Specialized Populations

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Report

10.2019 / By Manatt Health

This issue brief examines how state Medicaid agencies, families, advocates, providers and other stakeholders can partner to improve access to services for Medicaid-enrolled children with special health care needs.

Webinar & Presentations

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.

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 report examines a potential reform to Medicare that would simplify coverage for fee-for-service beneficiaries; streamline cost-sharing obligations for Medicare Parts A, B, and D; and create an out-of-pocket maximum.

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.

Brief

06.2019 / By Urban Institute

This brief examines the prevalence of precarious work schedules among working adults whose families participate in federal safety net programs, using data from the December 2018 Well-Being and Basic Needs Survey.

Brief

06.2019 / By Urban Institute

This fact sheet explores the extent to which families of young children experience material hardship and psychological distress.

Brief

06.2019 / By Urban Institute

This fact sheet explores the extent to which families with young children continue to experience food insecurity.

Commentary

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.

Commentary

In this article, Dan Sumrok, MD, DFASAM, ABAM, ABPM, discusses a possible connection between combat experience and physical and behavioral health problems.

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.

Webinar & Presentations

This webinar highlights how two providers operating in vastly different settings have incorporated a trauma-informed approach to care into their day-to-day practices for treating substance use disorder.

Report

05.2019 / By Urban Institute

This report uses data from the December 2018 Well-Being and Basic Needs Survey to provide systematic evidence on the extent of chilling effects among immigrant families before release of a final public charge rule.

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.

Report

This report explores challenges associated with providing complex care in rural and frontier communities and outlines opportunities to ensure effective programs.

Brief

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

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

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

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.

Brief

This brief outlines the basics of the Medicaid program, including financing and eligibility, for new state policymakers in order to lay the groundwork for considering the challenges and opportunities that lie ahead. 

Brief

This brief highlights priority issues for consideration and potential action, including: the structure of the Medicaid agency; enabling coverage and access; addressing the needs of special populations; and value-based payment policies.

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.

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

This report outlines the activities of three pilot sites pursuing Medicaid-driven strategies to support young children and their families, to help inform other cross-sector partnerships at varying stages of development.

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.

Brief

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.

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

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. 

Brief

This technical assistance tool shares criteria used by innovative organizations that are identifying individuals for their complex care programs, to help others develop or refine eligibility criteria for complex care management programs.

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.

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

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.

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.

Webinar & Presentations

This webinar featured the use of admissions, discharge, and transfer (ADT) data feeds to coordinate care for patients with behavioral health and other complex care issues in Tennessee and Washington. It provided lessons learned, including operational and financing strategies, linkages to quality metrics and outcomes, and alignment with other statewide payment and delivery system efforts.

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.

Report

08.2018 / By Urban Institute

This report investigates the work patterns of Medicaid beneficiaries in Kentucky who are are potentially subject to Medicaid work requirements. It finds that the structure of Kentucky’s Medicaid waiver does not seem to align with the reality of some working enrollees’ lives, and that working enrollees losing coverage may not have access to an employer plan.

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

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.

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

04.2018 / By Urban Institute

The Affordable Care Act (ACA) made private nongroup health insurance more accessible to nonelderly adults with chronic conditions through the federal and state-based Marketplaces. As repeal of the ACA individual mandate takes effect in 2019, protecting coverage gains while stabilizing nongroup premiums may depend on state-level efforts to spread the risk of enrollees’ health care costs across a balanced insurance pool.

Journal Article

This article analyzes the impact of the Affordable Care Act on health insurance coverage for verterans in states that chose to expand Medicaid and in non-expansion states using data from the 2013 and 2014 American Community Survey. The analysis found a substantial 24 percent relative decline in the rate of uninsurance for U.S. veterans between 2013 and 2014. Coverage gains in rural areas were due to gains in Medicaid and individual market coverage. The increase in the insured rate was three times larger in Medicaid expansion states versus non-expansion states.

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.

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.

Webinar & Presentations

This webinar features the Urban Institute's Dr. Fred Blavin, whose SHARE-funded research asks how medical spending burdens for near-poor families in non-expansion states would change if the states were to expand Medicaid.

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

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.

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

04.2017 / By Urban Institute

Before the ACA’s implementation, nearly one million veterans—almost one in 10—were uninsured. By 2015, the number of uninsured veterans fell to 552,000. Veterans uninsurance reduced by nearly 40 percent between 2013 and 2015 under the Affordable Care Act.

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

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.

Webinar & Presentations

Watch: Webinar discussing the impact of ACA implementation in Kentucky.

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

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

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.

Webinar & Presentations

In order to assist states in the facilitation of Medicaid enrollment and renewal for eligible SNAP participants, this webinar presents some of the necessary considerations for leveraging these data for enrollment purposes.

Journal Article

This article examines changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act using data from the National Health Interview Survey. The authors found significant improvements in coverage among children, adolescents, and young adults since 2010, along with some gains in access.

Report

This report identifies methodological challenges in measuring cost of care performance for organizations with a small number of attributed patients, and provides concrete strategies and resources for state purchasers to address this methodological challenge when evaluating PCMH and ACO cost performance and applying financial incentives and disincentives.

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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