Case Studies

Super-Utilizers in Colorado

Super-Utilizers in Colorado
This case study describes the innovations undertaken in Colorado to better identify and manage individuals who are the highest utilizers of healthcare resources, known as “super-utilizers”. Colorado state officials came together to build on the existing Medicaid delivery infrastructure to leverage a policy academy to organize and enhance regional interventions. Colorado’s regional care collaborative organizations are utilizing best practices to provide targeted care coordination at the community level for the highest utilizers of healthcare resources.

 

Minnesota's Workforce Innovations

Minnesota's Workforce Innovations
This case study describes the workforce innovations undertaken in Minnesota to address health inequities and access to primary care. The community health worker program was formed to address health and related service needs. The community paramedicine program was created in response to the persistent shortage of primary care providers in rural Minnesota. While evidence is still emerging of these programs’ outcomes, the sustainability provided through the policy tools used will allow the state to fully evaluate each program over time.

 

New Hampshire's All-Payer Claims Database

New Hampshire's All-Payer Claims Database
This case study describes the innovations undertaken in New Hampshire related to implementing an all-payer claims database (APCD). Escalating healthcare costs are placing significant pressure on already stretched state budgets, with Medicaid often at the center of the debate. Understanding Medicaid’s costs in the context of the surrounding healthcare market was a priority for New Hampshire’s state leaders. Through a cooperative effort between the New Hampshire Department of Health and Human Services, New Hampshire Medicaid, and New Hampshire Insurance Department one of the first APCDs in the United States was launched.

 

North Carolina's Transitional Care Program

North Carolina's Transitional Care Program
This case study examines how Medicaid, public health, and Community Care of North Carolina worked together to improve transitional care for at-risk patients in North Carolina. Community Care of North Carolina is a statewide, physician-led, public-private partnership that links Medicaid recipients to primary care patient centered medical homes. Based upon a foundation of electronic data collection, analysis, and communication, this transitional care program enjoyed growth and stability as a result of its demonstrated positive impact upon key components of the Institute for Health Improvement’s Triple Aim.

 

Early Elective Delivery Reduction in Texas

Early Elective Delivery Reduction in Texas
This case study describes the innovations undertaken in Texas to decrease the incidence of early elective deliveries and their adverse consequences. State officials from Medicaid and public health collaborated to develop policies and additionally, a state statute enacted in 2011 requires Texas clinicians to follow the ACOG recommendations for Medicaid beneficiaries, or they will not be paid for their services. Despite initial concerns about government interference, the collaboration has shown beneficial results.

 

Vermont's Medication Assisted Treatment Program from Opioid Addiction

Vermont's Medication Assisted Treatment Program from Opioid Addiction
This case study describes the innovations undertaken in Vermont to expand treatment capacity and provide comprehensive coordinated care to individuals with opioid addiction. The Care Alliance for Opioid Addiction (the Hub and Spoke model) is a collaboration among leaders within three Vermont state government entities, local addiction specialists, primary care practitioners, substance abuse treatment providers, and community organizations which attempts to comprehensively address opioid use disorders among Vermonters.