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.
Medicaid and Complex Care
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 ...
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 ...
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 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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
WASHINGTON—The National Governors Association Center for Best Practices (NGA Center) Health Division hosted an event at the National Press Club to discuss its new report, Building Complex Care Programs: A Road ...
