Online Program

State Health Agency Payment and Delivery Reform Technical Assistance Needs

Monday, November 2, 2015 : 3:00 p.m. - 3:15 p.m.

Megan Miller, MSW, Association of State and Territorial Health Officials (ASTHO), Arlington, VA
Kristen Wan, MS, PAPHS, Association of State and Territorial Health Officials, Arlington, VA
Background: The Association of State and Territorial Health Officials (ASTHO) is working to maximize the support and technical assistance (TA) available to state and territorial health agencies (S/THAs) as they develop and implement State Innovation Models (SIM) grants or payment and delivery reform initiatives. ASTHO is one of several national organizations receiving funding from the CDC to provide capacity building support for SIM grantees through a variety of TA.

Methods: In July-August 2014, ASTHO administered an online survey through Qualtrics to S/THAs to assess the needs and current activities of S/THAs in regard to SIM grants and other payment and delivery reform initiatives. Specifically, ASTHO was interested in understanding what types of support S/THAs need to be successful in their efforts.

Results: In total, 43 S/THAs (~70%) responded to the survey (N=24 SIM grant; N=19 non-SIM grant). The most successful reform initiatives were: “formalized partnerships”, “increased resources”, and “passed legislation/regulations”. The most frequently reported barrier for both SIM and non-SIM payment and delivery system reform planning was “differing perspectives on which steps to take”. In terms of implementation, “not having enough resources” was the biggest barrier for SIM states, while non-SIM states reported “challenges related to workforce” and “differing perspectives on which steps to take”. Respondents indicated that TA related to governance and financing models, understanding how to estimate return on investment, and linking clinical care to population health would be most helpful in planning or implementing payment or delivery reforms in the future.

Conclusions: While both SIM and non-SIM state have noted successes in their payment and delivery reform efforts to date, there are still many barriers to overcome. ASTHO has utilized the results of this survey to support S/THAs through a four-part TA call series, topic-specific site visits, and peer-to-peer site visits.

Learning Areas:

Public health administration or related administration

Learning Objectives:
Describe the payment and delivery reform technical assistance needs of state health agencies.

Keyword(s): Health Care Reform, Health Systems Transformation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the lead on a federally funded grant and a private foundation grant focusing on health care payment and delivery reforms that incorporate population health, as well as Medicaid and public health partnerships that work to achieve the Triple Aim. I have a master’s degree in social work from Boston College and an undergraduate degree in political science with a minor in economics from Marshall University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.