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Fitting Together the Pieces of State Health Reform

Wesley Epplin and Sharon Post
September 17, 2014


A common refrain in health policy circles is that it takes a great deal of effort just to know about and keep track of the “alphabet soup” of health reform. Each sector—primary care, health systems, safety net providers, long-term services and supports, behavioral health, and so on—has its own jargon and acronyms, making communication and collaboration difficult.

Yet the various programs, policies, and initiatives aimed at reform are often overlapping and interconnected, each accelerated at times and constrained at others by Federal, State, and local government regulations and funding opportunities.  All of this is happening within a context of changing needs and demands of patients, providers, and payers.  

Implementation of the Affordable Care Act (ACA), the rollout of a great many concurrent state health initiatives, and the ongoing struggle for adequate resources compete for advocates’ attention. Stakeholder meetings multiply and simply keeping track of the latest developments is a daunting task. All of this has led more than a few among our fellow advocates and colleagues at providers, health plans, and government agencies to express confusion and frustration and highlighted the need for more information about these initiatives.  

In that spirit, Health and Medicine Policy Research Group has prepared a draft report, State Health Reform in Illinois: Fitting the Pieces Together, describing the many reforms rolling out in Illinois.  Our report suggests that advocates engage with each initiative as part of a comprehensive whole, rather than seeing them as stand-alone reforms.

Is something missing?  
This report is currently in a draft form, and we know that our project is impossible without considerable partnership and mutual support among advocates and stakeholders.  We eagerly encourage your feedback and comments, and will happily revise it if there is interest in maintaining it as a resource going forward.

Some areas for which we are already aware of missing pieces and welcome others to share their expertise and experience include:
  • Challenges and opportunities facing Illinois Health Information Exchange (ILHIE) and more detail on how ILHIE projects connect to many other reform initiatives, as well as the role of improvements to the Medicaid Management Information System (MMIS)
  • How providers and health plans will delivery recovery-oriented mental health services within a reformed system, from short-term and longer-term perspectives
  • How the enormous need for housing assistance will be managed
  • The role of Medicaid rate reform for hospitals and nursing homes in the overall reform project
  • The role of Medicare and commercial Accountable Care Organizations in overall delivery system reform
  • Relevant oversight groups and websites for stakeholders to be involved and engaged in these different initiatives
  • Additional initiatives focused on public health and community health improvement, including Community Health Needs Assessments (CHNAs) and formation of Regional Health Improvement Collaboratives (RHICs)
  • Making sure that the expertise and services offered by smaller community based programs are included in new models of care when appropriate (e.g. domestic violence providers, school based health services)

Please email your comments to Sharon Post and Wesley Epplin or call: 312-372-4292.

Related to this, check out these two blog posts from earlier this year: