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Commentary

This commentary highlights several strategies states can pursue to help ensure a successful open enrollment period this year amid the COVID-19 pandemic.

Commentary

This commentary explores how adverse childhood experiences contribute to poor health outcomes, and the ways that these are exacerbated by the COVID-19 pandemic.

Commentary

This commentary explores how states are confronting the challenges that COVID-19 poses to dental care and oral health access in the United States.

Webinar & Presentations

This webinar details how three provider organizations are using population health management approaches to care for people with complex needs amid COVID-19.

Commentary

This commentary explores the key role Medicaid programs play in helping the health care system make the transition to the new normal of the COVID-19 crisis.

Webinar & Presentations

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.

Report

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. 

Brief

This brief compares four studies that project the effects of the COVID-19 recession on employment-based health insurance coverage and the number of uninsured people in 2020.

Commentary

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.

Report

This report examines examples from two state Medicaid programs and a nonprofit quality measurement and reporting organization of the data sources used to identify patients’ social risk factors when risk-adjusting payments or measuring quality.

Commentary

This commentary tells the story of Jim, who overcomes the challenges of living with cerebral palsy through services covered by Medicaid.

Commentary

This commentary tells the story of Linda, a high school teacher whose job does not provide health insurance benefits, and is therefore covered by Medicaid.

Commentary

Espri is a self-employed farmer whose family is covered by Medicaid in Indiana.

Commentary

Noah enrolled in Medicaid in Maryland when he lost his job and health coverage due to the COVID-19 pandemic.

Commentary

Sarah, a Michigan resident with multiple sclerosis, was covered by Medicaid during pregnancy.

Commentary

This commentary summarizes recent guidance from the Centers for Medicare & Medicaid Services on permitting health insurance issuers to provide certain premium rebates for 2020 and the conditions rebates must meet.

Commentary

This commentary analyzes how states are working to protect farmworkers during COVID-19.

Commentary

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.

Commentary

This commentary provides an overview of how COVID-19 is affecting state budgets and state health programs.

Commentary

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.

Commentary

This commentary discusses how potential requirements for workplace coronavirus testing may force essential workers to bear a disproportionate share of the cost.

Report

This report examines activity across six states that are exploring social insurance initiatives to help finance long-term services and supports.

Report

This report compares 2017 to 2018 changes in insurance coverage across three national surveys: The American Community Survey, Current Population Survey, and National Health Interview Survey. 

Webinar & Presentations

Two webinars on open enrollment period 2021 explore COVID-19 implications and effective strategies to consider as states design their outreach and education campaigns in a shifting health care environment.

Commentary

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.

Commentary

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.

Commentary

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. 

Commentary

In this podcast, Medicaid experts discuss how vision coherence is important for effective leadership.

Brief

This brief highlights how Nebraska’s Medicaid agency and its Division of Public Health partnered to share antibiotic prescribing information between Medicaid claims and evaluation and management codes to determine where targeted education and outreach efforts were needed.

Commentary

In this podcast, Medicaid experts share five tips for leaders to address today’s VUCA (volatility, uncertainty, complexity, and ambiguity) challenges within their organizations.

Commentary

This commentary outlines how state legislative sessions took a hit this year from the novel coronavirus pandemic.

Commentary

This commentary outlines recent data that examines how difficult it will be to predict the effect of the COVID-19 pandemic on the uninsured rate.

Commentary

This commentary outlines some of the collaborative and successful strategies states are taking to protect and support individuals particularly at risk for homelessness.

Graphic

This map provides information on each state's contact tracing program model, workforce, lead agencies, funding, technology, and contact tracing process.

Commentary

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.

Commentary

This commentary considers five frequently heard worst-case scenarios related to the Affordable Care Act and provides research evidence that these fears did not come to pass.

Report

This report uses data to examine how the COVID-19 pandemic has affected food insecurity and access to school meals and charitable food distribution for adults and their families in the United States.

Report

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.

Webinar & Presentations

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.

Commentary

This commentary features an interview on how health care systems can use trauma-informed care to support patients and frontline workers during the COVID-19 pandemic.

Commentary

This commentary reviews how various states are addressing their home visiting programs and implementing more telehealth services during the COVID-19 pandemic.

Graphic

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.

Webinar & Presentations

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.

Commentary

This commentary examines approaches states are taking to protect farmworkers during the COVID-19 pandemic and recommendations for policymakers.

Report

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.

Report

This report provides the first nationally representative estimates of changes in coverage during the initial months of the recession induced by the COVID-19 pandemic.

Report

This report outlines six key steps for governors to build and support a contact tracing workforce to respond to COVID-19.

Commentary

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.

Commentary

This commentary provides an overview of the state of COVID-19 testing in the United States.

Commentary

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.

Commentary

This commentary presents stories of innovative approaches to address food insecurity needs exacerbated by the COVID-19 pandemic.

Commentary

This commentary presents data on how the COVID-19 pandemic is affecting “deaths of despair” caused by suicides, alcohol abuse, and overdoses from opioids and other drugs. 

Journal Article

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.

Commentary

This commentary provides a snapshot of how states are navigating fiscal challenges of the COVID-19 pandemic, given declining revenues and rising spending demands.

Report

This report examines insurer responses to the COVID-19 pandemic to assess the effect the pandemic has had on their companies as well as actions they have taken to aid in the pandemic response.

Dataset

This dataset examines projected changes in federal and state Medicaid and CHIP expenditures for scenarios during the COVID-19 pandemic.

Commentary, Dataset, Report

This dataset shows that national health security capabilities continue to gain strength, but at a rate that has slowed down over time.

Commentary

This commentary examines the importance of home visiting during the COVID-19 pandemic, as families face new or expanding challenges like domestic violence, substance use, or mental health needs.

Commentary

This commentary assesses how insurers are developing their 2021 premium rates by reviewing preliminary actuarial findings in the District of Columbia, New York, Oregon, Vermont, and Washington.

Commentary

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.

Commentary

This commentary examines how states are developing COVID-19 testing programs without clear federal guidance.

Commentary

This commentary provides an overview of new federal guidance that attempts to answer questions about requirements for coverage of COVID-19 testing services.

Commentary

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.

Report

This report provides excerpts of health disparities and health equity contract language from Medicaid Managed Care contracts from five states, Washington, D.C., and the contract for California’s Health Exchange, Covered California.

Commentary

This commentary provides interactive maps that explore the status of the 50 states' and District of Columbia’s reporting of COVID-19 case and death data breakdowns by demographic categories. 

Commentary

This commentary, part of the Innovations Amid COVID-19 series, profiles a clinic's innovative approach to using online data to identify high-risk patients.

Commentary

This commentary discusses how job losses and reductions in hours have resulted in millions losing employer coverage or the income needed to pay premiums, increasing the uninsured rate.

