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Issue: Managed care organizations (MCOs) are integral to Medicaid payment and delivery reform efforts. In states that expanded Medicaid eligibility under the Affordable Care Act, MCOs have experienced a surge in enrollment of adults with complex needs.
Goal: To understand MCO experiences in Medicaid expansion states and learn about innovations related to access to care, care delivery, payment, and integration of health and social services to address nonmedical needs.
Methods: Interviews with leaders of 17 MCOs in 10 states that have seen large Medicaid enrollment growth and have undertaken payment and delivery reforms.
Findings and Conclusions: MCO leaders regard their ability to enroll and serve the Medicaid expansion populations as a signal achievement. They have focused on identifying and helping high-risk populations and addressing the social determinants of health. MCOs are testing value-based payment strategies that link payment with performance and are increasingly focused on engaging patients in their care. Leaders report common challenges: setting appropriate payment rates; managing members whose needs differ from traditional Medicaid beneficiaries; ensuring access to specialty care; and effectively implementing payment reform and practice transformation. All point to the need for a stable policy environment and a strong working relationship with state Medicaid agencies.
Carsey School of Public Policy at The University of New Hampshire;
Funding for the Children's Health Insurance Program (CHIP)—the federal program that extends health insurance coverage to low income children not eligible for traditional Medicaid—officially expired on September 30, 2017. Given that states implement CHIP in different ways, states will run out of funds at different times, with twelve states exhausting their federal allotment by the end of 2017 (see Figure 1).
Several of these states are populous, and together are home to nearly 9 million—or 30 percent—of the nation's publicly insured children, and to one in five publicly insured rural children. Lawmakers are discussing how to fund reauthorization, and in the meantime, children may become uninsured or switch to more expensive and less comprehensive alternate plans in the interim. As states begin planning for these transitions, legislators should consider both administrative costs and potential effects on family health and finances.
Foundation for a Healthy Kentucky;
Creating a Culture of Health in Appalachia: Disparities and Bright Spots is an innovative research initiative sponsored by the Robert Wood Johnson Foundation (RWJF) and the Appalachian Regional Commission (ARC) and administered by the Foundation for a Healthy Kentucky. This multi-part health research project will, in successive reports: measure population health and document disparities in health outcomes in the Appalachian Region compared to the United States as a whole, as well as disparities within the Appalachian Region; identify "Bright Spots," or communities that exhibit better-than-expected health outcomes given their resources; and explore a sample of the Bright Spot communities through in-depth, field-based case studies. Taken together, these reports will provide a basis for understanding and addressing health issues in the Appalachian Region. This research initiative aims to identify factors that support a Culture of Health in Appalachian communities and explore replicable activities, programs, or policies that encourage better-than-expected health outcomes that could translate into actions that other communities can replicate.
This first report, Health Disparities in Appalachia, measures population health in Appalachia and documents disparities between the Region and the nation as a whole, as well as disparities within the Appalachian Region.
Chicago Council on Global Affairs;
This report focuses how immigrants have helped offset native-born population loss and revitalized an aging workforce by examining 46 Midwestern metro areas as a refresh of a similar study published by the Chicago Council on Global Affairs in 2014. Metro areas are a useful barometer by which to measure the impact of immigration because the economies of central cities and their suburbs are tightly connected and because large immigrant communities are found in both central cities and suburbs of metro areas. Also, the extent to which immigration matters to metro-area economies heightens the importance of immigration as an issue and raises the stakes for immigration reform.
Great Lakes Higher Education Guaranty Corporation (an affiliate of Great Lakes Higher Education Corporation & Affiliates);
At Great Lakes we work to make postsecondary degrees, credentials and certificates accessible to as many students as possible. Specifically, we focus our philanthropy on helping those who traditionally have the most to gain from college, but who often have the least support in getting there: students from low-income homes, students of color and first-generation students.
This Report highlights our belief that overcoming barriers to graduation requires engaging both students and colleges—with success being their shared goal. In it you'll find details on many of the 50 grants we launched in 2016, several key findings and our goals for the coming year.
NextGen Climate America;
NextGen Climate America, in partnership with PSE Healthy Energy, is proud to announce the release of "Our Air." These reports examine the health and equity impacts of fossil fuel power plants in Pennsylvania and Ohio – two of the heaviest carbon pollution emitters in the U.S.
Fossil fuel power accounted for two-thirds of our electricity generation last year, with roughly equal contributions from coal and natural gas sources. The burning of these fuels is a major contributor to climate change, which affects communities around the world. But, the immediate health effects of fossil fuel power plants are felt locally because they contribute to dangerous levels of air and water pollution in neighboring communities, in addition to contributing to climate change.
A new set of reports by NextGen Climate America and PSE Healthy Energy found that in 2015, particle pollution from power plants in Pennsylvania and Ohio was responsible for more than 4400 deaths and more than $38 billion in health impacts. These states host coal and natural gas power plants that are disproportionately located in vulnerable and environmentally overburdened communities: more than 85% of fossil plants are located in areas with high concentrations of low-income and/or minority residents across the two states.
