Opportunities for Information Sharing to Enhance Health and Public Safety Outcomes (Research Report)
Justice-involved populations are more likely to suffer from chronic physical and behavioral health conditions. These conditions can jeopardize employment prospects and lead to reoffending and reincarceration. Information exchanges between the justice and health systems can help both criminal justice and community-based practitioners address these health conditions more effectively to improve outcomes. This report identifies 34 potential information exchanges and provides a blueprint for implementing effective justice-health information exchanges.
How are States and Evaluators Measuring Medical Homeness in the CHIPRA Quality Demonstration Grant Program? (Research Report)
|Posted to Web: September 05, 2013||Publication Date: September 05, 2013|
Many Medicaid and CHIP programs and private health plans are pursuing medical home initiatives aimed at improving the quality of health care, but varying conceptual definitions and measurement goals have led to the development of a number of different medical home measurement tools. This Evaluation Highlight, funded by the U.S. Department of Health and Human Services, examines the measurement of "medical homeness" in selected CHIPRA Quality Demonstration projects, describes the development of the Medical Home Index-Revised Short Form (an adaptation of the Medical Home Index survey), and presents preliminary statistics on medical homeness for demonstration practices in six States.
Achieving the Potential of Health Care Performance Measures (Policy Briefs/Timely Analysis of Health Policy Issues)
|Posted to Web: June 14, 2013||Publication Date: June 14, 2013|
There is a consensus that evaluating and reporting on the performance of health care providers can be instrumental in improving value in U.S. health care. But the growth of performance measurement has been accompanied by increasing concerns about the scientific rigor, transparency, and limitations of available measure sets, and how measures should be used to provide incentives to improve performance. This Robert Wood Johnson Foundation-funded paper describes the current state of performance measurement and reporting, details what’s wrong, and outlines seven policy recommendations that offer a path to achieving the promise of performance measurement while avoiding its adverse consequences.
Reducing Waste in Health Care (Research Report)
|Posted to Web: May 23, 2013||Publication Date: May 23, 2013|
A recent study by former Centers for Medicare and Medicaid Services administrator Donald M. Berwick and RAND Corporation analyst Andrew D. Hackbarth estimated that waste may constitute a third of US health spending. This policy brief examines waste in health care that may result from poor delivery of care, failed care coordination, overtreatment, administrative complexity, and uncompetitive pricing. The author concludes with presenting opportunities and challenges associated with efforts to eliminate waste in health care without harming consumers or reducing the quality of care provided.
Will There Be Enough Providers to Meet the Need? Provider Capacity and the ACA (Research Report)
|Posted to Web: February 21, 2013||Publication Date: February 21, 2013|
Much of the success of the Affordable Care Act (ACA) will hinge on issues surrounding access to care, particularly as millions of individuals become newly-insured and strain the capacity of provider systems. New service delivery reforms in state Medicaid programs and the private sector, as well as provisions in the ACA focused on increasing primary care reimbursement and provider supply, and increasing funding for Community Health Centers, hold promise to improve access to quality care. Drawing on the experiences of ten study states participating in the Robert Wood Johnson Foundation’s health reform monitoring and implementation project, this brief examines how states are addressing the complex issues of provider capacity and access to care.
Evaluation of Statewide Risk-Based Managed Care in Kentucky: A First Year Implementation Report (Research Report)
|Posted to Web: November 20, 2012||Publication Date: November 20, 2012|
This report is the first of a series of reports that will be prepared during a three-year evaluation of the statewide implementation of risk-based managed care in Kentucky's Medicaid program. The evaluation will assess the short- and medium-term effects of risk-based managed care implementation on the major partners- beneficiaries, providers, plans, and the Cabinet- with an eye toward understanding the impacts on costs and on the provision of care. In this report, we provide an overview of managed care implementation in Kentucky as of mid-2012 based on our case study analysis, conducted about eight months after the state began enrolling Medicaid beneficiaries in risk-based managed care state-wide.
Health Policy Brief: Improving Care Transitions (Policy Briefs)
|Posted to Web: November 02, 2012||Publication Date: November 02, 2012|
The term care transition describes a continuous process in which a patient's care shifts from being provided in one setting to another, such as from a hospital to a patient's home. Poorly managed transitions can diminish health and lead to hospital readmissions, thus driving up costs for Medicare and other payers. This Health Affairs brief examines the factors contributing to poor care transitions, describes effective care delivery models aimed at improving care transitions, describes initiatives in the recent health reform law aimed at incentivizing greater attention to care transitions, and explores policy issues surrounding payment reform in this area.
Payment Reform: Bundled Episodes vs. Global Payments (Opinion)
|Posted to Web: October 05, 2012||Publication Date: September 13, 2012|
There is widespread agreement that the current fee-for-service approach to paying for health care is problematic, but there is a lack of consensus on what should replace it. Medicare is pursuing bundled episode payments, and proponents like Francois de Brantes of the Health Care Incentives Improvement Institute have been laying the groundwork for implementation. But other experts, such as the Urban Institute's Robert Berenson, worry that the current interest in bundled payments will distract policy-makers from moving more decisively away from fee-for-service. In this Robert Wood Johnson Foundation-funded paper, de Brantes and Berenson debate the benefits and drawbacks of bundled payments and global capitation.
Medicaid and CHIP Risk-Based Managed Care in 20 States: Experiences Over the Past Decade and Lessons for the Future (Research Report)
|Posted to Web: September 18, 2012||Publication Date: September 18, 2012|
Over the first decade of the 21st century the role of risk-based managed health care for publicly insured beneficiaries has expanded substantially. This report examines this form of health care delivery in 20 states for both Medicaid and CHIP non-elderly adults and children, including people with disabilities. The 20 states were chosen because they include over 80 percent of both Medicaid and CHIP beneficiaries who are enrolled in risk-based managed care. Findings are based on interviews with state Medicaid and CHIP officials, as well as representatives from 40 Managed Care Organizations (MCOs) serving Medicaid and CHIP beneficiaries, and 40 health care providers or provider organizations. In addition, the report contains published data from various sources, including measures of access to care, quality of care, and satisfaction with care over the study period (2001-2010).
How Five Leading Safety-Net Hospitals Are Preparing For The Challenges And Opportunities Of Health Care Reform (Research Report)
|Posted to Web: September 07, 2012||Publication Date: September 07, 2012|
Safety-net hospitals will continue to play a critical role in the US health care system, as they will need to care for the more than twenty-three million people who are estimated to remain uninsured after the Affordable Care Act is implemented. Yet such hospitals will probably have less federal and state support for uncompensated care. At the same time, safety-net hospitals will need to reposition themselves in the marketplace to compete effectively for newly insured people who will have a choice of providers. We examine how five leading safety-net hospitals have begun preparing for reform. Building upon strong organizational attributes such as health information technology and system integration, the study hospitals' preparations include improving the efficiency and quality of care delivery, retaining current and attracting new patients, and expanding the medical home model.
|Posted to Web: August 31, 2012||Publication Date: August 31, 2012|