Commentary

This commentary provides a summary of state efforts to capture information on the coronavirus pandemic through state and local surveys fielded between March 2020 and May 2020.

Brief

This toolkit is intended to serve as a resource for states as they begin to strategize about reopening and plan for the next phase of the COVID-19 pandemic.

Brief

This brief provides a chart describing the effective dates of various federal provisions to allow for temporary flexibilities in the Medicaid and Children's Health Insurance Program programs.

Brief

This brief provides an overview of New Hampshire’s recent directed payment to six types of essential Medicaid providers in order to help them keep their doors open during the COVID-19 pandemic.

Report

Stakeholders in six states assess the impact of Medicaid insurers increasing dominance in the ACA marketplaces.

Commentary

This commentary outlines three key policy steps to help health centers survive in the short term and thrive beyond the COVID-19 crisis.

Webinar & Presentations

In this webinar, experts reviewed the current telehealth policy landscape and considerations for states as they design their post-apex telehealth policies.

Commentary

This commentary outlines how continuity between Medicaid and the marketplace is more important than ever.

Commentary

This chart describes each governor’s stay-at-home order, penalties for noncompliance, and dates when governors plan to reopen their economies and resume non-essential procedures.

Commentary

This commentary compiles thoughts from navigators across five states using the federally-facilitated marketplace about how they are faring during the COVID-19 pandemic.

Commentary

Destination: Home leadership discuss their county’s initial response to COVID-19 and their organization’s role in providing care and services for homeless individuals during the pandemic. 

Commentary

This commentary shows how every state and Washington, D.C. are innovating and expanding contact tracing to contain COVID-19 infections and reopen their economies. 

Report

This report examines the implications if the outstanding 15 states chose to expand Medicaid eligibility in 2020.

Commentary

This commentary examines the relief funds in the CARES and PPP Acts intended to help providers prevent, prepare for, and respond to COVID-19.

Dataset

This guide compiles more than 100 resources tracking state and local data and policy responses to COVID-19 in health care, food, housing, and income supports.

Webinar & Presentations

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.

Commentary

This commentary outlines challenges facing family caregivers in the COVID-19 environment and new opportunities for states to come to their aid.

Commentary

This commentary explains how, due to the loss of employer-sponsored insurance from the economic fallout of COVID-19, states may continue to see an increase in Medicaid enrollment.

Commentary

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.

Commentary

This commentary provides a survey of actions that state and local governments have taken to intentionally incorporate equity into their COVID-19 recovery and reopening policies. 

Report

This report uses new enrollment data to examine insurer type enrollment trends from 2016-2018.

Commentary, Report

06.2020 / By The RAND Corporation

This commentary gauges the potential effects on coverage and cost if public options become available in the country's health insurance exchanges, based on observations from a RAND COMPARE microsimulation model.

Commentary

This commentary provides state and local leaders with health equity principles that can serve as a compass to point leaders toward an equitable and lasting COVID-19 recovery. 

Commentary

This commentary assesses how the COVID-19 pandemic may accelerate a shift away from fee-for-service payments models in health care.

Report

This report documents access and affordability challenges facing uninsured new mothers using 2015–18 data from the National Health Interview Survey (NHIS). It also uses 2015–17 data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) to describe the health status of women who lost Medicaid coverage following their pregnancies.

Report

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.

Report

This report assesses how the pandemic is affecting family employment and caregiving, financial decisions, and material hardship among parents living with children under age 19.

Webinar & Presentations

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.

Report

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.

Commentary

This commentary examines strategies that successfully drove enrollment in state-based marketplaces during the COVID-19 pandemic.

Commentary

This commentary identifies actions federal and state policymakers have taken to address the impact of COVID-19 on their managed care performance incentive programs.

Commentary

In this podcast episode, Ed O’Neil, PhD, MPA, a leadership development expert, speaks with Hilary Kennedy, program director for Medicaid leadership at the National Association of Medicaid Directors, about strategies Medicaid leaders can use to continue developing their staff at a distance.

Commentary

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.

Webinar & Presentations

This webinar discussed the models that have been published of where individuals are expected to gain Medicaid and Marketplace coverage over the next 18 months.

Commentary, Dataset

This commentary looks at which states are regularly reporting data that helps shed light on the health equity issues of the COVID-19 crisis.

Commentary

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.

Brief

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.

Commentary, Dataset

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.

Commentary

States can use or revise this downloadable template to capture how much in federal coronavirus relief funds each hospital has received to date to guide states’ future CARES Act.

Graphic

This infographic highlights what states need to consider when providing pregnancy-related services to Medicaid enrollees through telehealth during the pandemic.

Report

This report focuses on the impact of the COVID-19 pandemic on family employment, financial security, and material hardship among non elderly Hispanic adults by family citizenship status.

Report

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. 

Webinar & Presentations

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. 

Report

This toolkit provides an overview for states of various coverage pathways for individuals, including those who are uninsured, in need of COVID-19 testing and treatment.

Commentary

This expert perspective looks in depth at states that are regularly reporting COVID-19 health equity data.

Webinar & Presentations

In this webinar, experts from Manatt Health and Georgetown University’s Center on Health Insurance Reforms summarize recent federal legislation and guidance related to COVID-19.

Brief

This document provides examples of potential Medicaid messaging states can use during the COVID-19 pandemic.

Webinar & Presentations

In this webinar, experts review strategies states can use to manage and process an increased number of Medicaid applications, and the federal authorities that permit states to do so.

Report

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.

Commentary

This commentary discusses the unique risk for COVID-19 associated with homelessness.

Commentary

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.

Commentary

This commentary discusses the steps states are taking during the COVID-19 pandemic to protect pregnant women and their infants during delivery.

Dataset

This chart details recent state actions affecting health insurance in response to COVID-19.

Commentary

This commentary discusses the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and the potential eligibility challenges it creates for both individuals and states.

Commentary

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.

Commentary

This commentary discusses the 1115 waiver applications submitted by states that have the potential to safeguard access to care and increase support for children during the COVID-19 pandemic.

Commentary

This commentary discusses state employee health plans (SEHPs) and the rapid changes they are making to address the COVID-19 pandemic.

Commentary

This commentary highlights the critical need for PPE and infection control expertise at nursing homes.

Dataset

This chart details the amounts and required oversight of federal funds allocated to hospitals, providers, and states by three federal COVID-19 laws.

Commentary

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.

Brief

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.

TOPICS
Brief

This Q&A responds to questions received regarding the April 9 Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis Webinar and corresponding Toolkit.

Brief

This brief addresses how Medicaid Managed Care Organizations (MCOs) and states can individually and collectively play a role in responding to the COVID-19 pandemic.

