The Secrets of Massachusetts’ Success: Why 97 Percent of State Residents Have Health Coverage
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The document summarizes a study on how Massachusetts achieved near-universal health insurance coverage through its 2006 health reform law. Key factors in its success were: 1) Using existing data to automatically enroll eligible residents in Medicaid and the new Commonwealth Care program; 2) Creating a single, integrated eligibility system across multiple programs; and 3) Conducting an intensive public education campaign along with grants to community groups for outreach and enrollment assistance. These innovative strategies were highly effective in quickly enrolling many newly eligible residents at a lower administrative cost than traditional individual applications. Lessons from Massachusetts' model could inform national and state health reform efforts.
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Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
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Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
Value-Based Healthcare Strategies
The document discusses emerging value-based healthcare payment models in the US and provides recommendations for stakeholders. It outlines recent legislation like MACRA that aims to shift Medicare payments from fee-for-service to value-based models. MACRA establishes the MIPS program which combines existing quality programs and the APM program which incentivizes participation in alternative payment models. It also describes various CMS pay-for-performance programs focused on readmissions, hospital value, and hospital-acquired conditions. The document concludes with recommendations for stakeholders to collaborate across the healthcare system to effectively transition to value-based models.
Reform Primer Oct 2007 version
This document summarizes the reasons for and key aspects of North Carolina's 2001 mental health system reform. The goals of the reform were to increase local control and governance, promote accountability, and shift away from reliance on institutions by increasing community-based services. The reform established Local Management Entities (LMEs) at the county level to oversee services provided by networks of community providers. It also aimed to focus the system on serving those most in need, increase evidence-based practices, and require more consumer and family input. Major challenges of fully implementing the reform included developing community treatment capacity, addressing inadequate funding, and transitioning from the existing institution-focused system.
State-Level Estimates for Tracking Health Reform Impact: Opportunities and Ch...
The document discusses state-level data needs for estimating the impact of national health reform. It outlines opportunities and challenges for states in developing estimates of newly insured populations under reform. Key points include: (1) States need estimates for implementing coverage expansions and meeting federal reporting requirements. (2) Existing national estimates provide limited state-level data. (3) States are using surveys and models to generate customized estimates, drawing on available federal and state data sources. (4) Developing accurate, timely estimates presents challenges around resources, flexibility and uncertainty.
Critical Access Hospitals’ Receipt of Medicare and Medicaid Electronic Health...
This policy brief has three purposes: 1) to describe current Critical Access Hospital (CAH) participation in the Medicare and Medicaid EHR incentive programs; 2) to compare CAH participation by state;and 3) to evaluate the differences in CAH participation by hospital
characteristics.
Riportella priester 2013 the affordable care act
This document provides an overview of the Affordable Care Act (ACA). It discusses key provisions of the law including expanding Medicaid eligibility, establishing health insurance marketplaces, mandating individuals have health insurance, and enforcing employer responsibilities. The document outlines how the ACA aims to increase access to health insurance through a combination of public programs, employer coverage, and online marketplace coverage. It also addresses ongoing implementation challenges and debates around the law.
Actionable Data for an Intelligent Health Delivery System
Actionable Data for an Intelligent Health Delivery SystemCMG - The Digital Transformation Association
The document discusses accountable care organizations (ACOs) and how health information technology can help achieve the goals of ACOs. It provides details on ACO models, challenges of ACOs, and preliminary results from ACO pilots that showed advanced health IT capabilities contributed to their success. The document advocates for continued pilots of diverse ACO settings to learn success factors and coordinated efforts with broader healthcare reforms.Landscape_Medicaid_Healthcare_Information_Technology.pdf
States are working to apply healthcare information technology (HIT) within their Medicaid programs to improve efficiency and reduce costs. Through initiatives like the Medicaid Transformation Grants and the Medicaid Information Technology Architecture (MITA) framework, states are using HIT to enhance clinical decision making, expand e-prescribing, and provide electronic health records for Medicaid beneficiaries. Going forward, organizations like the National Association of State Medicaid Directors and the State Alliance for e-Health continue to support greater adoption of HIT within Medicaid.
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Understanding the affordable care act riportella and meehan strub priester
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This document summarizes key findings from an analysis of trends in children's health insurance coverage between 2016 and 2017. Some key points:
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- The increase was driven by a decline in public coverage, particularly Medicaid. Uninsurance rose across most demographic groups.
- There was considerable variation between states, from a low of 1.4% uninsured in Vermont to a high of 10.7% in Texas.
- States with low uninsurance typically had high rates of employer-sponsored insurance or
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Slides from webinar webinar introducing two new measures of health outcomes and social determinants of health on SHADAC’s State Health Compare—Unhealthy Days and Unaffordable Rents. This presentation, hosted by SHADAC researchers Brett Fried and Robert Hest, examine these new measures and highlight how the estimates can be used to explore disparities between states and among sub-populations.
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Presentation by SHADAC Senior Research Fellow Emily Zylla at the 2018 Association for Public Policy Analysis & Management (APPAM) Fall Research Meeting in Washington, DC.
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This document summarizes research on modeling state-based reinsurance programs to stabilize individual health insurance markets. Key findings include:
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2017 Health Insurance Coverage Estimates: SHADAC Webinar Featuring U.S. Censu...
Join us for an overview of the 2017 health insurance coverage estimates from two key, large-scale federal data sources: The American Community Survey (ACS) and the Current Population Survey (CPS).
This webinar will examine the new estimates with technical insight from experts at the U.S. Census Bureau, which administers both the ACS and CPS, and from SHADAC researchers.
Attendees will learn about:
The new 2017 national and state coverage estimates
When to use which estimates from which survey
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How to access state-level estimates from the ACS using SHADAC tables
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Exploring the New State-Level Opioid Data On SHADAC's State Health Compare
Between 2000 and 2016, the annual number of drug overdose deaths in the United States more than tripled, from 17,500 to 63,500, and most of these deaths involved opioids. Despite widespread increases in overdose death rates from natural and semi-synthetic opioids, synthetic opioids, and heroin, individual states’ death rates varied widely. For example, in 2016, Nebraska’s rate of 1.2 deaths per 100,000 people was the lowest in the U.S. for natural and semi-synthetic opioids, while West Virginia’s rate (the highest) was more than 15 times larger, at 18.5 deaths. These deaths are the most glaring indication of the growing crisis of opioid abuse and addiction that has been spreading unevenly throughout the country over the past two decades.
On this SHADAC webinar, Research Fellow Colin Planalp will examine the United States opioid epidemic at the state level, analyzing trends in overdose deaths from heroin and other opioids, such as prescription painkillers. Using data available through SHADAC’s State Health Compare, he will look at which states have the highest rates of opioid-related deaths and which have experienced the largest increases in death rates.
Mr. Planalp will be joined by SHADAC Research Fellow Robert Hest, who will discuss the data on opioid-related overdose deaths from the U.S. Centers from Disease Control and Prevention (CDC) that are available on SHADAC’s State Health Compare. He will also discuss State Health Compare data from the U.S. Drug Enforcement Administration (DEA) on sales of common prescription opioid painkillers. Mr. Hest will show users how to access and use the data for state-level analyses.
Ibd intersectionality
This document summarizes research on the intersection of structural risk factors and insurance-based discrimination on healthcare access inequities. The study analyzed data on over 3,800 non-elderly adults in Minnesota to examine how experiences of insurance-based discrimination vary across gender, race, income and insurance status, both independently and combined. It also assessed how the synergistic effects of structural risk factors and reported discrimination influence access to a usual source of care and confidence in getting needed healthcare services. The results show that structural factors like race, income and insurance status combine to produce greater reported discrimination, which then interacts with those factors to further reduce healthcare access. The implications are that reducing inequities requires attention to the convergence of these structural barriers
Who gets it right
This study analyzed characteristics associated with accurate reports of health insurance coverage in census surveys. It found that reporting of public insurance was most accurate among low-income, less educated individuals who likely needed care. Reporting varied by specific public program, with family characteristics impacting Medicaid accuracy and respondent characteristics impacting MinnesotaCare accuracy. Private insurance reporting in the ACS was more accurate among advantaged groups, while the CPS saw greater accuracy among older respondents with long-term coverage. The results provide insight into survey design, editing, and using survey data for policy analysis by identifying who reports coverage most reliably.
Mn ltss projection model
- The document presents preliminary results from the Minnesota Long-Term Services and Supports Projection Model (MN-LPM), which projects LTSS utilization and costs for Minnesota's Medicaid elderly population through 2030.
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- The model uses Minnesota-specific data on the characteristics of elderly residents and current LTSS spending patterns to generate projections. It is intended to help evaluate potential policy changes that could impact future LTSS needs and costs in
Modeling financial eligibility, ltss
Modeling Financial Eligibility for Medicaid Payment of LTSS
1) Medicaid long-term services and expenditures (LTSS) are a large and growing part of state budgets. States may restrict LTSS eligibility rules to control costs.
2) The researchers modeled LTSS eligibility rules to understand their impact and potential consequences of restricting access.
3) The model found that restricting income eligibility rules had a larger impact on reducing the number of eligible individuals than restricting asset rules. This is because income rules are more broadly applied and generous under current policies.
Poster, section 1115 waivers
- Structured interviews were conducted with 33 current and former state agency and health plan staff across 4 states to understand challenges implementing Section 1115 Medicaid expansion waiver programs.
- Key challenges included the significant administrative resources and coordination required across entities, educating enrollees, and reconciling complex program rules across systems.
- While waiver programs allowed for innovative policy testing, the administrative complexity was substantial and ongoing. Implementation involved major efforts to develop new IT systems and operational protocols within tight timelines.
Modeling state based reinsurance
1. The document analyzes the potential impact and costs of state-based reinsurance programs using data from 2012-2015.
2. It estimates that reinsurance subsidies could range from $6.4 billion to $16 billion annually depending on the attachment point and coinsurance rate.
