The National Governors Association (NGA), Health Care Sustainability Task Force released a report providing several recommendations which the federal government can adopt to reduce barriers to innovation and further support state health care initiatives. Co-chaired by Gov. Bill Haslam (R-TN) and Gov. John Kitzhaber (D-OR), the Task Force is comprised of 10 governors from the following states: Alabama, Arkansas, California, New Mexico, New York, Oregon, South Dakota, Tennessee, Utah and Vermont. In addition, the immediate past leadership of the NGA Health and Human Services Committee, governors from Nevada and Maryland, serve on the Task Force as ex-officio members.
The Task Force met regularly from late May through November 2013. At the outset, the Task Force identified principles that governors believe should serve as the foundation for state-federal efforts. These principles provided a framework for the development of recommendations in four key areas: federal support of state health care innovation; Medicare-Medicaid enrollees (dual eligibles); long-term services and supports; and payment and delivery reform. Within each of these four key areas, the Task Force made several recommendations for the federal government to adopt. The following is a brief highlight of several of the recommendations included in the report:
- The Centers for Medicare and Medicaid Services (CMS) and other federal partners should standardize and streamline the process of reviewing and approving state proposals to innovate in Medicaid/CHIP, including waivers and state plan amendments.
- CMS should establish a work group with states to conduct a comprehensive review of existing options to serve dual eligibles and identify policy changes that would: (1) allow states to serve broader populations through these programs, and (2) support states’ ability to finance these programs through greater flexibility and shared savings.
- Congress should enact legislation giving states the option to pursue and test flexible payment and delivery transformation initiatives, including models that are not explicitly authorized in statute, under a sustainable budget arrangement. Congress should establish clear parameters for states to undertake such initiatives and allow states to realize a return on their investment by sharing in federal savings that accrue as a result of proven state health care transformation.
The Wisconsin Center for the Advancement of Postsecondary Education (WISCAPE) released an issue brief calling for states to collect more data from for-profit postsecondary institutions, so as to better assess the causes of these institutions’ disproportionately high student loan default rates.
The Minnesota Board of Dentistry (BOD) issued a report on the preliminary impact of dental therapists in Minnesota. The 2009 Minnesota Legislature directed the BOD, in consultation with the Minnesota Department of Health (MDH) and the Department of Human Services (DHS), to evaluate dental therapists’ impact on the delivery of and access to dental services. The BOD surveyed 15 clinics employing dental therapists from August 2012 through December 2013. Specifically, the report found that since licensing commenced in 2011, four complaints have been filed against dental therapists. Two have been resolved without BOD action and two are pending. None have been directly related to patient safety issues. Also the report found that 84% of patients served by dental therapists were enrolled in public health insurance programs. Preliminary findings suggest that dental therapists may reduce emergency room (ER) use by expanding capacity at dental clinics serving vulnerable populations. Surveyed clinics also reported additional impacts of dental therapists, including personnel cost savings, increased dental team productivity and improved patient satisfaction.