The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
We focus on a number of topic areas identified by state health policy leaders as important to population health.
The Center for Evidence-based Policy at Oregon Health & Science University is a national leader in evidence-based decision making and policy design.
Keep up with news and updates from the Milbank Memorial Fund. Get the latest from thought leaders, including Christopher F. Koller, president of the Fund.
We publish The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to population health.
News and Updates
December 20, 2017
Reforming States Group
One hundred and twelve health policymakers from 40 states, two local jurisdictions, and three other countries gathered this fall in St. Louis, Philadelphia, and San Diego for the 2017 annual Reforming States Group (RSG) meetings. The meetings, a hallmark of the RSG, which is now in its 25th year, provide an opportunity for participants from the executive and legislative branches to come together and share their experiences in a neutral, bipartisan place.
“There’s no other meeting that brings executive and legislative folks together like this,” said Laura Kelly, Kansas Senator. “I’m forever grateful.”
Added John O’Bannon, formerly from the Virginia General Assembly, “We close the door and we do policy. We focus on what’s good for people here.”
During the state update session of the meeting, participants spoke about the most significant health care-related issues in their regions. They questioned one another about policy achievements and failures, and how progress had been made—for instance, was there a legislative champion, bipartisan compromise, or work with agencies or stakeholders.
The structure of the RSG meetings encourages exchange between policymakers as well as in-depth briefings on carefully selected topics. “States are now in the driver’s seat when it comes to setting much of the health policy agenda,” said Fund program officer Trina Gonzalez. “With the Reforming States Group, the Fund is working hard to identify, inform, and inspire the leaders who will be determining that agenda for their jurisdictions. It is a privilege to help them do this important work.”
The topics selected by the RSG Steering Committee for the 2017 meetings were:
The Growing and Changing Nature of Family Caregiving
In 2015, the RSG began a multi-year commitment to focus on aging. This year, in a session co-sponsored with the John A. Hartford Foundation, the focus was on family caregivers and how states can support them. Today, family caregiving is more complicated, costly, stressful, and demanding than at any other time. Serious illness and chronic disability affect the family as well as the individual. With the aging of the baby boomer generation, many more family members and friends are needed to provide care. While the United States faces an unprecedented care gap, ensuring that family caregivers can continue to provide care has become an urgent public policy issue. This session brought together national experts, researchers, and state leaders to discuss changes in family caregiving, some of the challenges family caregivers face, and lessons from states that have instigated successful supports for family caregivers. Review the meeting presentations here.
Hospitals’ Role in Population Health: Leveraging Community Benefits and Health Improvement Activities
Historically, non-profit hospitals were recognized by the Internal Revenue Service (IRS) as charitable organizations that qualified for tax exemption because of their provision of charity care to those unable to pay. In recent years, the IRS has expanded hospitals’ reporting requirements for all the community benefits they purport to provide, as well as their health improvement activities. Some states have added their own reporting requirements—and the Affordable Care Act required hospitals to complete community health needs assessments.
This session, featuring a presentation by the Hilltop Institute, focused on how states can use data to monitor and guide hospital community benefit activities, including trends in hospital spending for uncompensated care and community health improvement and opportunities to align hospitals’ activities with state and local population health improvement goals and measures. A new website, Community Benefit Insight, funded by the Robert Wood Johnson Foundation, has been launched to make hospital community benefit data reported to the IRS more accessible.
Evidence-informed Health Policy: Medication-Assisted Treatment and Supportive Housing
State policymakers face complex and costly choices in developing and implementing policies and programs. Advocates and allies present evidence that support their own priority. But what is the best evidence? How can you evaluate it for yourself? And how can your state best use evidence to address policy challenges on an ongoing basis to pursue better results?
The Center for Evidence-based Policy presented information about ways to examine and apply evidence, using real policy examples that provided opportunities for leaders in their own states. For instance, medication-assisted treatment, including opioid treatment programs, combine behavioral therapy and medications to treat substance use disorders. What does the evidence show about the efficacy of these programs? In a second example, the group looked at supportive housing, which combines affordable housing assistance with wrap-around supportive services for people experiencing homelessness as well as people with disabilities. RSG members examined the extent to which supportive housing has been demonstrated to be an effective intervention for people experiencing chronic homelessness. See the presentation here.
The Milbank Memorial Fund is an endowed operating foundation that works to improve the health of populations by connecting leaders and decision makers with the best available evidence and experience.
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