Medicaid and Public Health Partnerships

State Work on Payment and Delivery Reform

ASTHO supports state and territorial health agencies in implementing payment and delivery reform initiatives to improve population health and patient care, as well as to control healthcare costs.

Senior Deputies Medicaid Innovations Group

ASTHO’s Clinical to Community Connections team convened the Senior Deputies Medicaid Innovations Group to help support State Health Officials and Senior Deputies as chief health strategists and support their work in healthcare delivery transformation. The group focuses on highlighting opportunities that connect Medicaid and state public health agencies to improve population health. The ad hoc group has been convening since January 2017. If you are interested in joining this group, please email Alexandra Kearly. Slide decks from past presentations can be found below:

June 2017: The CDC’s 6|18 Initiative with Experiences from Three States

This presentation includes an overview of the CDC’s 6|18 Initiative and outcomes from the first cohort of states: Rhode Island, Massachusetts, and Georgia.

November 2017: Medicaid and Addressing the Social Determinants of Health

This presentation introduces ASTHO’s new Center for Population Health Strategies and provides an overview of Medicaid’s role in addressing the social determinants of health.

March 2018: New Section 1115 Waivers

This presentation includes an overview of changing landscape of Section 1115 waivers including updates on work requirements and the American Lung Association’s work on the implications of recent changes in Medicaid programs and association health plans on tobacco cessation.

May 2018: Section 1115 Waivers on Place-based Initiatives and Healthy Behavior

This presentation includes an overview and state examples of Section 1115 Waivers that address place-based initiatives and healthy behavior incentives.

November 2018: Social Determinants of Health and Predictive Analytics

This ASTHOConnects webinar featured guest speakers and discussion on social determinants of health in Medicaid and the use of big data and predictive analytics in population health.

Payment and Delivery Reform Activities

In 2014, ASTHO surveyed its members to assess their technical assistance (TA) needs related to health systems transformation activities, particularly regarding payment and delivery model programs like the State Innovation Models (SIM) Initiatives. The following resources provide an overview of the survey results and outline how ASTHO has used the results of the survey to provide TA to all state and territorial health agencies.

ASTHO Resources

Blending, Braiding, and Block Granting Funds for Public Health and Prevention: Implications for States
This report shares insights and recommendations from state public health and Medicaid policymakers to help both federal and state leaders think strategically about possible responses to potential policy and funding changes. The suggestions presented were formed by an ad-hoc group of state officials during a meeting convened by the de Beaumont Foundation, in partnership with ASTHO and the National Academy for State Health Policy.

Telehealth Resource Guide
The ASTHO Telehealth Resource Guide summarizes resources available for state and territorial health officials and their staff as they look for innovative ways to increase access to care for vulnerable populations and improve population health. In addition to describing key issues and resources, the guide highlights telehealth programs in ten states to demonstrate the variety and range of ways that states are coordinating and leveraging telehealth. This guide was developed by ASTHO with support from HRSA and updated in 2017. The 2016 version is also available.

Improving Rural Health: Making an Impact in Five Years
The Centers for Disease Control and Prevention and Health Resources and Services Administration have supported states in building healthcare delivery systems in rural communities and expanding clinical and non-clinical interventions that demonstrate improvements in health outcomes and cost-effectiveness within five years. This issue brief highlights interventions that state health agencies are implementing to address the leading causes of death among rural Americans. The state case examples highlight the importance of multi-sectoral partnerships in improving the health of rural and underserved populations.

Financing Public Health Interventions through Pay for Success
The South Carolina Department of Health and Human Services has engaged in a cross-sector initiative involving the South Carolina Department of Health and Environmental Control, the Nurse-Family Partnership, Social Finance, and a consortium of philanthropic funders to advance an innovative, performance-based financing mechanism to implement and sustain a home visiting program for low-income, first-time mothers. This issue brief explores the mechanics of this Pay for Success model and its potential to lead to improved health outcomes and strengthened public-private partnerships.

Arizona Implements Emergency Medical Services-Managed Treat and Refer Program
The state of Arizona is helping paramedics move beyond their traditional role of emergency response and into primary care and community health services.

Health Policy Institute of Ohio Creates Health Value Dashboard
Ohio's new public health tool displays a snapshot of the state's population health, ranks it against other states, and pioneers the health value metric.
Montana Diabetes Prevention Program
Montana secured Medicaid reimbursement for chronic disease prevention services through a state plan amendment.
Kentucky Health Information Exchange Improves Care Coordination and Advances Meaningful Use
Kentucky’s Health Information Exchange is a secure, interoperable electronic network that supports statewide exchange of patient health information among healthcare providers.

Iowa Studies ACA's Effects on Public Health Programs to Drive Resource Reallocation
The Iowa Department of Public Health contracted with an actuarial firm to perform a comprehensive analysis of how Iowa’s Medicaid expansion program and federally-authorized marketplace health plans were impacting demand for four programs.

ASTHO Workgroup Resources

ASTHO was one of several national organizations receiving funding to provide capacity building support for SIM Grantees through a variety of technical assistance. ASTHO established a six state working group to share updates and resources on each state’s respective payment and delivery reform work. The six state working group consisted of Minnesota, Maryland, Massachusetts, Vermont, Oregon, and Washington. The following resources from Oregon offer insights into this work: