Health Care Reform
The health care system in the United States is changing as states and the nation continue to implement the Affordable Care Act while planning for its potential repeal and replacement. JSI has been instrumental in health-reform and service delivery redesign initiatives on the national, state, and local levels, and is helping programs and providers at community health centers and rural clinics to respond to and help shape the continually evolving policy environment. JSI’s technical assistance includes:
- Analysis of the impact of health care reform on federal programs;
- Guidance to states and provider groups in assessing value-based purchasing strategies and implementing payment reforms;
- Facilitation of emerging partnerships;
- Research and evaluation related to health insurance coverage;
- Strategic planning and implementation of ways to strengthen health care integration and delivery of primary care and mental health services, including accountable care organizations, patient-centered medical homes, and behavioral health integration in health care centers and health centers.
Payment Reform & Delivery System Transformation
Payment reform is both a prerequisite for, and a core element of, a transformed delivery system that achieves improved patient experience, improved population health, and reduced costs to the overall health system.
For more than 15 years, JSI has been researching payment reform and delivery system transformation and their applications to the safety-net. JSI has worked closely in multiple states with a variety of safety-net organizations—including health centers and public hospitals—that are designing and implementing innovative approaches to payment and delivery system reform. JSI experience and expertise includes:
- Conducting research on payment models, including assessing feasibility of payment models and their relationship to care transformation in the safety net
- Identifying opportunities for safety-net providers to actively participate in reforms
- Facilitating policy discussions with stakeholder groups around payment reform
- Facilitating workgroups through pilot and implementation stages of payment reforms
- Providing strategic consulting support to foundations, primary care associations and health centers regarding advancing payment reform
Read health care reform-related blogs from JSI experts.
Read more about our work in the Massachusetts Delivery Reform Incentive Payment Program.
Through the Center, JSI supports RWHAP recipients through national and targeted training and technical assistance strategies and development and dissemination of best practices and supporting resources.
JSI's most recent work with the RWHAP program will be to evaluate the impact of coverage obtained through the Affordable Care Act and RWHAP service use post-ACA on client health outcomes.
In partnership with the Agency for Healthcare Research and Quality’s ACTION III Network, JSI is conducting formative research to identify the key principles that should be incorporated into a re-engineered visit in primary care.
From a groundbreaking waiver allowing NY to reinvest billions in federal savings, JSI will support the Central NY Care Collaborative in implementing the waiver dollars - addressing critical issues throughout the state and encouraging comprehensive reform.
JSI examined the opportunities/challenges of increased coordination between the delivery of health, behavioral health, substance abuse, and social services to provide “whole-person care” while addressing the population’s health and socioeconomic needs.
The study will identify specific needs of high-risk groups within the Hispanic population and will inform outreach and enrollment strategies by examining local health centers and community-based organizations best practices.
JSI and partners are conducting case studies on four emerging ACOs serving safety-net populations in MA, MN, CA, to generate relevant information for those interested in improving care for vulnerable populations and reducing health disparities.
JSI developed a nationwide community-level estimate of the impact that expanding health insurance coverage has on the demand for primary care services and provider workforce adequacy from ACA implementation in 2014 through the year 2020.
JSI worked to strengthen states’ capacity to monitor and improve child health program outcomes for the HRSA Division of Services for Children with Special Health Care Needs by institutionalizing continuous quality improvement initiatives.
On April 2012, the state of Colorado expanded Medicaid to include adults without dependent children with incomes at or below 10% of the Federal Poverty Level. JSI conducted interviews to capture the lessons learned from this expansion.
Safety net hospitals, which serve the nation's most vulnerable populations, have high rates of avoidable Medicaid readmissions. To reduce costs and improve care, JSI will adapt and test current best practices for improving care transitions.
JSI is helping the Colorado Department of Health Care Policy and Financing develop a payment methodology for federally qualified health centers and rural health clinics, with the goal of improving health outcomes while containing costs.