Publications

In the “duals demo,” enrollment in integrated Medicare–Medicaid plans among eligible beneficiaries ranged from a high of 67% in Ohio to a low of 4% in New York. To discover the secrets to successful enrollment in states like Ohio, Mathematica researchers conducted a study of how state program design, concurrent state programs and policies, health plan markets, and other factors affected enrollment over time in all 10 participating states.   More

Abstract The rate of telehealth use, in which patients receive a virtual health care visit, in the home or other nonclinical setting, has outpaced…  More

Many health care challenges are exacerbated in rural areas, such as limited access to services, provider shortages, and the prevalence of avoidable…  More

This issue brief attempts to assess how participating payers in Comprehensive Primary Care (CPC) initiative feel about the program and its progress by exploring the perspective of payers in three distinct regional markets in the Comprehensive Primary Care Plus (CPC+) program: Colorado, Oklahoma, and Greater Philadelphia.  More

In this issue brief, John Kitzhaber, MD, former governor of Oregon, and Bruce Goldberg, MD, former director of the Oregon Office for Health Policy and Research, outline why strong Medicaid management matters. Speaking directly to governors, the authors spell out why greater state investment in Medicaid administration is critical to attracting and retaining the talent needed to ensure that the program is flexible and innovative, fiscally responsible, and stable.  More

A certificate of public advantage (COPA) is a tool used by states to permit and oversee hospital mergers that create monopoly powers. A few months ago, we published a paper about the use of a COPA in Tennessee and Virginia. But what happens when a COPA is repealed? This issue brief looks at the COPA law in North Carolina that was enacted in 1993 and repealed in 2015. It provides a cautionary tale for other states considering COPAs.   More

Providers, payers, and state policymakers are moving to implement behavioral health integration (BHI) models as evidence of their effectiveness builds. But many states face an obstacle—the lack of a health care workforce that has the legal authority, training, and skills necessary to practice in these new models. How can states accelerate the development of a BHI workforce?  More

The opioid epidemic has spawned numerous state efforts to develop strategies to combat the crisis. While each strategy on its own may be worthwhile, effectively coordinating these efforts will likely prove to be the key to reducing the number of families and communities damaged by opioid abuse. Summarizing the critical experience of senior officials working on the crisis, this issue brief identifies the key ingredients in a coordinated state opioid strategy.  More

In 2016, the original directors of the state-based insurance exchanges came together to reflect on their experiences implementing this option under the Affordable Care Act. This issue brief summarizes their collective lessons, using the state health capacities framework developed in a report published earlier this month on “State Policy Capacity and Leadership for Health Reform.” How leaders make decisions and implement new health polices is especially timely given the continuing debate about changes to the Affordable Care Act.  More

In the last few years, hospitals have had to respond to changes in the health care environment. Some of the challenges they’ve faced involve…  More