Dataset

This data set tracks which states are reporting case and mortality data by race and ethnicity data on a state, zip code, or community level.

Report

In this report, researchers estimate the fiscal impacts of several approaches for increasing federal Medicaid matching rates, providing state-level estimates for each approach.

Report

This report estimates the extent to which workers in industries most vulnerable to pandemic-related unemployment and their family members would be eligible for Medicaid, the Children’s Health Insurance Program, or marketplace subsidies if workers lose their jobs.

Brief

This brief discusses the new established guidelines regarding placing COVID-19 related ads on social platforms.

Commentary

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.

Webinar & Presentations

This webinar highlights funding opportunities and key provisions relevant to states included in the CARES Act. 

Commentary

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.

Brief

This Q&A provides a moment-in-time update in response to questions about the federal government’s response to the COVID-19 pandemic.

Webinar & Presentations

This webinar discuses the impact of COVID-19 on Medicaid Managed Care Performance Incentives.

Commentary

This commentary looks in-depth at which states are regularly reporting data that helps shed light on the health equity issues of the COVID-19 crisis.

Report

This report assesses market trends in seven states—Colorado, Georgia, Iowa, Mississippi, New Hampshire, Texas, and Utah—through a review of insurer participation, premiums, and enrollment data and through structured interviews with health insurance brokers.

Commentary

This commentary examines state strategies for addressing barriers to telehealth for opioid use disorder during the COVID-19 pandemic.

Commentary

This commentary examines state strategies to promote health insurance enrollment to protect consumers from potentially exorbitant medical bills during the COVID-19 pandemic.

Commentary

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. 

Commentary

This commentary examines how Connecticut became one of the first states to put guardrails in place to guide how hospitals will use federal relief funds from the CARES Act.

Commentary

Valerie and her husband Christopher wanted to adopt two sons from foster care, both with challenging health conditions, but were not sure if they could afford the medical bills. Valerie learned both children were automatically covered by South Dakota Medicaid because of their time in foster care.

Commentary

April was born with sickle cell anemia, a genetic blood disorder that is deeply painful and must be managed with proper medication. Medicaid covered April’s treatment and her electric wheelchair, which empowers her in her new everyday life.

Commentary

This commentary includes a list of the unique special enrollment periods (SEPs) available in state-based marketplaces, including life-changing events, unexpected health plan changes, or enrollment in dental coverage.

Commentary

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.

Commentary

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.

Commentary

This commentary discusses new federal and state laws that are making significant steps to eliminate consumer cost-sharing for coronavirus (COVID-19) testing, diagnosis, and prevention.

Commentary

This commentary discusses the Coronavirus Aid, Relief and Economic Security Act (CARES) and how policymakers can make informed decisions about how best to target these resources.

Commentary

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.

Commentary

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.

Brief

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.

Report, Webinar & Presentations

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.

Report

This report assesses the cost of Medicaid relative to private insurance in the health insurance landscape under the Affordable Care Act (ACA).

Commentary

This commentary discusses how states are mobilizing to meet the crushing health care demands resulting from the COVID-19 pandemic.

Commentary

This commentary discusses what states are doing as coronavirus hospitalizations and ICU bed demand surge across the country.

Commentary, Dataset

This resource library provides key guidance, reference materials, and tools for states as they try to lessen the impact of COVID-19 on Medicaid populations.

Commentary

This commentary includes a list of state recommendations and restrictions on the dispensing chloroquine and hydoxychloroquine.

Commentary

This perspective discusses strategies state Medicaid and CHIP agencies can pursue as part of their emergency preparedness planning for, and response to, COVID-19.

Brief

This brief provides a template for states to inform residents of health insurance options during the COVID-19 pandemic.

Brief

This brief is a compilation of state marketplace communications examples during the novel coronavirus outbreak.

Brief

This brief is a compilation of communication examples from state departments and agencies during the COVID-19 pandemic.

Webinar & Presentations

In this webinar, experts explore the key health care provisions in the Families First Coronavirus Response Act and the implications for states.

Brief

This brief provides some answers about who is eligible to enroll in coverage as many seek new health coverage, or help paying for coverage, during the novel coronavirus outbreak.

Report

This Special Enrollment Period (SEP) Reference Chart is a tool for those who are helping people enroll in health coverage through a special enrollment period.

Brief

This brief examines the strategies being implemented by states to combat opioid use disorder in the midst of the COVID-19 pandemic.

Brief

This brief examines the Families First Coronavirus Response Act that was signed into law to provide resources to help states address the effects of COVID-19.

Brief

This Q&A examines what the Families First Coronavirus Response Act is doing to help states address the COVID-19 pandemic.

Brief

This brief gives an overview of the multiple actions states are taking toward ensuring accessible coronavirus (COVID-19) testing and cross-agency collaboration. 

Commentary

This commentary reviews key information for states about the recent federal medical assistance percentage (FMAP) increase and conditions states must meet to qualify for it.

Commentary

This commentary explains insurers' moves to extend coverage grace periods during the COVID-19 crisis.

Report

This report examines the kinds of health insurance unemployed workers have and how coverage patterns have shifted under the Affordable Care Act (ACA).

Commentary

The federal government has offered Medicaid waivers to give states flexibility to quickly increase their health care workforces in response to the COVID-19 pandemic.

Report

This resource provides a six-step framework for healthcare organizations to improve minority health and foster equity.

Report

This brief examines the effect of a recently announced federal program allowing states to apply for Medicaid block grants or per capita caps in exchange for new flexibility to limit enrollment and benefits.

Commentary

This blog posts pulls together frequently asked questions about the novel coronavirus to help guide Navigators, brokers, assisters, and consumers through this complex and trying time.

Dataset

The 2020 County Health Rankings highlight how health outcomes and health factors differ by place within states and illustrates how health differs among racial/ethnic groups within places.

Report

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. 

Report

This report examines the Families First Coronavirus Response Act and its implications for Medicaid and the Children's Health Insurance Program (CHIP).

Commentary

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.

Report

03.2020 / By Urban Institute

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.

Commentary

This podcast discusses the many ways that states are working to address the challenges surrounding maternal and infant mortality, specifically the significant disparity experienced by black women,

Commentary

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.

Report

This report describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities in five areas: coverage, enrollment, benefits, models of care, and quality improvement.

Report

In this report, researchers reviewed laws and interviewed state officials and insurers in six states—California, Georgia, Massachusetts, North Carolina, Pennsylvania, and Texas—to determine current policies and best practices to protect patients from disruptions in services and financial burdens as a result of disputes between providers and payers.

Report

This FAQ answers questions about whom the Department of Homeland Security (DHS) public charge rule will impact, what benefits are implicated by the rule, and how the rule might be administered.

