Medicaid and Complex Care

States continue to drive toward improving the health of their residents and, because health care costs are a large and growing component of state budgets, governors also are looking for long-term, transformational ways to improve the efficiency of their Medicaid programs. Generally, a small segment of the enrollee population account for large portion of states’ Medicaid expenditures. Those individuals with complex care needs, also known as “super-utilizers,” tend to have a history of chronic illness, multiple comorbidities, special needs and other non-clinical complications that may be related to unstable housing, employment, food and transportation and interaction with the criminal justice system. They often use emergency departments and inpatient services when home and community-based interventions could be employed with good outcomes and at lower costs. By appropriately redirecting state funds to address the comprehensive needs of people with complex care needs, states can rein in escalating costs and improve the quality of care delivered to high-risk and vulnerable Medicaid beneficiaries.

State Strategies to Support Marketplace Plan Enrollment as the Medicaid Continuous Coverage Requirement Winds Down

State Strategies to Support Marketplace Plan Enrollment as the Medicaid Continuous Coverage Requirement Winds Down

Just as states have customized their Medicaid programs and State-Based Marketplaces to meet the needs of their populations, they have been developing innovative approaches to prepare for the unwinding of ...
State-Driven Initiatives to Support Moving to Value-Based Care in the Era of COVID-19

State-Driven Initiatives to Support Moving to Value-Based Care in the Era of COVID-19

This issue brief summarizes four key areas where state-driven strategies can standardize and streamline broader adoption of value-based payment models, supplemented by case examples and priority areas where additional federal ...
BALANCING MEDICAID BUDGETS AND SERVING STATE RESIDENTS DURING A PANDEMIC

BALANCING MEDICAID BUDGETS AND SERVING STATE RESIDENTS DURING A PANDEMIC

This paper outlines key factors for Governors and state leaders to consider when balancing state budgets and making difficult decisions about funding Medicaid during the COVID-19 crisis and subsequent economic ...
State Strategies to Advance Health Data Interoperability

State Strategies to Advance Health Data Interoperability

The goal of this paper is to share strategies governors and other state leaders can pursue to expand access to data and technology that will improve the health and wellbeing ...
A Strong National Economy Depends on Strong States and Territories

A Strong National Economy Depends on Strong States and Territories

Topline Through prudent fiscal management and due to fundamental strengths in the broader economy, states and territories have so far averted the worst-case scenarios in cuts to their workforces and ...
Supporting A Trained Direct Care Workforce In Facility Settings During And After The Covid-19 Pandemic

Supporting A Trained Direct Care Workforce In Facility Settings During And After The Covid-19 Pandemic

The direct care workforce is a critical component of a well-functioning health system. These occupations are reliable entry points into the health sector, but limited wage potential as well as ...
Associations Release Roadmap on Strategies for Countering Opioid Misuse in Correctional Settings

Associations Release Roadmap on Strategies for Countering Opioid Misuse in Correctional Settings

As opioid overdoses continue to claim tens of thousands of American lives each year, the National Governors Association (NGA) and the American Correctional Association (ACA) released a roadmap outlining strategies ...
Expanding Access to Medications for Opioid Use Disorder in Corrections and Community Settings

Expanding Access to Medications for Opioid Use Disorder in Corrections and Community Settings

This roadmap highlights existing state efforts and serves as a policy development tool for Governors and state officials seeking to improve coordination and bolster existing efforts across state agencies to ...
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 ...
NGA Publications 2020

NGA Publications 2020

The coronavirus may be the most critical challenge of 2020, but there are a number of other important issues Governors have addressed this year. Timothy Blute | Director, NGA Center ...