Health Systems Transformation: Access, Cost and Quality

Health care in the United States is in a period of rapid change. Throughout the health care system, from providers of care to purchasers and policymakers, stakeholders are driving changes that are aimed at improving the quality of care, improving health outcomes and reducing costs. States are involved with the health care system at many levels and are uniquely positioned to innovate and catalyze efforts to transform health care delivery and payment systems. Governors, in their role as chief executives of their states, have the ability to lead and coordinate transformation initiatives across their states to improve the health of residents and move towards improved financial sustainability. Governors can not only influence health system transformation as one of the largest purchasers of health care in their state but also as one of the chief regulators of health care and as one of the most effective conveners of the public and private sectors.

The National Governors Association Center for Best Practices (NGA Center) is working closely with governors and senior state staff to develop and implement evidence-based transformation initiatives. The NGA Center works with states to assist them to in reforming their Medicaid, state employee health insurance programs, health insurance exchanges and other sources of coverage to drive towards broader delivery and payment system transformation. Such reforms include implementation of new risk-based payment models focused on health outcomes, identifying early intervention tools to address potential behavioral health needs for children and creating care delivery models for high needs high cost patients. In assisting states with these efforts, the NGA Center has provided targeted technical assistance and served as a conduit between states and other partners nationwide, including the federal government and leading experts. As states continue to transform their health care systems, the NGA Center will share lessons and best practices to help facilitate further improvements in patient care and cost sustainability.


NGA Resources

Maternal and Child Health Update 2020

Maternal and Child Health Update 2020

The Maternal and Child Health Update includes findings from a survey of senior state and territory health officials regarding MCH policy topics. Questions are modified from year to year to ...
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The Future of  State Telehealth Policy

The Future of State Telehealth Policy

This paper summarizes the types of telehealth policy flexibilities provided by states and the federal government during the COVID-19 pandemic and longer-term considerations for Governors regarding the impact of such ...
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Understanding the Effects of Medicaid Innovation

Understanding the Effects of Medicaid Innovation

Considerations for Evaluating State Medicaid Policies (View/Download) Executive Summary Section 1115 Medicaid demonstrations are important vehicles for experimenting with new Medicaid policies. Rigorous evaluations of these policies, if done well, ...
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State Actions Addressing COVID-19 in Long-Term Care Facilities

State Actions Addressing COVID-19 in Long-Term Care Facilities

This table provides an overview of notable state actions to address COVID-19 in long-term care facilities. (View/Download) This table provides an overview of notable state actions to address COVID-19 in ...
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Improving Outcomes and Reducing Cost of Care for Complex Care Populations With Behavioral Health and Social Support Needs: Toolkit for Governors

Improving Outcomes and Reducing Cost of Care for Complex Care Populations With Behavioral Health and Social Support Needs: Toolkit for Governors

The toolkit features lessons learned from Arizona and Michigan, who served as models for the participating states, and supplements the NGA road map for building complex care programs and the ...
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Governors Call on the Administration to Delay Changes to Hospital Reporting Requirements

The National Governors Association, on behalf of the governors in all 55 states and territories, urges the Trump administration to delay the changes to hospital reporting requirements announced on Monday ...
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Strategies for COVID-19 Response for Populations Receiving Long-Term Care

(View/Download) This memo, originally published on April 3, and was last updated on July 13. Introduction As governors consider ways to mitigate the spread of COVID-19 and protect high-risk communities, ...
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COVID-19 Testing in Long-Term Care Facilities

(View/Download) Introduction Many states are prioritizing and, in some cases, requiring COVID-19 testing of all residents and staff at long-term care (LTC) facilities. This brief provides considerations for developing a ...
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Overview of Section 1135 and Section 1115 Waivers

On March 13, President Trump issued an emergency declaration under both the National Emergencies Act and the Robert T. Stafford Act concerning the Novel Coronavirus and COVID19. Department of Health ...
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Governor Considerations Regarding Crisis Standards of Care

As part of state public health emergency preparedness initiatives, many states have developed guidelines or frameworks to address crisis standards of care (CSC). CSC are intended to help health systems ...
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