Although many people require treatment for both physical and behavioral health conditions, our physical and behavioral health systems typically operate independently, without coordination. Medicaid has a significant stake in addressing this issue because physical and behavioral health comorbidity rates among beneficiaries are high. This brief examines five promising approaches currently underway in Medicaid to better integrate physical and behavioral health care.
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Federal and State Standards for “Essential Community Providers” under the ACA and Implications for Women’s Health
Safety net providers such as community health centers and family planning clinics have served a significant role in the provision of primary care and reproductive health care services to low-income and uninsured people, particularly women. The Affordable Care Act (ACA) has a provision aimed at assuring that newly-insured individuals, as well as those without coverage, can continue seeing their trusted safety net providers, also called Essential Community Providers (ECPs). This brief reviews the definition of ECPs, examines the federal and state rules that govern the extent to which plans must include these providers in their networks, identifies the variation from state to state, and discusses the particular importance of these rules and providers for women’s access to care.
A new survey from The Commonwealth Fund and The Kaiser Family Foundation asked primary care providers—physicians, nurse practitioners, and physician assistants—about their experiences with and reactions to recent changes in health care delivery and payment. Providers’ views are generally positive regarding the impact of health information technology on quality of care, but they are more divided on the increased use of medical homes and accountable care organizations. Overall, providers are more negative about the increased reliance on quality metrics to assess their performance and about financial penalties.
Survey Finds Many Primary Care Physicians Have Negative Views of the Use of Quality Metrics and Penalties for Unnecessary Hospital Readmissions
Primary Care Providers View Health IT as Improving Quality, But Tilt Negatively on ACOs Half of the nation’s primary care physicians view the increased use of quality-of-care metrics and financial penalties for unnecessary hospitalizations as potentially troubling for patient care, according to a new survey from The Commonwealth Fund and…
Health Center Patient Trends, Enrollment Activities, and Service Capacity: Recent Experience in Medicaid Expansion and Non-Expansion States
In thousands of medically underserved communities across the U.S., community health centers enroll low-income people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and service capacity, comparing states that implemented the ACA Medicaid expansion in 2014 and states that did not expand Medicaid in 2014. The study is based on data from the federal Uniform Data System and a 2014 national survey of health centers.
Research demonstrates that improving population health and achieving health equity will require broad approaches that address social, economic, and environmental factors that influence health. Recently there has been increased recognition of the importance of these factors to health. Moreover, the ACA includes provisions to help bridge health care and community health. Reflecting the increased focus and new opportunities provided under the ACA, a growing number of initiatives are emerging at the national, state, and local level to address broader determinants of health. Given Medicaid’s longstanding role serving a diverse population with complex health, behavioral, and social needs, efforts to address social determinants of health are emerging through many Medicaid delivery and payment initiatives. This brief provides an overview of the broad factors that influence health and describes emerging efforts to address them, including initiatives within Medicaid.
A new survey from The Kaiser Family Foundation and The Commonwealth Fund asked primary care providers—physicians, nurse practitioners, and physician assistants—about their views of and experiences with the Affordable Care Act (ACA) and other changes in health care delivery and payment, as well as their thoughts on the future of primary care.
Kaiser–Commonwealth Fund Survey: Most Primary Care Providers Report Seeing More Medicaid or Newly Insured Patients Since January 2014, But Little Change in Ability to Provide Quality Care
As with the Public, Physicians’ Views on Affordable Care Act Split Along Party Lines The first in a series of reports on a comprehensive new survey finds most primary care doctors, nurse practitioners, and physician assistants report an increase in Medicaid or newly insured patients since the Affordable Care Act’s…
Community health centers are an integral part of the health care safety-net, providing access to care for nearly 22 million people in underserved communities. The ACA established trust fund for health center growth, and with increased patient revenues attributable to expanded coverage, health centers’ grant funding to support care of the uninsured can go further. This brief provides a 2013 data profile of health centers; highlights pre-ACA differences between health centers in Medicaid expansion and non-expansion states; and considers financial challenges facing health centers and the implications of state Medicaid decisions, the outcome of King v. Burwell, and the approaching sunset of the special trust fund for health centers’ capacity to ensure access to care for the communities they serve.
This brief draws on federal data and our 2016 survey of health centers to provide a 2015 profile of health centers, analyze recent changes in patient coverage and service capacity, and compare health centers in Medicaid expansion and non-expansion states. It also considers the implications of a repeal of the ACA for health centers and the low-income communities they serve.