CHCS Report on Oral Health Integration in Statewide Delivery System and Payment Reform

An issue brief from the Center for Health Care Strategies looks at new approaches to integrating oral health care with other medical care. Because Medicaid dental coverage for adults varies greatly among states, beneficiaries face inadequate and uneven access to oral health care. Even among children, who have guaranteed comprehensive oral health benefits under Medicaid, access to care is limited. As a result, Medicaid beneficiaries often have untreated dental disease that can lead to severe pain, emergency department use and social consequences such as reduced employability.

In response, states are increasingly using creative value-based payment strategies to integrate oral health care into broader delivery system reforms. The focus on oral health has been particularly notable among states receiving Center for Medicare and Medicaid Innovation’s State Innovation Model grants. This brief explores how states are including oral health in payment and delivery system reform.

Issue Brief Highlights Accountable Communities of Health Programs in Four States

An issue brief by the National Academy for State Health Policy (NASHP) provides a cross-state analysis of the Accountable Communities of Health (ACH) programs in California, Minnesota, Vermont and Washington state and highlights key state levers and resources that advance ACHs. This brief also weighs the roles states and communities have played in establishing core ACH components including governance structures, geographic boundaries, financing mechanisms, priority conditions and target populations.

Successful LTSS Integration in Five Plans Examined

A report published by the Long-Term Quality Alliance (LTQA) analyzes the key components that affect integration of medical care and long-term services and supports (LTSS) for Medicaid and Medicare-Medicaid enrollees in managed care plans. Based on case studies of five experienced plans in Arizona, California, Massachusetts, New York and Texas, the report concludes that:

  • Significant statutory and regulatory barriers exist to integrating medical services and LTSS, including:
    • Medicare requirements for enrollee choice of plans and providers that can limit health plan enrollment and care management
    • Administrative complexities posed by the separation of Medicare and Medicaid payments for services
    • The siloed structure of the service delivery system, especially the separation between medical care and LTSS
    • Better integration of financing and payment is needed to take advantage of opportunities to manage medical risk and LTSS in a more integrated way
    • Care management is at the heart of what integrated programs do and is key to achieving results
    • Targeting high-cost, high-need enrollees is key to achieving positive outcomes and savings.

Webinar Resources Available on Tennessee HCBS Transition Plan; Using Data to Improve Care for Older Adults

Slides from the Centers for Medicare and Medicaid Services’ webinar on how Tennessee developed its Statewide Transition Plan and how the state is implementing the Home and Community Based Services (HCBS) final rule are now available. Speakers from Tennessee discussed the ways that external stakeholders and advocates meaningfully engaged in their state’s HCBS implementation process.

A recording of the Center for Consumer Engagement in Health Innovation’s webinar on using data to improve care for older adults is now available. This webinar focused on the new Dartmouth Atlas report on the needs of older Americans and speakers discussed how this information can be used by advocates in policy and practice work for older adults.

Profile of an Initiative at the Intersection of Health and Housing

A recent Community Catalyst blog post looks at Boston’s Health Starts at Home initiative, which seeks to improve health outcomes for children and their families by ensuring families’ housing needs are addressed in conjunction with their health and other social service needs. Each project is approaching the intersection of health and housing differently, each with a variety of partners, including hospital/health centers, social services agencies, housing providers, legal services, and/or homeless programs.