Quality Strategies
Identifying and examining current quality and efficiency efforts will enable states to make informed decisions about how to use the resources provided by the ACA to enhance existing quality efforts or to develop new efforts that complement existing efforts.
*Milestone details:
*Full name: Assess existing state efforts to support health care quality and health system efficiency.
*Relevance to the ACA:
The ACA provides several supports and potential templates to states for the evaluation of current quality and efficiency related policies and programs, but does not require an assessment of all existing state efforts. Relevant provisions include:
§2801 - Medicaid and CHIP Payment and Access Commission assessment of policies affecting all Medicaid beneficiaries including those affecting quality of care, interaction with Medicare, and enrollment and retention processes.
§2951 - Requires all states to assess statewide needs and identify at risk communities including the quality and capacity of existing programs or initiatives for early childhood home visitation as a condition of receiving funds under §501 of Title V of the Social Security Act.
§4102 - Improvements to the Pregnancy Risk Assessment Monitoring System which provides state-specific data for planning and evaluating health programs to improve the health of mothers and infants by reducing adverse outcomes.
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District of Columbia
The February issue of Health Affairs focuses on patient engagement, including two articles focusing on the relationship between quality outcomes and engagement.
In the first, the authors assess evidence and find that patients who are more engaged have better health outcomes, but that there is limited evidence on the cost impact.
In the second article, the authors examine data to determine the effects of enhanced support for shared decision making. They find that patients who received this additional support had overall lower medical costs and also reduced incidence of "preference sensitive" heart surgeries.
Rhode Island
The Payment and Delivery Reform Workgroup of the Rhode Island Healthcare Reform Commission released a report on current payment and delivery system reforms underway in Rhode Island and how opportunities provided by the ACA could enhance and strengthen efforts to redesign the delivery system in a way that promotes high quality of care, sustainable costs and population health.
North Carolina
As part of the North Carolina Health Reform implementation efforts, the New Models of Care work group identified ongoing efforts in North Carolina to test new models of health care delivery and financing. We matched these efforts to some of the provisions mentioned in the ACA. This analysis is on pp. 160-181 of the Interim Report: Implementation of the Patient Protection and Affordable Care Act in North Carolina. This report is available at: http://www.nciom.org/wp-content/uploads/2011/03/HR-Interim-Report.pdf
In addition, the Quality work group cataloged existing efforts to improve quality. This is available at pp. 153-154 of the same Interim report.
Maine
This is a great resource -- thanks so much for sharing, Pam!
Oklahoma
Community members who are interested in this milestone may wish to learn more about Oklahoma’s Patient Centered Medical Home program for SoonerCare members. To learn more, please follow this link:
http://www.statereforum.org/node/602#comment-7932
Massachusetts
In 2009 The Massachusetts Health Care Quality and Cost Council released the analysis of its consumer friendly website called MyHealthCareOptions. The analysis was prepared by Massachusetts Health Quality Partners. The report identifies specific methodological changes to the website that the Council approved and will adopt.
Read the executive summary at:
http://www.mass.gov/Ihqcc/docs/2009_04_Website_Report_Executive_Summary.pdf
In June 2011 the Division of Health Care Finance and Policy will hold health care cost trends public hearings. The hearings will call on witnesses who can speak to the factors that contribute to cost growth within the Commonwealth of Massachusetts’ health care system and to the relationship between provider costs and payer premium rates. Read the hearing notice below.
http://www.mass.gov/?pageID=eohhs2terminal&L=6&L0=Home&L1=Researcher&L2=...
Maine
This presentation reviews ACA provisions related to payment reform, discusses payment reform efforts already underway in Maine, and analyzes risks and opportunities for payment reform going forward.
Access the presentation here:
http://www.statereforum.org/sites/default/files/me_paymt_reform_pres.pdf
District of Columbia
This report from St. Luke's Health Initiatives discusses the implication of ACA on Arizona and various policy opportunities related to coverage and access, the healthcare system and special populations. Access the report here: http://www.statereforum.org/sites/default/files/impactarizonaoct-10.pdf
District of Columbia
This report by the New York State Health Foundation details the challenges and opportunities NY faces in implementing reform, including Exchange, benefit design and payment issues. Access the report here: http://www.statereforum.org/sites/default/files/nyroadmappaper_aug2010.pdf
Maine
Those interested in this milestone may wish to see the post on New York's Adirondack Medical Home Demonstration here: http://www.statereforum.org/node/1545
as well as the post on New York's Health Home program here:
http://www.statereforum.org/node/1510