Commentary

This podcast discusses the strategies and challenges faced while developing meaningful consumer engagement strategies for Colorado and Washington State Medicaid.

Report

This report assesses attitudes toward and concerns about the 2020 Census, drawing on data from the December 2019 Well-Being and Basic Needs Survey.

Commentary

Carolyn was working two jobs without health insurance when she fell in her home and cracked her hip. Unable to afford out-of-pocket expenses, Carolyn received disability coverage through Medicaid.

Commentary

Alecia was born with Down Syndrome, a lifelong condition that comes with physical and developmental challenges. Iowa’s Medicaid coverage empowers her to live independently.

Report

This report focuses on how Medicaid programs can use data from the American Community Survey (ACS), to inform and target interventions that seek to address social determinants of health and advance health equity.

Report

This report proposes a measurement model for trauma-informed primary care and suggest variables that could be assessed for each major intervention component.

Report

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.

Brief

This article examines Advancing Integrated Models (AIM), a project through which eight organizations are designing and piloting new strategies for integrating innovative, “next-generation” approaches to person-centered care for individuals with complex health and social needs.

Report

02.2020 / By Urban Institute

This report studies New Hampshire’s Medicaid work requirement program to understand how it was implemented and why it appears to fail to protect coverage and promote work.

Report, Webinar & Presentations

This report reviews the key features of the proposed capped funding demonstrations and highlights the considerations for states. On January 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) inviting states to apply for Section 1115 demonstration projects that would impose caps on federal Medicaid funding for the adult expansion and some other adult populations in exchange for new programmatic flexibility.

Commentary

In this podcast, three individuals from the Wisconsin Department of Health Services discuss how they have created an environment that values transparency and staff well-being.

Webinar & Presentations

This webinar explores how two health care innovators are engaging communities and using consumer feedback to rethink how services are designed and delivered.

Report

01.2020 / By ZERO TO THREE

This annual report compares national and state-by-state data on the well-being of infants and toddlers.

Report

This report gives an overview of the federal authorities under which states are able to cover nonclinical housing-related services for high-need Medicaid enrollees, and also details how states are using these authorities to invest in supportive housing for diverse high-need Medicaid populations.

Report

01.2020 / By Urban Institute

This report shows the changes in average lowest silver premiums from 2017 to 2020 by state and in the lowest silver premiums offered by each insurer in selected markets.

Dataset

This resource identifies areas where states are doing well and areas where they can improve on healthcare affordability.

Report

This guide is intended for health departments as they continue their journey to become equity-focused organizations, both in awareness and practice.

Report

12.2019 / By Urban Institute

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

Graphic

This infographic highlights key considerations for health care systems on how to successfully convene and maintain a consumer advisory board (CAB).

Commentary

This commentary identifies key considerations to help guide health care systems in creating successful community advisory boards (CABs),

Report

This report identifies the states and people who would face the largest coverage losses if the Affordable Care Act were repealed, including estimates by city.

Commentary

In this podcast, Connecticut’s Medicaid director Kate McEvoy and chief financial officer Mike Gilbert discuss their experiences working with partners in the executive and legislative branches to build trust and a shared vision for sustaining critical programs.

Report

12.2019 / By Manatt Health

This report investigates the health care cost benchmarking programs adopted in Massachusetts and Oregon.

Report

12.2019 / By Urban Institute

This report examines preferences between a public option for health insurance and Medicare for All among nonelderly adults.

Commentary

This perspective outlines benefits and risks of health plan standardization, raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.

Brief

This blog from the Delta Center illustrates five key insights related to program design and evaluation from the productive partnership between the Partnership HealthPlan of California (PHC) and local community health centers (CHCs) to create a care coordination (CCM) program.

Report

This issue brief draws from the experiences of states that were among the first to implement their substance use disorder waivers to profile how the American Society for Addiction Medicine (ASAM) Criteria is used within the context of managed care and utilization review, and the challenges and best practices associated with its use.

Commentary

This piece investigates each of the non-ACA-compliant plan types and provides a brief description along with current estimates of enrollment or projected enrollment.

Commentary

These four bog posts focus on local and national innovations to offer guidance on serving complex populations.

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

This guide is a practical, hands-on resource to help assisters and consumers navigate this enrollment season.

Report

This brief provides an annual update to comparisons of uninsurance estimates from four federal surveys.

Report

10.2019 / By Urban Institute

This report analyzes commercial insurers’ experiences competing in marketplaces with managed care organizations, which only offered coverage within public programs prior to ACA implementation.

Report

This FAQ examines who will be affected by the Department of Homeland Security's final public charge rule, what benefits are implicated, and how the rule might be administered.

Report

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

Commentary

Paul needed a kidney transplant to save his life, and couldn't have afforded the costs without Medicaid.

Commentary

When Stacia needed treatment for substance use and mental health, Medicaid covered her care.

Report

This report investigates what is motivating states to transition to full state-based marketplace status, assesses the benefits and risks of such a switch, and identifies considerations for other states considering a similar move.

Commentary

When Sheila's daughter was born with birth defects, Sheila couldn't afford her care. Then she found Medicaid.

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.

Report

09.2019 / By Urban Institute

This report explores what child care challenges parents with Medicaid work requirements may face, and suggests parents may struggle to find care that is affordable, good quality, accessible, and available for nontraditional or unpredictable work schedules.

Report

09.2019 / By Urban Institute

This brief explores state variation in health insurance coverage changes during implementation of the primary health insurance coverage reforms of the Affordable Care Act (ACA) using data from the 2013 and 2017 American Community Survey. 

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

This report provides an overview of the behavioral health system’s engagement in Medicaid value-based payment (VBP) models and provides policy recommendations to support VBP adoption.

Commentary

09.2019 / By That's Medicaid

When Jennifer and Jerry welcomed their daughter into the family, Medicaid gave her a healthy start.

Commentary

09.2019 / By That's Medicaid

When Hannah and Martin's son was born, he needed immediate open-heart surgery. Medicaid covered their son’s birth, surgery, and follow-up care.

Report

09.2019 / By Urban Institute

This report updates previous analysis of the coverage and health spending implications of Healthy America and analyzes two additional options: one without an individual requirement and one that would lead to universal coverage for all legal residents of the US.

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.

Commentary

09.2019 / By That's Medicaid

Soon after Gail was diagnosed with breast cancer, she lost her job and her health insurance. Medicaid was a lifeline.

Commentary

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.

Commentary

08.2019 / By That's Medicaid

To stay alive, Bridget must receive dialysis for four hours a day, three times each week. Medicaid is an essential part of her health care coverage, and helps her to lead a normal life.

Report

This report examines implementation considerations for fiscal mapping from sites in Maryland and Minnesota to help inform similar mapping activities in additional states and communities.