Woodrow Wilson National Fellowship Foundation;
The report offers a series of short essays from 18 teachers, each reflecting on what inspired and guided them into the teaching profession. Some of the highlights include:
"I've come to realize that my learning process in the classroom actually feels a whole lot like the science I practiced at the bench: engineering experimental procedures, collecting and analyzing data, and formulating questions about next steps. It turns out that my scientific worldview can really improve learning outcomes for my students," said Kristin Milks, a biology and earth science teacher in Bloomington, IN, who enrolled in a teacher preparation program shortly after completing her Ph.D. in biochemistry.
"What transforms someone from being a good teacher to being a great teacher is the passion to make connections with students, to constantly evaluate and adjust their practice to do what is in the students' best interest," said Catherine Ann Haney, a Virginia Spanish teacher who has recently been teaching in Santiago, Chile.
"Enrolling in a teacher education program, instead of starting my career as a teacher first and then obtaining my master's degree after, meant I had a cohort of other soon-to-be teachers to learn with as we persevered through a very rigorous and demanding year," said Jeremy Cress, a math teacher in Philadelphia.
"I realized that being a good math teacher does not mean explaining clearly, making kids like me, or making math fun. Rather, it means giving students the opportunity to solve problems by themselves from start to finish, to struggle and persevere, and to learn from each other's particular strengths," said Brittany Leknes, a math teacher from Sunnyvale, CA.
"Together my students and I co-create their identities, their sense of themselves, and their understanding of their place in society. Because I believe wholly in my students' own power, I teach to disrupt school cultures that suggest that students need to be anything less than their whole selves," said Kayla Vinson, who taught social students in the Harlem Children's Zone.
Created in 2007, the Leonore Annenberg-Woodrow Wilson Teaching Fellowship was designed to serve as the equivalent of a national "Rhodes Scholarship" for teaching. Working with Stanford University, the University of Pennsylvania, the University of Virginia, and the University of Washington, the Woodrow Wilson Foundation provided $30,000 stipends for exceptionally able candidates to complete a yearlong master's degree program. In exchange, the teacher candidates agreed to teach for three years in high-need secondary schools across the country. The Leonore Annenberg Teaching Fellowship was funded through grants from the Annenberg Foundation and Carnegie Corporation of New York. It served as the basis for the Woodrow Wilson Foundation's successful Teaching Fellowship program, which now operates in five states (Georgia, Indiana, Michigan, New Jersey, and Ohio), operating in partnership with 28 universities. Woodrow Wilson Teaching Fellows complete a rigorous yearlong master's degree program, coupled with a robust yearlong clinical experience. Once they earn their degrees, Woodrow Wilson Teaching Fellows teach in high-need STEM classrooms, while receiving three years of coaching and mentoring.
Health Care Cost Institute;
Children's Health Spending: 2010-2014 examines spending on health care for children covered by employer-sponsored insurance from 2010 to 2014. For the first time, HCCI analyzed children's health care spending trends at the state level, reporting on Arizona, Connecticut, Florida, Illinois, Maryland, Ohio, Texas, Virginia, and Wisconsin, as well as the District of Columbia.
Per capita spending on health care for children grew an annual average of 5.1% per year between 2010 and 2014, reaching $2,660 in 2014.
Rising prices were the chief driver of growth in spending for children's health care in 2014.
At the same time, there was a general decline in the use of health care services between 2012 and 2014.
Among the states studied, Arizona had the lowest per capita spending ($2,151 per child in 2014), while Wisconsin had higher per capita and out-of-pocket spending than the national average in every year studied – reaching $3,017 per capita in 2014.
Great Lakes Higher Education Corporation & Affiliates;
With over half of jobs now requiring a postsecondary credential, college completion has never been more important. Yet it remains elusive for too many students -- especially students from low-income backgrounds, students of color and first-generation students. For 50 years, Great Lakes has focused on helping traditionally underserved students who have the most to gain from a college education -- yet often have the least support in getting there -- make their way to and through college. Our 2015 report highlights the three distinct and purposeful funding approaches we use in pursuit of this goal and details several grants we made over the past year.
Corporation for Enterprise Development (CFED);
The Assets & Opportunity Scorecard is a comprehensive look at Americans' financial security today and their opportunities to create a more prosperous future. It assesses the 50 states and the District of Columbia on 130 outcome and policy measures, which describe how well residents are faring and what states are doing to help them build and protect assets. The Scorecard enables states to benchmark their outcomes and policies against other states in five issue areas: Financial Assets & Income, Businesses & Jobs, Housing & Homeownership, Health Care, and Education.
Mathematica Policy Research, Inc.;
Mathematica Policy Research examined the implementation of Enroll America's field outreach campaign during the second open enrollment period, to understand whether and how it adapted the campaign compared to its first year activities, to assess second-year performance, and to document Enroll America's expectations for their work in 2015 and beyond. The findings in this report are based on two rounds of interviews with Enroll America staff and outside stake holders conducted in October and November 2014 and again between May and July 2015.