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.

Opioid Crisis Legislation

Opioid Crisis Legislation

Letter to Senate Majority Leader Mitch McConnell and Senate Minority Leader Chuck Schumer regarding passage of legislation geared toward combatting the opioid epidemic. DOWNLOAD THE LETTER Full text August 16, ...

Criminal Justice, Corrections, and Sentencing Reform

NGA’s Work with Governors  Many states have enacted and implemented some type of criminal justice reform, and justice system improvements. Each year, through NGA’s annual Institute for State Criminal Justice ...

Health Care Workforce Redesign

Scope of Practice Scope of practice defines the types of services that a particular health care worker can provide as well as the circumstances under which such services can be ...

State Options Under ACA Section 1332

Section 1332 of the Affordable Care Act (ACA) gives states significant flexibility to change many elements of their individual and small group private health insurance markets. The ACA provided flexibility ...

Data-Informed Policy

Data can serve as an extremely powerful tool to set governors’ priorities and inform their decision-making. State leaders are in a unique position to use data to create policies that ...

State Health Innovations and State Innovation Models

Through the State Innovation Models (SIM) initiative, 38 states (including territories and the District of Columbia) have received financial and technical support from the federal government to design or test ...

Medicaid Transformation in States

Governors and state health officials continue to face budget pressure stemming from ongoing increases in health care costs. Increasingly, governors are interested in aligning economic incentives across public and private ...

State Health Reform Initiatives

The U.S. health care system is currently undergoing significant change. Much of the change happening today is focused on finding ways to pay for and deliver care that will lead ...

NGA Announces Three New Health Initiatives With States

WASHINGTON —The National Governors Association (NGA) announced three new health policy initiatives today to assist states. NGA’s Harnessing the Power of Data to Achieve State Policy Goals: The Foundation for State Success ...

Letter Urging Congressional Support on Combatting Opioids

Dear Speaker Ryan and Minority Leader Pelosi:  On behalf of the nation’s governors, we write to thank you for your efforts to combat our country’s opioid crisis and urge continued ...