All Innovations

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Health Care Payment and Delivery Reform in Minnesota Medicaid

March 1, 2013 - Minnesota's Medicaid program is a leader in piloting innovative health care payment and delivery reforms. This case study is one of three in a series on innovations being undertaken by states to improve quality and efficiency in their Medicaid programs.

Case Study

Medicaid Is One of Multiple Payers in Vermont’s Health Care Reforms

March 1, 2013 - Vermont Medicaid is a key player as the state pioneers multipayer health care delivery and payment reforms. Under Vermont Blueprint for Health, most Medicaid beneficiaries and state residents will be served in 2013 by medical homes with community health teams, with additional support services for Medicaid enrollees with complex conditions.

Case Study

Aligning Incentives in Medicaid: How Colorado, Minnesota, and Vermont Are Reforming Care Delivery and Payment to Improve Health and Lower Costs

March 1, 2013 - Colorado, Minnesota, and Vermont are working to align incentives between health care payers and providers to improve care delivery and outcomes while controlling costs. This synthesis describes the common drivers of reform across the states and lessons learned.

Case Study

Medicaid Payment and Delivery Reform in Colorado: ACOs at the Regional Level

March 1, 2013 - Colorado is one of a handful of states piloting innovative health care payment and delivery reforms through Medicaid. Under the Accountable Care Collaborative Program, which began enrollment in May 2011, the state Medicaid agency contracts with seven regional organizations to create networks of primary care providers and ensure care coordination for Medicaid enrollees.

Case Study

Dual Eligible Demonstrations: Resources for Advocates

May 22, 2012 - A new Commonwealth Fund–supported Web site offers educational resources for consumer groups and can serve as a platform for sharing ideas and strategies for improving care for dual eligibles.


California First with Exchange Legislation Under National Reform

March 11, 2011 - As the first state to enact legislation to create a health insurance exchange since the passage of the Affordable Care Act, California is an early example of how the law's vision of state-based exchanges can be implemented.

State Profile

Utah Health Exchange

March 11, 2011 - The Utah Health Exchange is a Web portal through which small businesses can make a defined contribution—a fixed dollar amount per employee—toward health insurance, and their employees can compare and select health plans from a range of options.

State Profile

Massachusetts Health Connector

March 11, 2011 - The Massachusetts Health Connector was created as an independent state agency charged with implementing many elements of the state's 2006 health care reform.

State Profile

Missouri: Pioneering Integrated Mental and Medical Health Care in Community Mental Health Centers

January 20, 2011 - Missouri has pioneered a program for Medicaid beneficiaries with severe mental illness that is based in community mental health centers and provides care coordination and disease management to address the "whole person," including both mental illness and chronic medical conditions. The initiative is a partnership among Missouri's Departments of Mental Health, MO HealthNet, and the Missouri Coalition of Community Mental Health Centers.

State Profile

Minnesota: Health Homes Tie Together State, National Health Reform Concepts

January 20, 2011 - Minnesota plans to use the ACA's Medicaid health homes option to build on its current statewide medical home initiative, which began in 2003. Jeffrey Schiff, M.D., the medical director of health care programs at Minnesota's Department of Human Services, said that the provision "is very compatible with our program.

State Profile

Rhode Island: Incorporating Culture Change into the Nursing Home Survey Process

October 22, 2010 - Some states are using regulatory oversight of nursing facilities to advance the culture change movement and promote resident-centered care. For example, Rhode Island's nursing home survey agency, part of its Department of Health, has prioritized measures of quality of life—in addition to measures of clinical care—in its nursing home survey and certification process.

State Profile

Michigan: Measuring the Long-Term Care Workforce

October 22, 2010 - Another approach to improving the quality of care as well as the quality of life for recipients of long-term care involves development of a high-quality and stable workforce. Michigan is focusing on the needs of its direct-care workers (e.g., nursing assistants, home care aides) as part of the foundation for its quality improvement activities.

State Profile

Colorado: Incorporating Quality of Life into Medicaid Reimbursement

October 22, 2010 - State budget constraints and a cap on the annual nursing facility provider fee have resulted in the cancellation of P4P payments for applications submitted in the year ended June 30, 2010, but the model Colorado developed may serve as a blueprint that could be replicated in other states and could be reinstated in Colorado, as budgets permit.

State Profile

Virginia: Tackling Health Reform on Two Fronts

August 11, 2010 - Virginia is among the 21 states with a lawsuit challenging the federal health care legislation, but it is also preparing to implement reform, acknowledging that the legal challenge may take years to resolve and the federal law may prevail.

State Profile

Pennsylvania: Building on an Existing Structure

August 11, 2010 - Pennsylvania is building on its existing Office of Health Care Reform, established by Governor Edward G. Rendell in 2003, to implement national reform.

State Profile