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 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 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 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 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 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 commentary highlights the promise and challenge of telehealth tools, including unconventional uses of telehealth technology, scalability of interventions, the effect of patient preferences on behavior adoption, and the effect of patient demographics on adoption.
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 paper summarizes emerging evidence in the field of how social determinants of health shape health outcomes and identifies key areas where more research is needed to advance implementation and policy development.
This brief estimates charitable feeding use by demographic and socioeconomic characteristics and explores how use of charitable feeding intersects with other material hardship measures and safety net program participation
This webinar reviewed the Department of Homeland Security's final version of its public charge rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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,
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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)
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.