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  • Behavioral Health: Can Primary Care Help Meet the Growing Need?

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    The health reform law has specific provisions covering mental health and substance use conditions, as well as general provisions to benefit those in need of behavioral health services. While addressing unmet needs, the reform law provisions raise new challenges. Given their budgetary constraints, will states be able to expand capacity to meet the demands of increased enrollment? Will sacrifices in other benefits and services be needed in order to provide mental health parity? Will the…

  • Integrating Care for Dual Eligibles: What Do Consumers Want?

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    Many deficit reduction plans have recognized the need to improve care for the 9 million beneficiaries dually eligible for Medicare and Medicaid. How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are Health and Human Services initiatives encouraging innovations to integrate care for dual eligible beneficiaries? What kind of programs are currently available? What do consumers think about different ways of getting care? What lessons for program design can…

  • Innovative Medicaid Initiatives to Improve Service Delivery and Quality of Care: A Look at Five State Initiatives

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    A number of states have used the flexibility of the Medicaid program to develop innovative payment and delivery systems designed to coordinate and improve quality of care. This brief, based on site visits from November 2009 through March 2010, highlights care coordination and related efforts in five states: Alabama, Oklahoma, Oregon, Pennsylvania and Washington state. Such efforts by states to realign the provider payment and delivery systems are key to improving Medicaid and to successfully…

  • Strengthening Medicaid with Health Information Technology: Are Providers & States Up to the Challenge?

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    Health care providers can receive Medicare and Medicaid payment incentives when they adopt electronic health records and demonstrate their "meaningful use." Additionally, states must establish a website by 2014 for Medicaid beneficiaries to electronically enroll and renew coverage. Yet many challenges remain so that health information technology (HIT) can help the Medicaid program operate more effectively. How can Medicaid health plans and providers use HIT to provide better care delivery and improve health outcomes while…

  • The Innovation Center: How Much Can It Improve Quality and Reduce Costs – and How Quickly?

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    The new Center for Medicare and Medicaid Innovation (CMMI) seeks to test new health care payment and service delivery models that can potentially enhance quality of care for beneficiaries while reducing costs. How is the agency planning to administer its $10 billion in funding? What early projects is the center undertaking? Is there private sector evidence that its goals can be achieved? What will happen to existing innovations now being rolled out by providers and…

  • Explaining Health Reform: Uses of Express Lane Strategies to Promote Participation in Coverage

    Issue Brief

    Under the Patient Protection and Affordable Care Act (ACA), millions of uninsured adults and children will gain eligibility for Medicaid or health coverage through new health insurance Exchanges beginning in 2014. The law calls upon states to develop simple and streamlined processes for establishing, verifying, and updating eligibility for Medicaid, the Children's Health Insurance Program and federal subsidies for Exchange coverage. This issue brief examines how states can employ "express lane" principles in designing systems…

  • Public Reporting of Quality Outcomes: What’s the Best Path Forward?

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    The Affordable Care Act aims to promote higher quality care in part by rewarding – and eventually requiring – the reporting of certain quality measures. Previous efforts suggest that public reporting can add significant value. Yet there are concerns about the best way to measure outcomes and quality, the possible unintended effects of public reporting, and whether purchasers and consumers actually use the information to make choices. Panelists at this April 27 briefing co-sponsored by…

  • Shared Medical Decision Making: We’re in This Together

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    In recent years, awareness of the patient’s important role in managing his or her own care has been steadily growing—fed not only by such trends as the proliferation of health information on the internet and direct-to-consumer advertising, but also by the emerging science of patient-centered decision making. One way to facilitate shared decision making is through the use of decision support tools, which offer the patient high quality medical information in an easily understandable format.…

  • Innovations in Primary Care: What’s in the ACA?

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    The Patient Protection and Affordable Care Act aims to move the health care system away from an episodic, fee-for-service approach and towards a coordinated, preventive model of care delivery. Exactly how does the law encourage innovations in primary care? What roles will states and purchasers of care play in this transformation? This December 13 briefing, cosponsored the Alliance for Health Reform and The Commonwealth Fund, explored this and related questions. For more information, please visit…

  • Investing in Health IT: What the U.S. and Other Countries Are Learning

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    Recent legislation, including the stimulus package and the new health reform law, invests substantial funds in health information technology which can help prevent medical errors and improve the quality and value of care. However, questions have been raised about the cost of implementation and personal privacy considerations. This briefing addressed questions such as: What have the U.S. and other countries learned from their experience with health IT? How is the adoption of this technology progressing…