As federal health care reform law is implemented and assessed, states are exploring various reforms in health care coverage, quality of care, and methods of delivery and payment. Given the many interests involved, and the myriad applicable laws and regulations that apply, creating new models of health care delivery is daunting at best.
Our experts can help state policymakers throughout the cycle of health care policy reform. For example, we were integrally involved in development, drafting, and implementation of Massachusetts’ 2006 and 2012 landmark health care reforms, which embody many of the system delivery and payment reform principles included in the Affordable Care Act (ACA). We also support hospitals, physicians, academic medical centers, payers, professional associations, and other health care organizations implement the changes that impact health care providers, plans, and patients.
Our particular areas of expertise in health care reform include:
- Creating new care and alternative payment models
- Expanding coverage and access, particularly for vulnerable populations
- Building legal framework and financing models for comprehensive reform initiatives
- Integrating models of care for individuals who are dually eligible for Medicaid and Medicare
- Integrating behavioral health care and primary care
- Persuading policymakers to enact reform initiatives
- Disproportionate share hospital programs
- Clinical guidelines and related analytics
- Medicaid and/or Children’s Health Insurance Programs waivers
- ACA-related pilots and demonstration projects