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From the President: Emerging Issues

 Health Systems Transformation: Evolving for Changing Times

​By Stacy Collins, Atyya Chaudhry, Emily Eckert, Sara Miller and Elliane Yashar
Health Systems Transformation Team, AMCHP

megaphone-1725694_1280.jpgAs we start the new year, this AMCHP team has a note-worthy announcement. In January, the AMCHP Health Reform Implementation (HRI) team formally changed its name to the Health Systems Transformation (HST) team. The HRI team was formed in 2011, following passage of the Affordable Care Act (ACA). For five years, the HRI team monitored and reported on executive branch ACA activities, supported the government relations team in responding to congressional action related to the law and most importantly, educated AMCHP members and others on the emerging issues and opportunities within the ACA that benefited MCH populations. The team's new name reflects not only the reality of today's political environment, but the continual transformation of our nation's health care system. Ensuring that this system optimally serves women, children and families is a task that will endure far beyond the tenure of any single president or Congress. The HST team will continue to serve as a resource to members on the changing landscape of health reform at the national level.

The start of the new year offers a chance to reflect on the successes of the past 12 months and share highlights of our 2017 agenda.

The AIM-Access project

Throughout 2016, AMCHP played a pivotal role in the Alliance for Innovation in Maternal and Child Health: Expanding Access to Care for MCH Populations (AIM-Access) project, funded by the U.S. Maternal and Child Health Bureau (MCHB) The project is a collaboration of six national organizations committed to working intensively with states to achieve impact in three focus areas: strengthening continuity of coverage and care for pregnant women and children, improving systems of care for CYSHCN and promoting implementation of Bright Futures.

15128895_10155435611094460_2890466562295992045_o.jpgIn June, AMCHP and its AIM partners hosted a kickoff meeting in Denver for the second cohort of AIM states, including American Samoa, Colorado, Minnesota, Montana, North Dakota, South Dakota, Utah and Wyoming. State teams composed of Title V leaders and state health officials, state legislators, gubernatorial staff and American Academy of Pediatrics chapter leaders came together to develop state-specific projects to address AIM topic areas. HST team members Emily Eckert and Stacy Collins served as state team facilitators for American Samoa and North Dakota, for whom they provided technical assistance in project design and implementation.

In 2016, HST staff also produced AIM-related tools and programs to keep members up to date on health transformation issues related to insurance enrollment, benefits, state waivers and policymaker relationships. In partnership with Family Voices, staff produced an essay, Stories of the Newly Enrolled: How New ACA Coverage Options are Impacting Women and Families Raising Children with Special Health Care Needs and an issue brief, Section 1332 of the Affordable Care Act: An Opportunity for Innovation in Maternal and Child Health. In September, AMCHP partnered with the National Institute for Health Care Management Foundation (associated with the Blue Cross/Blue Shield health plans) to host a webinar entitled Pregnancy and Oral Health in the ACA Era: How Are Expectant Moms Faring? An outgrowth of the webinar was a customizable public service announcement on the importance of dental care during pregnancy, now available to AMCHP members and others in the MCH community.

In addition, AMCHP and Family Voices co-hosted two webinars on strategies to enroll young adults and other hard-to-reach populations in insurance coverage. At the national CityMatch conference in September, AMCHP co-hosted a successful workshop with AIM partner – the National Conference of State Legislators – on working with state lawmakers to improve systems of care for CYSHCN. Going forward, the HST team will embark on projects related to continuity of care for women of reproductive age with opioid addiction and coaching states in round three of the AIM project.

The National MCH Workforce Development Center

national mch.pngThe HST team remains a key member of the National MCH Workforce Development Center (the Center), a HRSA-MCHB funded project offering state Title V programs intensive training designed to strengthen MCH leadership capacity in the current health transformation environment. In 2016, HST team member Atyya Chaudhry coordinated an in-state meeting to assist Michigan Title V and its partners in designing a project for increasing access to care for children and youth with epilepsy through telemedicine. The site visit offered an opportunity for the team to prioritize ideas and recommendations, develop a sustainability plan and incorporate quality improvement methods to ensure project success.

In addition, HST team members provided technical expertise at the Center's Summer Skills Institute in Chicago in August. Some 134 participants from 34 states, jurisdictions and territories attended a week of intensive skills-building activities, designed to address a specific health transformation challenge related to their chosen national performance measures. In 2016, the Center was awarded a five-year continuation grant from MCHB. By providing state coaching and other technical assistance, the HST team looks forward to working in partnership with the Center in the year ahead.

Kellogg Foundation support for member education on MCH and health reform

With support from the Kellogg Foundation, the HST team continues to produce member educational materials on health reform provisions that directly support women and children's health. In 2016, the HST team produced Opportunities to Optimize Access to Prenatal Care Through Health Transformation and Mental Health Parity for Medicaid & CHIP Populations, which describes how new federal regulations extend parity protections to more than 23 million children and adults covered by these programs. 

National health reform policy

Beginning in February 2017, the AMCHP Government Affairs and HST teams will host monthly all-member calls to discuss policy changes and respond to member inquiries regarding the Affordable Care Act, Medicaid and other programs of importance to the MCH community. Updates will be sent out frequently through Member Briefs and AMCHP Legislative Alerts. As always, the HST team is readily available to AMCHP members for consultation and technical assistance on all MCH health reform-related matters.

National Performance Measure implementation support

As part of AMCHP's 2016 webinar series on the new MCH national performance measures (NPMs), the HST team hosted a webinar in January on NPM 15 – percent of children ages 0 through 17 who are adequately insured. In the year to come, the HST team will lead a community of practice  for the life course NPMs (13-15). This platform will serve as an opportunity for states to share strategies, best-practices, challenges and solutions in meeting these performance measures.

The HST team looks forward to engaging AMCHP members and partners throughout 2017, as the scope and impact of health reform continue to unfold.