State Update

October 2013 Reports of Interest

(Reports of Interest) Permanent link   All Posts

The Robert Wood Johnson Foundation (RWJF) released three oral health reports. Researchers commissioned by the RWJF examined 25 programs that addressed barriers to preventive oral health services with solutions in non-traditional, community and mobile settings. The reports below culminate a two-year collaborative effort led by a team from RWJF and consultant ICF International.

Dental Professionals in Non-Dental Settings (report)
The report evaluates nine programs that seek to increase access to preventive oral health care in non-dental settings, such as senior centers, schools and Head Start sites. Each program works to expand the dental workforce by training new types of providers.

Providing Preventive Oral Health Care for Infants and Young Children in Women, Infants, and Children (WIC), Early Head Start, and Primary Care Settings (report)
The report evaluates seven oral health programs that provide preventive oral health care to young children (infants, toddlers, and children up to 5 years old) in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Early Head Start (EHS), and primary care settings. All of the programs strive to increase access to preventive oral health care by integrating dental services into primary care settings, WIC clinics, or EHS centers.

Innovations that Address Socioeconomic, Cultural, and Geographic Barriers to Preventive Oral Health Care (report)
The report evaluates nine programs seeking to increase the number of children from low-income families who receive preventive oral health care, and to encourage families and communities to prioritize oral health. Two of the programs evaluated incentives for providers to see more Medicaid-eligible clients; seven established new clinics and mobile units, some staffed by dental hygienists; and eight programs identified Medicaid-eligible children through Head Start and social service agencies.

The University of North Carolina at Chapel Hill released a report on 17 states(3) that could serve as policy laboratories to provide federal and state policymakers with a range of innovative ideas about how to reform graduate medical education (GME) policy, governance and finance. While the study revealed numerous instances of successful attempts to reform GME, no single state employed innovative approaches in all four study aims.(4) However, the report offered recommendations to state policymakers as they continue to address GME funding. Recommendations included the following: states should create a GME advisory entity that promotes discussion, coordination and education about GME; all payer, third-party payer, Medicaid and state appropriations for GME need to be carefully considered and designed to be responsive to the state’s population health needs; and new GME funding should be tied to performance metrics and require monitoring about how funds are spent.

Health Affairs and the Robert Wood Johnson Foundation released an issue brief providing details on the new excise tax on high-cost health plans proposed to both slow the rate of growth of health costs and finance the expansion of health coverage under the Affordable Care Act. The provision is often called the "Cadillac" tax because it targets so-called Cadillac health plans that provide employees the most generous level of health benefits. These high-end health plans' premiums are mostly paid for by employers. In addition, the plans have low, if any, deductibles and little cost sharing for employees.

The U.S. Department of Health and Human Services, Office of Inspector General issued a report finding that the 12 states that volunteered to work with the Centers for Medicare and Medicaid Services had made little progress in implementing the Transformed Medicaid Statistical Information System (T-MSIS). T-MSIS is designed to be a detailed national database of Medicaid and Children’s Health Insurance Program information to cover a broad range of user needs, including program integrity.

The Kaiser Commission on Medicaid and the Uninsured issued a report surveying the Medicaid budgets for all 50 states and the District of Columbia. The report found that improvements in the economy resulted in modest growth in Medicaid spending and enrollment in FY13. States moving forward with the Medicaid expansion are expected to see higher enrollment and total spending growth driven by increases in coverage and federal funds. Additionally, according to the report, the implementation of the Affordable Care Act (ACA) will result in major changes to Medicaid eligibility and enrollment for all states, whether they are implementing the ACA Medicaid expansion or not.  

Trust for America’s Health released a report finding that 28 states and the District of Columbia scored six or less out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Two states—New Mexico and Vermont—achieved the highest score, receiving all 10 possible indicators, while South Dakota scored the lowest with only two. According to the report, prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and the District of Columbia. To view state-by-state prescription drug overdose death rates and learn how your state scores on the 10 key steps to curb abuse, click here.

 


 

(3) The 17 states studied include: California, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New York, North Carolina, Tennessee, Texas, Utah, Vermont, and WWAMI states (which include Washington, Wyoming, Alaska, Montana, and Idaho). The latter 4 states have an agreement whereby they send students to the University of Washington, which serves as a public medical school for all 5 states. According to the report, researchers did not interview any experts from Alaska or Wyoming for the study, but did interview WWAMI experts who were familiar with GME policies and programs in all 5 states.

(4) The objectives of this study were to examine the extent to which states have, or plan to: 1) use health workforce data to assess residency training needs; 2) implement novel GME financing initiatives, including all payer systems; 3) create governance structures to allocate GME positions between specialties, geographies and training sites; and 4) establish policies or measures to encourage accountability of public funds invested in GME.