3. Reinsurance costs are estimated to range from close to $300,000 in Illinois to $2 billion in California under sample programs with an 80/20 coinsurance split.
Comparing Health Insurance Measurement Error (CHIME) in the ACS & CPS
This document summarizes a study that compared survey responses about health insurance from the American Community Survey (ACS) and Current Population Survey (CPS) to actual administrative insurance records to assess accuracy. The study found that both surveys produced reasonably accurate aggregated estimates but that some types of coverage, like direct purchase plans, were less accurately reported. Specifically:
- Both surveys had high sensitivity in detecting those with any insurance but the ACS performed better for direct purchase plans.
- The predictive power of reported coverage types varied, with direct purchase again less accurately predicted than employer-sponsored coverage.
- Prevalence estimates based on surveys were generally within a few percentage points of administrative records, though CPS estimates were less accurate for
Who Gets It Right? Characteristics Associated with Accurate Reporting of Heal...
This document summarizes a study examining factors associated with accurate reporting of health insurance coverage type. The study used survey data matched to enrollment records from a health plan. It found:
1) Reporting accuracy was highest for those with employer-sponsored insurance and lowest for those with direct purchase or Medicaid coverage.
2) Among those with direct purchase insurance, reporting accuracy was higher for those who were white, non-Hispanic, fully employed, and from higher income households.
3) For Medicaid enrollees, reporting accuracy was higher for those who were unemployed, from lower income and education households.
Medicaid vs. Marketplace Coverage for Near-Poor Adults: Impact on Out-of-Pock...
1) The document analyzes the impact of state Medicaid expansion decisions on out-of-pocket health expenses and insurance coverage for low-income adults making 100-138% of the federal poverty level.
2) It finds that Medicaid expansion was associated with lower total out-of-pocket spending (a reduction of $353), lower premium spending (a reduction of $118), and lower medical spending (a reduction of $235) compared to non-expansion states.
3) Medicaid expansion also increased Medicaid coverage by 11.1 percentage points and decreased the uninsured rate by 4.5 percentage points for this low-income group relative to non-expansion states.
The Impact of Medicaid Expansion on Employer Provision of Health Insurance
- The study examines the impact of Medicaid expansion under the ACA on employer-sponsored health insurance (ESI) offers, out-of-pocket premiums, and eligibility using data from 2010-2015.
- The results show Medicaid expansion decreased worker eligibility for ESI offers by 4 percentage points but had no effect on ESI offers or out-of-pocket premiums. There was also no differential effect for low-wage establishments.
- The authors note the short-term effects may differ from long-term effects, and ongoing uncertainty could impact employer behavior and outcomes over time as more states expand Medicaid.
Physician Participation in Medi-Cal: Is Supply Meeting Demand?
This document summarizes a webinar presentation on physician participation in California's Medicaid program, Medi-Cal. The presentation was given by Janet Coffman from UCSF and Alan McKay from the Central California Alliance for Health.
Key findings from Coffman's presentation include: California physicians are less likely to accept new Medi-Cal patients than patients with private insurance or Medicare; acceptance rates vary by specialty, practice type, and region; and the most common reasons physicians limit Medi-Cal patients are delays in payment and administrative hassles.
McKay discussed the Alliance's efforts to expand Medi-Cal provider capacity after expansion, including grant programs for recruitment, equipment, practice coaching,
Shadac acs cps-webinar 2016-final_sept21
The document summarizes key information from a webinar about 2015 health insurance coverage estimates from the American Community Survey (ACS) and Current Population Survey (CPS). It provides an overview of the surveys' methodologies, measures of health insurance coverage, changes in insurance rates from 2013 to 2015, and resources for accessing public data from the ACS and CPS. New products for analyzing health insurance coverage from both surveys were also announced.
2014 SAHIE: Overview with Census Experts
The document summarizes a webinar presented by experts from the U.S. Census Bureau on the Small Area Health Insurance Estimates (SAHIE). SAHIE provides county-level estimates of health insurance coverage across various demographic groups. The webinar discussed the 2014 SAHIE release, which incorporated more up-to-date Medicaid data and showed substantial changes in insurance rates from 2013 to 2014. The webinar also reviewed the data sources and methodology used to produce the SAHIE estimates.
Adding complexity to an already difficult task: Monitoring the impact of the ...
The document summarizes research comparing estimates of Medicaid enrollment in 2013 and 2014 from the American Community Survey (ACS) and Centers for Medicare and Medicaid Services (CMS) administrative data. The research finds that states with the largest increases in Medicaid enrollment according to CMS also tended to have the largest differences between ACS and CMS estimates, with ACS generally reporting lower enrollment. This suggests the ACS may overstate uninsurance rates where Medicaid enrollment increased substantially. However, misreported coverage likely represents shifts between coverage types rather than uninsurance. Future research should analyze additional years of data and link administrative and survey sources to better understand reporting errors.
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