Commentary

08.2019 / By That's Medicaid

LaVerne was covered by Medicaid while she earned her bachelor's degree in nursing, opening the door for her service in the U.S. Army Nurse Corps.

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

08.2019 / By Urban Institute

This report assesses public support for Medicare for All proposals, as well as some incremental reforms for expanding health insurance coverage, using data from the March 2019 round of the Health Reform Monitoring Survey.

Commentary

08.2019 / By That's Medicaid

Laura's high-risk pregnancy, and a car accident that left her husband Jed permanently disabled, threw her family's life off course. Learn how Medicaid helped Laura and Jed get it back on track.

Report

This report describes preliminary observations regarding implementation of Medicaid housing support demonstrations in California, Maryland, and Washington.

Commentary

08.2019 / By That's Medicaid

When Shari's disease worsened, she knew she needed more assistance. Learn how Medicaid helped her maintain her independence, so she could help others in need.

Commentary

07.2019 / By That's Medicaid

Tom was a successful insurance agent with a college degree and a six-figure salary, when personal tragedy sent him spiraling. Learn how Medicaid helped him get back on his feet.

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.

Commentary

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

Commentary

This commentary outlines ways in which Congress can look to actions by state-level policymakers for guidance on how to achieve legislative compromise on balance billing.

Webinar & Presentations

07.2019 / By Vox

This short video explains what Medicaid expansion is.

Webinar & Presentations

07.2019 / By Vox

This short video explains the difference between Medicaid and Medicare.

Webinar & Presentations

07.2019 / By Vox

This short video explains how Medicaid has expanded its coverage to cover roughly 1 in 5 Americans.

Webinar & Presentations

07.2019 / By Vox

This short video explains the effect of Medicaid on children's health.

Commentary

These tip sheets provide general guidance to help state agency leadership develop and refine the necessary skills and expertise to successfully lead their state programs.

Brief

These resources describe the core roles of state Medicaid and public health agency staff when partnering to implement evidence-based prevention interventions.

Brief

06.2019 / By Urban Institute

This analysis examines how people with different characteristics would be affected if the Texas v. United States decision invalidates the Affordable Care Act.

This blog reflects on the value of Medicaid and the critical role of Medicaid directors since the program's inception more than 50 years ago.

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.

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

06.2019 / By Urban Institute

This study assesses potential barriers facing Medicaid enrollees in meeting work requirements through employment on a sustained basis, using pooled data from the September 2018 and March 2019 Health Reform Monitoring Survey.

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.

Commentary

A new podcast series, Medicaid Leadership Exchange, is launching to help Medicaid directors and their senior management teams steer the course.

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 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

In this report, insurance experts share findings from a case assessing New York’s experience with its Surprise Billing law, five years in.

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.

Report

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

Report

This report evaluates common methods for better using categorical income measures, such as the one in the BRFSS, to calculate income as a percent of the federal poverty guidelines. 

Report

This resource examines changes in health insurance coverage from 2016 to 2017 for children nationwide and in each state.

Brief

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

Report

This report examines ACA marketplace participation by insurers that participated in Medicaid but not in private insurance markets prior to the ACA.

TOPICS
Webinar & Presentations

The webinar highlights six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program.

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.

Brief

The issue brief identifies the key questions for states pursuing Medicaid buy-in programs to consider as they seek to design and implement their proposals.

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.

Report

04.2019 / By Urban Institute

This analysis examines some of the consequences should a case pending before the U.S. Court of Appeals for the Fifth Circuit be decided in favor of the plaintiffs, who argue that the entire Affordable Care Act (ACA) be eliminated.

Brief

04.2019 / By Urban Institute

This brief found that ACA markets have become more competitive between 2018 and 2019, but have not regained the level of competition they had in 2017.

Brief

This issue brief looks at progress made in using multi-payer claims databases for various strategic purposes, and offers considerations for states seeking to optimize claims databases to improve health care system performance improvement.

Journal Article

This article estimates the costs of implementing state-based reinsurance programs in four large states whose size provides a useful cost-projection base for other state policymakers considering reinsurance programs.

Webinar & Presentations

This webinar explored how several states are using their multi-payer claims databases, including how they are employing claims databases to enhance the value of care and lessons learned for others.

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.

Report

03.2019 / By Manatt Health

This report examines monitoring and evaluation of work/CE demonstrations and reviews the data assets and infrastructure necessary to support states and their researcher partners in robust monitoring and evaluation efforts.

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.

Commentary

In this interview with Louisiana's Medicaid Director Jen Steele, she shares her approach to leveraging Medicaid’s role to improve health outcomes and health equity.

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.

Commentary

This commentary provides a brief background on the recent litigation surrounding cost sharing reductions, including executive actions, and state and insurer responses, as well as what could happen next.

Brief

This brief reviews considerations for policymakers assessing their state Medicaid managed care programs and exploring strategies for advancing cost, quality, and accountability goals.

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.

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.

Report

This analysis examines the use of 1332 State Innovations Waivers to stabilize individual health insurance markets, comparing the use of this strategy in three states; assessing how they navigated the process; identifying lessons learned; and discussing future concerns.

Report

02.2019 / By Urban Institute

This report finds between 2006 and 2017, growth in spending per enrollee in Medicare and Medicaid was much slower than in private insurance.

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

The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.

Webinar & Presentations

This webinar examines the complexities of state Medicaid oversight of the pharmacy benefit in the managed care environment.

Report

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

Webinar & Presentations

This webinar walked through key components of the proposed annual Notice of Benefit and Payment Parameters for 2020, and discussed potential state considerations for states.

Report

02.2019 / By Urban Institute

This study assesses short-term plan insurers’ marketing tactics in the wake of new federal rules and how regulators have prepared for this new market.

Dataset, Report

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

Report

01.2019 / By Urban Insitute

The Urban Institute conducted interviews with marketplace administrators and insurers selling marketplace coverage in ten states. They analyze marketplace insurer participation and pricing decisions, as well as several related topics.

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.

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.

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.

Webinar & Presentations

This webinar discusses state considerations for developing a Medicaid buy-in proposal, as well as evolving models.

Graphic

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

Report

12.2018 / By Urban Institute

This analysis examine four policy scenarios meant to improve the ACA, which, taken together, could reduce the number of uninsured by 12.2 million people and to 7.3 percent uninsured.

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

This webinar discusses the implications of the proposed regulations easing the rules governing health reimbursement arrangements (HRA) and other account-based, tax-preferred health care benefits; and possible state responses.

Report

Alaska, Minnesota and Oregon were the first to gain approval and federal funding to implement their own reinsurance programs under a 1332 waiver. This issue brief assesses their progress and lessons learned to date.

Brief

New health insurance coverage estimates for Q1-Q2 2018 from the National Health Interview Survey find nationwide, 12.5% of nonelderly adults were uninsured in the first half of 2018.

