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Financing Prevention

How states are balancing delivery system & public health roles

Good Governance

States have the opportunity to create a new balance in how community-based interventions are financed by capitalizing on health care delivery system mechanisms.

This report, developed by NASHP and produced by ChangeLab Solutions, focuses specifically on state health policy and the unique role that state governments can play in building bridges between the public health and health care sectors. The report also highlights leading states’ approaches to support community-based prevention initiatives by bridging the health care delivery and public health systems. It examines various mechanisms – both previously existing and created through health care reform – that states can leverage to implement sustainable community-based prevention programs and build a culture of health. They include Medicaid waivers, federal grants, accountable care and medical home models, pooled funding, and new federal requirements for nonprofit hospitals.

The report looks at how eight leading states – California, Maryland, Massachusetts, Minnesota, North Carolina, Oregon, Texas, and Vermont ­– have combined many of the new policy levers and resources offered through the Affordable Care Act with existing state authority to create a new balance between the health care delivery and public health systems with the ultimate goal of the Triple Aim: improving care and health outcomes, and reducing costs.