Resources for Moving Forward - 11.22.11
National Academy for State Health Policy Webinar: Looking into the Crystal Ball: Preparing for the Essential Health Benefits: Thursday, December 8, 2:30 - 4:00 PM EST Register Here
In this webinar, expert presenters will help states identify how to get started on benefit design, provide insights on how what HHS' guidance on the essential health benefits package might look like. Discussion topics will include:
| MEDICAID
Shaping Medicaid Managed Care Expansions to Better Serve Consumers (Community Catalyst, October 2011) Half of all Americans covered by Medicaid are in managed care plans run by companies paid a per member fee to provide most medical services. State governments are increasingly mandating this approach for seniors in long-term care and for people with disabilities, rather than serving them through traditional fee-for-service. In many states, these changes are motivated by efforts to control growth in Medicaid costs. At its best, Medicaid managed care provides opportunities for improved coordination, quality and efficiency of services. But it comes with risks for consumers, such as restricted access to needed care, requiring vigilance and advocacy from consumer groups and providers. The principles outlined in this policy brief can help guide consumer advocates as they work for managed care that best serves seniors and people with disabilities. |
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FUNDING
The Obama Administration has announced as much as $1 billion in grants as part of the Health Care Innovation Challenge designed to improve not only public health, but also create much needed health care jobs. Proposals are encouraged to focus on high cost/high-risk groups including populations with multiple chronic diseases and/or mental health or substance use issues, poor health status, multiple medical conditions, high cost individuals or the frail elderly. These grants will be awarded in March 2012 to applicants who implement the most compelling new ideas to deliver better health, improved care and lower costs to Medicare, Medicaid and CHIP enrollees, particularly those with the highest health care needs.
SAMHSA has announced $15 million in grants to support and promote better primary care and behavioral health services for individuals with mental and substance use disorders. These grants are funded by the ACA's Prevention and Public Health Fund to improve health status by improving the coordination of healthcare services delivered in publicly funded community-based behavioral health settings, including community mental health centers and public health departments.
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| PARITY
Beyond Parity: Mental Health and Substance Use Disorder Care under Payment and Delivery System Reform in Massachusetts(Blue Cross Blue Shield of Mass. Foundation, October 2011) Massachusetts, like most other states, is grappling with implementing major health care changes with passage of the ACA of 2010 and the Wellstone Domenici Mental Health Parity and Addiction Equity Act of 2008. It is important to examine how these two laws and policy initiatives will impact care for individuals and families with mental health and substance use disorders. The purpose of this report is to describe the policy context and to offer preliminary recommendations to initiate a community conversation about how these major policy changes might be implemented with the goal of improving mental health and addiction care in Massachusetts. |
The Maryland Citizens' Health Initiative officials have presented a road map to state leaders at the Maryland Health Exchange Board, whose members are working to implement the national health care reform law. The proposal was supported by documents prepared by the Johns Hopkins Bloomberg School of Public Health, the Center for Medical Technology Policy, and America's Agenda. The extensive proposal can be viewed here.