Graphic

Data from the 2017 American Community Survey (ACS) show that many of the remaining uninsured are clustered in metropolitan areas; this map illustrates those geographic concentrations of the uninsured.

Commentary

This national scan summarizes the health care reforms and innovations that newly-elected governors promoted in their campaigns and may become policy in 2019.

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.

Brief

11.2018 / By Urban Institute

This monitoring and tracking project will document changes to the implementation of national health reform to help states, researchers and policymakers learn from the process as it unfolds.

Report

11.2018 / By Urban Institute

Using data from the American Community Survey and the Current Population Survey, this report assesses whether coverage gains from 2010 to 2016 were associated with changes in labor market outcomes across occupations.

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.

Report

The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.

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

These tables of state and county uninsurance estimates for 2017 and comparison year 2016 come from the 2017 American Community Survey via the U.S. Census Bureau's American FactFinder tool.

Graphic

New health insurance coverage estimates from the American Community Survey show that there was a statistically significant 0.2 percentage point increase in the national uninsured rate between 2016 and 2017, for the first year since 2010. This graphic analyzes the data.

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.

Report

09.2018 / By Urban Institute

This report provides detailed estimates of changes in health insurance coverage types between 2013 and 2016 by demographic, socioeconomic, and geographic characteristics. In addition, state fact sheets detail coverage changes by income group in all 50 states and DC.

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

CMS approved state work/community engagement (CE) waivers in Arkansas, Indiana, Kentucky, and New Hampshire; and additional states have submitted or are poised to submit similar waivers. This series of charts outlines the legal, policy, financial and operational tasks and issues that states will face in adding a work/CE condition to their Medicaid program.

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.

Report

08.2018 / By Urban Institute

The Trump administration finalized regulations for short-term limited duration policies in early August 2018, which increase the maximum length of short-term, limited-duration insurance policies to just less than one year. This report provides updated tables taking these state legislative changes into account.

Report

08.2018 / By Urban Institute

This report examines brokers’ evolving role in the individual market, consumer purchasing decisions, and brokers’ observations about how the market and consumers are responding to recent federal policy adjustments to the ACA.

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.

Report

This report explores options for states as they consider oversight of risk-bearing organizations (RBOs), with a focus on states that have elected to act to protect against provider insolvency. The State Health Policy Highlight reviews specific state considerations when overseeing RBOs; case studies examine approaches in California, Massachusetts, New York and Texas.

Webinar & Presentations

This webinar reviews the Stewart v. Azar decision and potential implications for states with approved, pending or planned Medicaid waivers that include work/community engagement requirements. The court’s findings may shape what analysis will be necessary to demonstrate that future waivers advance the Medicaid statute's objectives.

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.

Report

06.2018 / By Urban Institute

To understand the marketplace enrollment gains and losses observed in 2018 relative to 2017, the Urban Institute interviewed key stakeholders in Rhode Island, Washington, and New York, which saw marketplace enrollment increases, and in West Virginia and Louisiana, which saw enrollment drops. This report explains the different features of the five states, presents cross-state findings, and discusses important factors in next year’s open enrollment period.

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.

Webinar & Presentations

The Trump Administration is expanding the availability of alternatives to Affordable Care Act-compliant health insurance. Rules to expand association health plans and short-term limited duration health plans are imminent. This webinar explores what options states have to respond to these developments, featuring experts from Georgetown University’s Center for Health Insurance Reform.

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.

Journal Article

This article uses data from the American Community Survey to examine changes in uninsurance and uninsurance disparities by race/ethnicity in Kentucky since the state’s implementation of the Affordable Care Act. It was published in the American Journal of Public Health.

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.

Report

States continue to identify and pursue strategies to further reduce the number of uninsured to make coverage more affordable for consumers and to improve access to care. This issue brief presents two possible models for a Medicaid buy-in program for states, and details the design considerations and authorities needed to implement each model.

Brief

05.2018 / By Urban Institute

An analysis of what would happen if the remaining 19 states that have not expanded Medicaid did so.

Journal Article

05.2018 / By Urban Institute

We assessed rates of employer health insurance offer, take-up, and coverage in June 2013 and March 2017 among workers. Overall, offer rates remained stable, and take-up and coverage rates increased. In Medicaid expansion states, the share of workers with family incomes at or below 138 percent of the federal poverty level who had employer-based coverage held steady, while uninsurance rates declined.

Graphic

This map tracks state Medicaid expansion decisions and approaches states are taking for expanding eligibility to 138 percent of the Federal Poverty Level. It also includes information on state legislative activity around Medicaid expansion, governors’ stances on the issue, and fiscal and demographic analyses from the state or other institutions. For states that are expanding Medicaid, but using an alternative to traditional expansion, the map also contains brief descriptions of these demonstration waivers.

Graphic

In January 2018, the Centers for Medicare & Medicaid Services issued a new policy allowing states to implement work and community engagement requirements for certain Medicaid enrollees. States are permitted to seek federal approval to require non-elderly, non-pregnant, and non-disabled adults to participate in these types of activities to qualify for Medicaid or certain aspects of Medicaid coverage. This chart summarizes states’ pending and approved Section 1115 waivers, waiver renewals, and waiver amendments to implement work and community engagement requirements.

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).

Webinar & Presentations

This webinar untangles HHS's annual Notice of Benefit and Payment Parameters and its many implications for states. The rule is a collection of policies governing the ACA’s marketplaces, insurance reforms, and premium stabilization programs. Speakers include Sabrina Corlette and Justin Giovannelli from Georgetown’s Center on Health Insurance Reforms, Joel Ario from Manatt Health, and Jason Levitis.

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.

Report

04.2018 / By Urban Institute

In this brief, we provide an overview of the lessons learned from work requirements for Temporary Assistance for Needy Families (TANF, or cash assistance) and Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) and discuss the implications of introducing or expanding work requirements.

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.

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.

Report

04.2018 / By Urban Institute

The Profile of Virginia’s Uninsured provides a detailed picture of the Commonwealth’s uninsured using the 2016 American Community Survey. In 2016, 10.3 percent of Virginians under age 65 were uninsured. Most of these uninsured nonelderly Virginians had family incomes at or below 200 percent of the Federal Poverty Level (FPL), and more than three-quarters were part of working families.

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.

Webinar & Presentations

Watch: Results of the 2017 Minnesota Health Access Survey.

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.

Graphic

This analysis examines educational attainment and access to health care, looking at the extent to which adults (25 years and older) with different levels of education skipped needed care due to cost and did not have a personal doctor.

