Category Archives: Affordable Care Act

National Commission to Issue Sharp Warning That Efforts to Improve Health Will Fail Unless the Nation Invests in Broad New Efforts Outside the Health Care System

RWJF Commission to Build a Healthier America to Release New Recommendations that Call for Major Initiatives in Early Childhood Development, Creating Healthy Communities, and Broadening Role of Health Care Providers; Funding Early Childhood Development For All Children by 2025 Critical to Nation’s Health

On January 13, the Robert Wood Johnson Foundation Commission to Build a Healthier America will issue new recommendations aimed at improving health now and for generations to come.  The recommendations and new report, from a nonpartisan, diverse group of national experts and thought leaders, will highlight the need to:

  • Prioritize investments in America’s youngest children
  • Encourage leaders in different sectors to work together to create communities where healthy decisions are possible
  • Challenge health professionals and health care institutions to expand their focus from treating illness to helping people live healthy lives

Building on its original work from 2009 – which helped advance a national movement to address non-medical factors that affect our health – the RWJF Commission to Build a Healthier America reconvened in 2013 to assess changes that could have the greatest and most immediate impact on improving health. The Commission will release the new recommendations on Monday, January 13, 2014, at 2:30 p.m. ET, during a live online event from the Newseum’s Knight Studio in Washington, DC.

The event will feature Commission Co-Chairs Mark McClellan and Alice Rivlin; Commission Staff Director, and the leading national expert on social determinants of health, David Williams; Robert Wood Johnson Foundation President, Risa Lavizzo-Mourey; and Commission members (full list below). Innovative programs and policies from across the nation will be highlighted, including tangible examples of the kind of change the Commission is calling for on a broad scale.

Register for the January 13 live online event now.

For More Information or to RSVP: Please contact Sara Knoll at 301-652-1558 or

sknoll@burnesscommunications.com; or Christine Clayton at 609-627-5937 or media@rwjf.org.

Where We Are Now: Expanding the Medicaid Program in Alaska

Discussions in Alaska about expanding Medicaid continues to be a hotly debated topic. Recently, Governor Parnell announced his intention not to expand Medicaid in Alaska. Below is a brief synopsis of the timeline and activity highlights surrounding Medicaid expansion in Alaska as we understand it. Readers are welcome to comment on the blog to enrich the discussion.

To contribute to the public dialog about Medicaid expansion, Alaska Native Tribal Health Consortium (ANTHC) commissioned two independent analyses, one from the Urban Institute and one from Northern Economics. ANTHC then summarized the findings from both and publicly released a final report, Healthier Alaskans Create a Healthier State Economy on February 1, 2013. The ANTHC summary reported that both analyses concluded that Medicaid expansion would contribute to improvements in the health of both Alaskans and the Alaska economy.

In April 2013, The Lewin Group of Falls Church, VA, delivered to Governor Parnell a final report that analyzed the impact of Medicaid expansion in Alaska. Efforts by legislators and others to review the report were unsuccessful.

On November 15, 2013, Governor Parnell announced that he would not seek to expand Medicaid in his FY2015 budget proposal. [Read the text from his announcement here.] However, he declared continuing interest in providing a sustainable safety net of health care services for vulnerable Alaskans.

To that end, he proposed the creation of a Medicaid Reform Advisory Group to address issues related to the Medicaid structure and to propose reforms to the state Medicaid program. The group is to meet three key health reform mandates: budget sustainability and predictability, efficient navigation by providers, and the inclusion of behavioral health treatment. The group is to deliver the report to the legislature for approval no later than November 15, 2014.

Also at the press conference, the Lewin Report was made available to the public.

Commissioner Bill Streur followed Parnell’s announcement with a statement in which he addressed planned improvements in the Division of Public Assistance communication plan targeting the most vulnerable Alaskans.

Governor Parnell’s decision not to expand Medicaid in Alaska was met with some criticism. For example, the Alaska Chamber announced its disappointment that Governor Parnell determined not to pursue Medicaid expansion in Alaska, which the chamber considers an “important part of the chamber’s goal of reducing or containing the cost of doing business in Alaska.”

