to COVID-19.
This commentary examines the launch of a New Jersey-based Project ECHO initiative to share COVID-19 expertise between specialists and primary care to meet the needs of pregnant and parenting women during the crisis.
This commentary revisits the history of certificate-of-need and state health planning efforts to inform future decisions as hospitals and state policymakers plan for a post-COVID-19 health care system.
This journal article focuses on how state-level Medicaid program flexibility and emergency waivers can expand Medicaid financial eligibility for long-term supports and services for at-risk individuals.
This commentary discusses how some states are bolstering their community health workforces to curb COVID-19 and improve the quality of care delivered to communities that have faced decades of discrimination.
This commentary features insights from state health agencies and health insurance marketplaces that have actively identified opportunities to conduct outreach in communities disproportionately affected by COVID-19.
This commentary provides an overview of CMS relief guidance and flexibility to state hospitals, facilities, and providers on reporting measures for value-based purchasing and quality reporting programs.
This webinar presented results from a financial model examining the Medicaid fiscal implications of the interaction between the COVID-19 pandemic, the emerging economic downturn, and recent policy changes.
This report shows how the additional levels of unemployment insurance provided through the Federal Pandemic Unemployment Compensation program affects eligibility for subsidized coverage in expansion and nonexpansion states.
This report outlines potential IT investments in responding to COVID-19 and strategies for states to support these investments, and to secure current and future IT investments that enable ongoing Medicaid program operations and advance health information exchange.
This webinar reviews potential information technology (IT) investments in responding to COVID-19 and strategies for states to support these investments to secure current and potential IT investments that enable ongoing Medicaid program operations and advance health information exchange.
This commentary provides an overview of strategies that states can consider to help address gaps in coverage to ensure as many people as possible get access to comprehensive care as the country continues to respond and recover from the COVID-19 health and economic crisis.
This webinar reported on how states are tracking the disproportionate impact of the disease on vulnerable populations and provided a framework for states to examine their COVID-19 response efforts to yield better outcomes for such populations.
This commentary argues states can begin to foster a more equitable and just COVID-19 response, relief, and recovery effort by employing a few key guidelines. Asking a series of core questions and immediately responding with appropriate action can strengthen initial responses and lay the foundation for broader reforms to advance health equity.
This report uses new data from the Urban Institute’s Health Reform Monitoring Survey to examine the effects of the coronavirus outbreak on families’ employment and abilities to meet basic needs, as well as disparities in the economic impact of the pandemic.
This report estimates how health insurance coverage could change as millions of workers lose their jobs because of the slowdown in economic activity resulting from public health efforts to reduce the spread of the coronavirus.
This chart describes each governor’s stay-at-home order, penalties for noncompliance, and the dates when governors plan to reopen their economies and resume non-essential, medical, surgical, and dental procedures.
This brief provides an overview of Children Health Insurance Program (CHIP) Health Services Initiatives (HSIs) and identifies ways that states can leverage them as part of their targeted response to the COVID-19 pandemic.
This commentary discusses the need for states to be sound stewards of taxpayer dollars and why the need to do so now is particularly acute as states confront financial landscapes devastated by the pandemic.
This commentary discusses the states that have rapidly amended their Medicaid home- and community-based services for older adults and their family caregivers to ensure access to long-term services and supports during the COVID-19 crisis.
This commentary discusses the huge rise in the number of people without health insurance in the wake of mass layoffs resulting from the COVID-19 pandemic and are seeking strategies to protect them from high prescription drug prices.
This commentary discusses details of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) signed into law on March 27, 2020. It considers the policy implications and challenges for states, and discusses potential state measures to address these challenges.
This commentary discusses the use of Telemedicine during the COVID-19 pandemic. It summarizes the federal legislation and guidance and discusses actions state departments of insurance can take to encourage greater access to telehealth services.
This commentary includes examples of how states can address new needs, including housing, food, transportation, education, and employment, and how the CARES Act can support and amplify states' work to help stop the spread of COVID-19 and assist people with health-related social needs.
This commentary includes some of the options available to states to ensure that individuals with complex medical conditions and their families have access to necessary home- and community-based services during the coronavirus (COVID-19) crisis through waiver and state plan amendment applications.
This commentary features recommended communication strategies and examples for how states can elevate coverage options and help ensure that more residents can access health insurance during these uncertain times.
This commentary reviews the key indicators currently being tracked by states via their COVID-19 dashboards and also provides an overview of “best practices” states can consider when developing or modifying these same COVID-19 dashboards.
This brief includes communication examples to help states answer questions on how health insurance covers COVID-related testing and treatment, encourage consumers to enroll in coverage, and engage with providers to keep them informed.
This webinar walks through tools states can use to increase payments to providers through both fee-for-service and Medicaid managed care, despite COVID-19 driven changes to utilization. An accompanying toolkit is included that identifies the immediately available tools for states.
This brief estimates that in the four weeks leading up to April 11, 2020, as many as 18.4 million individuals in the United States may be at risk of losing their employer-sponsored health insurance (ESI) coverage, including policyholders and their dependents.
This report assesses the demographic and socioeconomic characteristics of adult food preparation and food service occupations and provides state-level estimates of their numbers and uninsured rates before the outbreak.
This post presents two sample hospital reporting templates to help policymakers capture the information they need to critically evaluate the community benefit investments hospitals make in exchange for their tax exemptions.
This report presents presents estimates of the number of occupied versus unoccupied beds at the national, state, and county levels, using data from the 2018 American Hospital Association Annual Survey.
This blog post discusses the challenges and risks associated with implementing cost-sharing requirements for COVID-19 testing and treatment, and the implications that these requirements may have in individuals delaying or avoiding care altogether.
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.
This blog outlines how states like Oregon and Connecticut go beyond federal requirements to ensure that hospital community benefit spending is substantial, meets community needs, and addresses state goals in exchange for tax exemptions.
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.
This interview features two physicians who participated in planning New Jersey’s statewide office-based addiction treatment program and their experiences treating addiction within primary and specialty care settings.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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,
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.
This case study explores how Indiana’s Family and Social Services Administration is working to rethink how to optimize the integration and delivery of health and social services for Medicaid beneficiaries.
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.
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.
The Minnesota State Employee Group Insurance Program has covered Minnesota state employees and their dependents using a tiered provider model since 2002. A recent SHARE-funded analysis examined the tiering model as well as patient and clinic responses to this tiered provider network approach.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The AHCA, which proposes to repeal and replace the ACA, would dismantle the Prevention and Public Health Fund (PPHF). States received over $625 million from the PPHF in fiscal year 2016, and stand to lose more than $3 billion over five years if it is repealed. The bill would repeal all new appropriations for the PPHF starting in fiscal year 2019, and rescind any funds left over at the end of 2018.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.