Report

03.2018 / By Urban Institute

Although congressional efforts to repeal and replace the Affordable Care Act (ACA) did not succeed in 2017, the law continues to face an uncertain future. This brief examines insurers’ participation and pricing decisions for the 2018 and 2019 plan years through structured interviews with 10 insurance companies participating in the individual market in 28 states and the District of Columbia.

Report

03.2018 / By Urban Institute

On February 20, 2018, the Departments of Treasury, Labor, and Health and Human Services released a proposed regulation that would increase the maximum length of short-term, limited-duration insurance policies to one year. The brief analyzes the national and state-specific effects of ending the individual mandate and loosening limits on short-term, limited-duration policies.

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.

Report

03.2018 / By Urban Institute

In January 2018, CMS approved Kentucky’s Section 1115 Medicaid demonstration waiver, which allows the state to require some beneficiaries to participate in “community engagement” activities for at least 80 hours a month to retain their Medicaid coverage. This brief revises an earlier analysis on who could be affected by Kentucky’s Medicaid work requirements based on new information posted on Kentucky’s website.

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.

Brief

Many states continue to encounter challenges in stabilizing their individual health insurance markets, including large premium increases and declining insurer participation. One solution is a state-based reinsurance program similar to the federal program that reduced premiums by more than 10 percent per year from 2014 to 2016. The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.

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.

Webinar & Presentations

On January 11, CMS released a State Medicaid Director letter providing guidance for states seeking 1115 waivers that condition Medicaid eligibility on work and community engagement, quickly followed by approval of Kentucky’s 1115 waivers that include these requirements. In this webinar, State Health and Value Strategies and Manatt Health review the new guidance, including key design parameters, budget neutrality requirements, and monitoring and evaluation criteria.

Report

State Medicaid programs are increasingly requiring their Medicaid managed care organizations (MCO) to implement APMs. It is important for states to develop ways to ensure that their MCOs are complying with the APM requirements within their contract, and monitoring the progress and challenges with the implementation of APM strategies with Medicaid providers. This report focuses on different ways in which states may set standard APM definitions to track MCO progress toward meeting state APM goals, and support comparison of APM implementation within a state and nationally.

Report

The Health Care Payment Learning and Action Network Alternative Payment Models Framework (the LAN APM Framework) is an increasingly common method being used by states to measure plan progress toward implementation of APMs. This report provides real-world examples of APMs within the LAN categories and can help states and other interested purchasers develop a common understanding of what types of payment models fit within the framework categories.

Webinar & Presentations

With effective repeal of the federal individual insurance mandate scheduled for 2019, many state policymakers are exploring ways to stabilize their insurance markets, including creating a state-based mandate similar to one in Massachusetts. This webinar includes a deep dive into Massachusetts’ mandate, and features a Maryland proposal to create an auto-enrollment process for individuals through its marketplace.

Commentary

In response to President Trump’s October 12 executive order, the U.S. Departments of Health and Human Services, Labor and Treasury have published proposed rules to expand the availability of health coverage sold through short-term, limited duration insurance (STLDI).

Brief

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

Brief

This brief provides an overview of State Health Compare's most recent estimates for state public health funding, which come from data collected by the Trust for America’s Health.

Report

This report summarizes findings from the 2017 Minnesota Health Access Survey, focusing on trends in how Minnesotans obtained health insurance coverage, and provides an understanding of how the 2017 climate may have contributed to a contraction of coverage.

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.

Brief

01.2018 / By Urban Institute

This brief provides an analysis of legislation recently introduced in the U.S. Senate that would create a mechanism for states to offer their residents the opportunity to buy a Medicaid-based public insurance option.

Webinar & Presentations

On January 11, 2018, CMS released guidance for states seeking 1115 waivers that condition Medicaid eligibility on work and community engagement, quickly followed by approval of Kentucky’s 1115 waivers that include these requirements. Both the new guidance and recent waiver approval represent a significant departure from past Administrations’ positions. This webinar reviews the new guidance and discusses state legal, policy, and operational considerations.

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.

Brief

In response to President Trump’s October 12 executive order (EO), the U.S. Department of Labor (DOL) published proposed rules to expand the availability of health coverage sold through associations to small businesses and self-employed individuals. The full brief provides state health officials with a detailed review of the content of the proposed rule and examines the implications for states.

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.

Report

Prior to the passage of the Affordable Care Act in 2010, Minnesota's health insurance market was relatively high-functioning across indicators of health insurance access and quality of care, although the state faced common challenges in the area of health care costs. This report considers Minnesota's health insurance market before and after the passage of the ACA and the outlook for the state's market given the current policy environment.

Webinar & Presentations

RWJF’s SHVS together with experts from Manatt Health, host this webinar that highlights and defines potential policy options, including the “Medicaid Buy-in,” that states may consider to leverage Medicaid to achieve their goals with respect to coverage availability and affordability. Conditions that make each option more or less favorable for a state, and implementation issues or other considerations in play for states are discussed.

Brief

Uncertainty about the future of health insurance options and concern about the ability of Affordable Care Act (ACA) marketplaces to offer adequate competition and choice have spurred states to look for new coverage approaches. Innovative strategies states are proposing include allowing consumers to buy into state Medicaid programs and developing state-specific coverage options within the ACA’s framework.

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).

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 provides an overview of three areas of value-based innovation and then affords a deeper examination into specific examples of state employee purchaser activity in California, Connecticut, Massachusetts, Minnesota, Tennessee, and Washington.

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.

Brief

CMS released two informational bulletins detailing a new, streamlined approach for the review and management of Section 1115 demonstrations and state plan amendments and 1915 waivers. The streamlined approach may enhance states' ability to design innovative health care delivery initiatives in their Medicaid programs. These changes come at a critical time as states develop new approaches to reduce health care costs and stem the opioid epidemic.

Brief

HHS released proposed changes in its annual notice that governs standards for issuers and the health insurance marketplaces. The annual notice is one of the most significant tools the Administration wields in shaping the health insurance markets and this proposed notice carries significant implications for markets and states.

Brief

Understanding premium increases for individual market plans is more complicated this year. In many states, carriers attempted to recapture that lost revenue by increasing the premium of the silver plan relative to other metals. ‘Silver-loading’ gives subsidized non-cost-sharing reduction (CSR) consumers the opportunity to purchase a relatively more affordable bronze or gold plan.

Brief

With three states using Section 1332 waivers to help fund reinsurance programs for the 2018 plan year, many more state officials are considering the model for their state in future years. Having worked directly with the 2018 reinsurance states, State Health and Value Strategies presents a to-do list for states as they consider reinsurance for 2019.

Report

11.2017 / By Urban Institute

This report examines six states that faced the prospect of bare counties for 2018: Iowa, Nevada, Ohio, Oklahoma, Tennessee, and Washington.

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.