Further, the Alaska Chamber reports, “As taxpayers, all Alaskans are subject to the increased federal taxes established to fund the new national healthcare law. If Alaska does not expand Medicaid, Alaskan’s taxes will pay for the uninsured in other states. The concern is that Alaska businesses and all insured Alaskans will bear even higher insurance premiums and health care costs to cover those uninsured.”

Measuring The Outcomes Of Health Reform: Opportunities For Federal And State Policymakers

The article from HealthAffairs.org examines the reporting requirements of CMS, and discusses how states can take advantage of data collection to evaluate the outcomes of health reform. An excerpt from the discussion follows.

Beyond CMS’ reporting requirements, we anticipate that there will be a need and opportunities for states to collect and analyze data from a broad array of sources to evaluate the role of Marketplaces in achieving national and state policy goals as well as tactical and business oriented metrics that measure operational efficiency, customer service and effectiveness of outreach efforts.  Thus, establishing a broad baseline dataset prior to or as close to the start of ACA implementation is critical in order to track the impact of these reforms.  To do this, states should take this opportunity to leverage investments in new systems and data sources to better understand ACA implementation as well as their own state specific goals.

States should also take this opportunity to explore the development of an infrastructure to collect, integrate and analyze data from multiple sources (e.g., All Payers Claims Database, Health Information Exchange, etc.) to understand the impact of the ACA on insurance markets, access to care, and ultimately – the impact on population health. Similarly, it will be important for agencies involved with measuring the impacts of health reform to establish strong collaborative relationships across various state agencies, constituents of the health care market, and other stakeholder groups as part of this effort.  Relevant data typically resides within various data sources in the state, and timely access to data will be important for measuring and tracking progress.  In addition, this will encourage administrative efficiencies, rather than promoting redundancy in data reporting.

Finally, while national policy makers are seeking to standardize goals, measures, and data sources, it is important to keep in mind that different states will measure success differently – based on their market dynamics and population – with the overarching goal of using the tools offered by the ACA to best serve the health care needs of their citizens. (excerpted directly from the article)

The Substance Abuse and Mental Health Services Administration (SAMHSA) Releases its Report to Congress

The Substance Abuse and Mental Health Services Administration (SAMHSA) in collaboration with the Health Resources and Services Administration (HRSA) recently released its Report to Congress on the Nation’s Substance Abuse and Mental Health Workforce Issues. Provides an overview of the facts and issues affecting the substance abuse and mental health workforce in America. The report contains demographic data on the behavioral health workforce, major factors that impact the workforce, and efforts to address workforce challenges. It also addresses how the Affordable Care Act and the Mental Health Parity and Addiction Equity Act may impact the behavioral health workforce and delivery of care.

View the full report here.

Affordable Care Act and Implications of Medicaid Expansion in Alaska

By Christine Brubaker-Schauble, RN

Due to the complexity and scope of Medicaid expansion-related ACA provisions, much is still unknown about how Medicaid expansion would alter the structure of current state-funded programs for the uninsured and other health care delivery stakeholders such as hospitals, clinics, clinicians, employers, private insurers, and Tribal health organizations. Alaska Center for Public Policy in collaboration with Christine Brubaker-Schauble will work to summarize components of the ACA and provide a roadmap to published information relevant to various stakeholder groups. When publications with quality Alaska-specific data are not available, summaries of national-level data/information supplemented with key informant interviews will be provided.

Alaska’s health care delivery system has both cutting-edge innovations (such as the Community Health Aide Program and telemedicine) and substantial challenges to overcome (such as how to keep vaccine viable when delivering to rural communities via unheated bush plane). Our issues are unique as compared to the Lower 48 states so in the end only Alaskans know the answers to questions like, “Will an expanded Alaska Medicaid program meet the health care needs of low-income Alaskans and if not, what alternatives do we have for meeting those needs?”

This project seeks to give practical information to Alaska decision-makers and health policy experts on the potential impact of opting for a Medicaid program expansion. A series of policy briefings will be published in segments during the remainder of the 2013 legislative session and throughout the summer, and will include

  • a review of key components of the Medicaid expansion provision and how it fits within the context of the ACA as a whole,
  • an overview of the Medicaid program in Alaska, and
  • key informant interviews with stakeholders, providers, and organizations in Alaska.

Keep reading…

Access the full list of resources utilized for this paper here. Your comments are also appreciated. 

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