Improving Health System Performance Legislative Staff Seminar 2018


Summary: This invitational meeting, sponsored by NCSL and supported by The Commonwealth Fund (TCWF), brought together professional state health policy staff to learn about and discuss state strategies to improve health system performance, payment reform and service integration to make health systems more efficient and effective. Presentations and resources are now available to NCSL members.

Meeting materials:


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WednesDay, Oct. 10
Time Sessions  (Includes all session segments with available linked resources)
5:45-8 p.m.

Welcome, Introductions and Opening Session, A High-Performing Health Care System
This session will provide a brief overview of the meeting and highlight both NCSL’s mission and legislative staff opportunities and The Commonwealth Fund’s mission and work to promote a high-performing health care system that achieves better access, improved quality and greater efficiency. Participants will introduce themselves.



  • Laura Tobler, division director, State Policy Research, NCSL
  • Rachel Nuzum, vice president, Federal and State Health Policy, The Commonwealth Fund


  • Peter Croughan, chief of staff to the Secretary, Louisiana Department of Health & Human Services


ThursDay, Oct. 11


9-10:15 a.m.

State Health System Performance: What We Know and Why It Matters
This session will provide an overview of health system performance at the state level. It will highlight key areas of The Commonwealth Fund’s scorecard and areas and strategies for improvement.



  • Laura Tobler, division director, State Policy Research, NCSL


  • Eric Schneider, M.D., senior vice president, Policy and Research, The Commonwealth Fund

State respondents:

  • Utah: Mark Andrews, policy analyst
  • Nevada: Marsheilah Lyons, chief principal policy analyst
  • Colorado: Elizabeth Haskell, constituent services
10:30 a.m.-12:30 p.m.

Medicaid: Innovations in Coverage, Delivery and Financing

States continue to implement innovations in their Medicaid programs to expand access to care, improve health status and make programs more effective and efficient. From payment and delivery reforms to new federal waiver options, state policymakers have a variety of issues to consider when considering changes to their Medicaid programs.



  • Rachel Nuzum, vice president, Federal and State Health Policy, The Commonwealth Fund


  • Dianne Hasselman, deputy executive director, National Association of Medicaid Directors (NAMD)
  • Joan Alker, executive director, Center for Children and Families, Georgetown University and Research Professor, McCourt School of Public Policy
  • Karen Llanos, director, Medicaid Innovation Accelerator Program, Center for Medicaid and CHIP Services

State respondent:  

  • Arkansas: Jessica Beel, Legislative Attorney
2-4 p.m.

Addressing the High Cost of Complex, Chronic Conditions


People with chronic health conditions who also have a mental illness or substance use disorder are among the highest cost patients. In addition, the opioid epidemic has exacerbated problems with over-burdened health and behavioral health services. This session will explore how integrating care can help improve quality, improve patients’ health and help contain costs. It will also highlight promising practices for addressing challenges related to opioid misuse.


  • Kate Blackman, group director, Health Program, NCSL


  • Melinda Abrams, vice president, Delivery System Reform, The Commonwealth Fund
  • Ben Miller, chief strategy officer, Well Being Trust
  • Dr. Rochelle Head-Dunham, executive and medical director, New Orleans Metropolitan Human Services District; former assistant secretary and medical director, Office of Behavioral Health, Louisiana Department of Health
FriDay, Oct. 12
8:30-10 a.m.

Exploring Strategies to Fix the Private Health Insurance Market



With headlines that indicate some health plans withdrawing from exchanges and costs that continue to rise, what does this mean for states? What do the Trump administration’s policy changes mean for states, such as association health plans? As states anticipate this year’s marketplace enrollment and changes in state insurance oversight, hear and share what roles legislatures will play. Will fresh state ideas and 1332 waivers emerge from more state capitols?



  • Colleen Becker, policy specialist, NCSL  


  • Sara Collins, vice president, Health Care Coverage and Access, The Commonwealth Fund
  • Kevin Lucia, JD, research professor and project director, Center on Health Insurance Reforms, Health Policy Institute, Georgetown University, Washington, D.C.
  • Wesley Miller Director of Health Policy & Association Affairs, Blue Cross Blue Shield of Louisiana.

State Respondents

  • Alaska: Jean Mischel, Assistant Revisor, AK Legislative Staff
  • Wisconsin: Tamara Dodge, Senior Legislative Attorney, Legislative Reference Bureau


10:15-11:30 a.m.

Prescription Drugs: What Can States Do?
Prescription drugs provide life-saving treatments and help control diseases and debilitating conditions. They also present legislators and other policymakerrs with challenges, including affording some of the new “miracle drugs” for Medicaid patients and state employees. This session will highlight a range of prescription drug issues, including new laws in dozens of states and fast-paced developments from federal agencies.


  • Dick Cauchi, program director, NCSL  


  • Shawn Bishop, vice president, Controlling Health Care Costs and Advancing Medicare, The Commonwealth Fund
  • Anne Winter, principal, Health Management Associates; former director at Arizona Medicaid, Arizona
  • Sandra Wilkniss, program director, NGA Center for Best Practices, Health Division, National Governors Association, Washington, D.C.

State Respondents:

  • Vermont: Jennifer Carbee, deputy chief counsel, VT legislative staff
  • Oklahoma: Will Robinson, Fiscal Analyst, OK Senate
    Oklahoma: Scott Tohlen, Research Analyst & Comm. Staff, OK House
12:30 pm



NCSL gratefully acknowledges The Commonwealth Fund for supporting this meeting.


The Commonwealth Fund is a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. The views presented here are those of the presenters and not necessarily those of The Commonwealth Fund, its directors, officers, or staff.