Families USA Health Action Conference, 2010 State Opportunities in Health Reform Sonya Schwartz Program Director National Academy for State Health Policy January 29,

Families USA Health Action Conference, 2010 Outline I.States Current Roles II.Challenges for States in Implementing Health Reform III.Opportunities for States in Implementing Health Reform IV.Advocates Have an Important Role V.NASHP Resources Can Help

Families USA Health Action Conference, 2010 States Current Roles Define populations to serve Link residents to available services Determine benefits and design delivery systems for targeted populations Purchase healthcare services Deliver services to institutional residents Promote population health Promote system-wide improvement Educate and train healthcare professionals Protect consumers Finance Regulate Employ Establish legal framework Coordinate with related programs 3

Families USA Health Action Conference, 2010 Health Reform: State Challenges 4 Timing Capacity Resources Leadership

Families USA Health Action Conference, 2010 Health Reform: State Opportunities Connect people to needed services Promote coordination and integration in the health system Improve care for populations with complex needs Orient the health system toward results Increase health system efficiencies 5

Families USA Health Action Conference, 2010 Connect People to Services 6 Coverage based on income and not family status Investments in primary care and prevention Assistance in navigating health care system

Families USA Health Action Conference, 2010 Promote Coordination and Integration Streamlined enrollment and retention in programs Improved continuity of care across programs as income changes New authority to align Medicaid and Medicare 7

Families USA Health Action Conference, 2010 Improve Care for Complex Needs Improved access to home and community-based services Expansion of patient-centered medical homes Investments in secondary prevention for the newly insured 8

Families USA Health Action Conference, 2010 Orient Health System toward Results Payment reform demonstrations across programs Improved data collection and coordination Quality measurements in Medicaid 9

Families USA Health Action Conference, 2010 Increase Efficiency Limit administrative costs System-wide planning across agencies and programs Opportunities to allocate resources to higher-value care 10

Families USA Health Action Conference, 2010 Advocates Have an Important Role Organizing and expertise of advocates needed more than ever States will have unprecedented need for help: –Information and analysis –Strategic/implementation planning –Topic specific technical assistance –Convening stakeholders –Development of new models Take risks, share information, allow for mid- course corrections 11

Families USA Health Action Conference, 2010 NASHP Resources Can Help 1.A State Policymakers Guide to Federal Health Reform – Part I: Anticipating How Federal Health Reform will Affect State Roles 2.State Policymakers Priorities for Improving the Health System 3.Supporting State Policymakers Implementation of Federal Health Reform More tools and resources in development, stay tuned at: or