Webinar & Presentations

The research included in this panel illustrates both the intended and unintended consequences of state policy decisions on a range of health systems outcomes and highlights the necessity of access to different types of federal surveys for the purposes of health policy evaluation. Federal survey data is especially critical when analyzing variation between states, as when comparing outcomes by Medicaid expansion status. As policy flexibility for states continues to grow, this ability to compare states to one another will continue to be essential.

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

This brief puts a state lens on emerging proposals in the ACA repeal and replace debate. Over the last decade, 21 states introduced legislation to sell across state lines, only five states enacted such laws, but no insurer has yet to offer.

Report

This toolkit is designed to assist states interested in implementing value-based purchasing approaches with their Medicaid managed care organizations (MCOs). Using a value-based purchasing approach can mean significant and ongoing changes for a state Medicaid agency and its MCOs.

Brief

Sens. Lamar Alexander (TN) and Patty Murray (WA) released a bipartisan bill designed to bring short-term stability to the health insurance market. While there are indications that Alexander and Murray secured the 60 votes needed for passage in the Senate, it faces an uncertain fate in the House and with the President. 

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.

Brief

The prospects for these new players reflect tensions for the market as a whole. Clearly the massive number of net exits signals a retrenchment by many market participants in 2018, resulting in shrinking of territorial footprints and outright withdrawal by large parts of the industry. For a variety of reasons, including attempts to repeal the ACA, the potential of the individual market has not yet been fully realized. Yet, it still remains the source of coverage for millions of people.

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)

Report

This SHADAC chartbook uses data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to highlight the experiences of private-sector workers with employer-sponsored insurance (ESI) from 2012 through 2016 at the national level and in the states. The ESI chartbook is accompanied by state-level fact sheets summarizing key ESI characteristics from 2012 to 2016.

Brief

While there are risks to the stability of their markets that states cannot well control, one important route to adverse market outcomes may be state policy decisions. There are frequent calls for more state flexibility, but these data suggest that the exercise of existing state flexibility is one way that states have visited a considerable amount of trouble upon their markets. Yet there is a hopeful note here as well, since this suggests that there are steps that states can take to improve their situation.

Report

This report discusses the scope of state authority and tools available to ensure that consumers living within their borders benefit from the insurance protections promised under federal law. It also discusses specific statutory and administrative options for states in the event of selected possible federal administrative actions, including a: Rollback of the essential health benefits; relaxation of marketplace health plan oversight; re-definition of what constitutes minimum essential coverage; loosening of medical loss ratio standards; and an expansion of off-marketplace enrollment opportunities.

Brief

This blog reviews cost-sharing reduction (CSR) programs designed to reduce the cost of insurance for consumers purchasing policies on individual markets.

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

The Senate released two bills as part of its efforts to repeal the Affordable Care Act (ACA): A revision to the Better Care Reconciliation Act (BCRA) eliminating the “Ted Cruz Amendment,” which provided funding to create coverage alternatives for high-risk individuals, and the Obamacare Repeal Reconciliation Act (ORRA), which would repeal many of the major provisions of the ACA within a two-year period, but does not offer plans to replace those provisions.

Brief

The data thus far suggest that most counties will have at least two insurers offering plans on the exchange, and most people will be able to choose from at least three.

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

CMS has signaled a willingness to evaluate new types of Medicaid proposals from states, such as Medicaid waiver applications that include programs to connect individuals to employment or incorporate features of private market coverage. In response to CMS’ letter, some states have developed proposals that include these types of requirements for certain individuals covered by the Affordable Care Act’s Medicaid expansion—and a few states are seeking similar changes for their non-Medicaid expansion populations.

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.

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

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.

Webinar & Presentations

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

Brief

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.

Brief

HHS Secretary Tom Price issued a letter to governors encouraging them to take advantage of Sec. 1332 State Innovation Waivers under the Affordable Care Act and cited Alaska‘s request as an example. Alaska’s waiver seeks federal funds to support a reinsurance plan to stabilize its individual insurance market.

Graphic

This chart summarizes how the American Health Care Act, passed out of House committees the day before, differed from the Affordable Care Act. State leaders, representing the diversity of states and breadth of state health policy agencies and officials, met at a summit to discuss those changes and how they might affect states.

Brief

Congressional action to repeal and replace the ACA is on the fast track. The administration and GOP leaders have outlined a three-pronged effort to reform healthcare beginning with passage of the American Health Care Act (AHCA). Congress released Manager’s Amendments to the AHCA, inclusive of a series of policy and technical changes to the bill. Here is a full statutory text of policy and technical amendments.

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.

Brief

Recent state waivers can inform the question of whether and how low-income individuals could benefit from health savings accounts (HSAs) with high-deductible health plans. State experiences incorporating health savings accounts into Medicaid can be instructive, as policymakers consider the role of HSAs in proposed health care reforms. This brief looks at health savings and similar accounts in Michigan and Indiana.

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.

Webinar & Presentations

The “Buying Value Measure Selection Tool” was developed to assist state agencies, private purchasers and other stakeholders in creating aligned measure sets, and was first released in 2014. This webinar explains this tool and recent updates for state officials and other stakeholders involved in developing and maintaining aligned quality measure sets for health care entities and programs including for health plans, accountable care organizations, and patient-centered medical homes. This webinar presents strategies for selecting measures and reveals an updated version of the tool. 

Brief

Congress began its ACA repeal effort and evolving replacement options are receiving considerable attention. NASHP is tracking issues that appear in multiple proposals and will provide state perspectives, including: How might they impact states? What might they cost? Have they been tried before in states and what did we learn from past initiatives?

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. 

Graphic

This chart provides an overview of ACA provisions and snapshot of the implications for states if the ACA is repealed. States are the primary regulator of insurance and as such had laws in place prior to the enactment of ACA. Some states repealed those laws and replaced them with ACA provisions, while other states revised their laws but left other old, preempted laws on the books. 

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.

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.

Report

Health coverage transitions—sometimes referred to as churn—have always existed to some degree, but with the Affordable Care Act there are additional possibilities for churning to occur across multiple coverage sources. This report examines current efforts in some states to measure these coverage transitions and provides broader context on the issue of churn.

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.

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.

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

In this brief, we explore two revenue sources states may deploy to fund the non-federal share of expansion: provider assessments and provider donations. Both are authorized by federal law and both have been used by states in connection with expansion.

Brief

This issue brief examines seven safety-net ACOs across five states to understand their origins, organization, characteristics and functions and to identify federal and state policy questions associated with their emergence. The issue brief identifies both challenges facing safety-net provider ACO aspirants and state strategies to support safety-net provider development of ACOs.

Report

This report identifies key lessons from ACO activities across the country to date. It examines how ACOs can build upon these initial successes and informs policymakers, researchers, and foundations about key considerations to further the development of effective ACO approaches across the health care market.

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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