Prioritizing high-need, high-cost Medicaid populations by risk and level of need can help states and health plans identify "high-opportunity" beneficiaries and target quality improvement resources appropriately. While predictive modeling tools have historically been use... more
The National Health Plan Collaborative (NHPC) created this toolkit of resources, lessons, best practices, and case studies to help other health plans reduce racial and ethnic health disparities. The toolkit shares what NHPC members have done to develop and test new meth... more
According to American Diabetes Association, continuous glucose monitors (CGMs) are the standard of care for treating people with type 1 diabetes and people with type 2 diabetes on insulin pumps or multiple daily insulin injections, and a recommended tool for people wit... more
Medicaid leaders play a critical role in guiding their programs to meet the needs of the people they serve. State agencies, however, often face challenges finding and retaining employees, particularly senior leaders. Most senior Medicaid leaders are promoted from withi... more
Health care systems across the U.S. are increasingly focused on opportunities to achieve greater health equity. Cultivating meaningful relationships with their surrounding communities and involving community members in program and policy decision-making is integral for... more
Medicaid health homes, made possible under Section 2703 of the Affordable Care Act, provide states with a mechanism to support better care management for people with complex health needs with the goal of improving health outcomes and curbing costs. As of January 2019, 2... more
The Affordable Care Act (ACA) gives Medicaid programs the option to create health homes to coordinate and better integrate primary, acute, behavioral health and long-term services and supports for beneficiaries with complex and chronic conditions. Growing evidence sugge... more
With Medicaid enrollment exploding at the same time that states are facing unprecedented budget pressures, there is widespread recognition that expanded access to care is unsustainable without changes in how states deliver and pay for care. Reforming Medicaid payment po... more
To provide more integrated, coordinated care for its residents dually eligible for Medicare and Medicaid, Ohio is operating MyCare Ohio, a capitated model demonstration under the Financial Alignment Initiative offered by the Centers for Medicare & Medicaid Services.... more
Through the Centers for Disease Control and Prevention’s (CDC) 6|18 Initiative, the Rhode Island’s Department of Health and Medicaid agency are partnering to obtain Medicaid reimbursement for the Home Asthma Response Program (HARP). Established in 2010 by the stateâ... more
Many trauma-informed care (TIC) programs focus on upstream variables such as changing provider behavior and developing workforce wellness practices, yet the evaluation of health care interventions are traditionally oriented toward impact on patient outcomes. While patie... more
Across the country, states, health plans, and provider organizations are increasingly seeking opportunities to integrate community health workers and promotores (CHW/Ps) into health care delivery to improve the quality of life and health outcomes of individuals they ser... more
