In 2015, the Center for Health Care Strategies (CHCS) published a wide range of resources focused on advancing innovations in health care delivery for low-income Americans. We invite you to join us as we look back at our 10 most popular publications and two top-viewed blog posts from the last year. Keep an eye out for new developments in 2016!
- Medicaid Accountable Care Organizations: State Update States are exploring the viability of Medicaid accountable care organizations (ACOs) that align provider and payer incentives to focus on value instead of volume, with the goal of keeping patients healthy and costs manageable. This fact sheet walks through the progress of Medicaid ACOs and describes how emerging state programs are seeking to drive accountability.
- Supporting Social Service Delivery through Medicaid Accountable Care Organizations: Early State Efforts Many states recognize the connection between social determinants of health — housing, transportation, nutrition, etc. — and health care utilization and outcomes. This brief highlights the initial efforts of seven states incorporating social services into their emerging Medicaid ACO models.
- Trauma-Informed Care: Opportunities for High-Need, High-Cost Medicaid Populations Trauma-informed care acknowledges the role that trauma has played in patients’ lives, shifting the question from “What is wrong with you?” to “What happened to you?” This brief provides an introduction to trauma-informed care and describes how this approach can be adopted to better serve Medicaid populations, including examples from three innovative programs across the country.
- Medicaid Adult Dental Benefits: An Overview As many states expand Medicaid coverage for adults through the Affordable Care Act, there are new opportunities to expand much-needed dental coverage for low-income adults. This fact sheet identifies challenges related to oral health care access and utilization, outlines states’ coverage of dental benefits for adults in Medicaid, and suggests opportunities for states to increase oral health care coverage and access for this population.
- Using Medicaid Resources to Pay for Health-Related Supportive Services: Early Lessons State policymakers increasingly recognize that addressing the social determinants of health is a critical component for both improving outcomes among Medicaid beneficiaries and reducing health care spending. This brief provides practical state case studies to help inform supportive service payment strategies within ACOs, health homes, and other value-based delivery system reforms.
- Opportunities to Improve Models of Care for People with Complex Needs This report and literature review examine emerging evidence to shed light on what works to drive better health outcomes and reduce costs for individuals with complex needs. The analysis identifies critical gaps that must be addressed to improve care with a particular focus on social determinants of health and opportunities to more effectively integrate health and social services.
- State Payment and Financing Models to Promote Health and Social Service Integration This brief reviews potential financing mechanisms to facilitate the integration of medical care and social services, with a particular focus on Medicaid. Drawing from interviews with experts across the country, it offers models ranging from one-time seed funding for pilot projects to blended or braided financing arrangements that support comprehensive integration.
- Strategies for Hiring and Training Care Managers in Integrated Programs Serving Medicare-Medicaid Beneficiaries Effective care coordination and care management are essential to delivering person-centered, quality care in programs that integrate services for individuals dually eligible for Medicare and Medicaid. This brief shares strategies for hiring and training care managers for health plans with integrated care programs serving Medicare-Medicaid beneficiaries.
- Programs Focusing on High-Need, High-Cost Populations CHCS conducted a preliminary scan of programs across the United States to identify those that are focusing on the top five percent of high‐cost beneficiaries. The resulting map and chart provide an initial inventory of programs based on CHCS’ scan and feedback from others in the field.
- Building a Culture of Engagement for Medicare-Medicaid Enrollees: Health Plan Approaches Health plans serving individuals dually eligible for Medicare and Medicaid need to effectively engage their members in order to support individuals’ diverse needs via integrated care. This brief outlines promising strategies for engaging Medicare-Medicaid enrollees with complex medical, behavioral health, and social service needs.
- Opportunity Knocks to Improve Care for “Super Utilizers” Just five years ago, improving care and controlling costs for Medicaid’s most complex and expensive beneficiaries was far from a mainstream issue — now, a “super-utilizer” groundswell has emerged. This March 2015 blog post from CHCS’ Alison Hamblin outlined key drivers catalyzing this movement.
- Approaching the Tipping Point? Medicaid ACO Momentum Continues to Build More than one-third of states have launched or are developing Medicaid ACO programs. This July 2015 blog post by CHCS’ Rob Houston explored Medicaid ACO developments, including a review of Minnesota and New Jersey’s innovative models, and discussed the potential for ACOs to become woven into the fabric of our health care system.