Director's Corner: Person-Centered Care – Sharing Evaluation Results, Progress and Threats

Last week, I had the pleasure of joining health care and public health leaders at a Kaiser Permanente-sponsored Washington Post Live event to talk about how health care can better address social needs and social determinants of health. I was gratified that the conversation acknowledged the need to change policy and to build the leadership of diverse communities in this effort: two topics that we cover in this month’s issue of Health Innovation Highlights.

First, on consumer leadership, I’m honored to share the results of the final evaluation of our Consumer Voices for Innovation (CVI) program. Two years ago, we set out to understand how we could engage consumers with complex health and social needs and best support them in developing powerful voices in the shaping of delivery system reform. We supported consumer advocacy organizations in six states in identifying, organizing and supporting consumer leaders, particularly people from low-income communities, people of color and/or older adults. Advocates and consumer leaders worked to influence delivery system reform efforts happening in their community or state – to make these programs more person-centered.

Over two years:

  • Nearly 30,000 consumers were reached
  • Over 1,000 new consumer leaders were trained and engaged in leadership activities
  • Programs in all participating states incorporated changes recommended by consumers

I am grateful to the advocates and consumer leaders who made this work such a success, and I hope you’ll take a few minutes to read the report and share your feedback.

Second, on policy change – the (potentially) good kind:

This month we feature a post I authored for The Commonwealth Fund’s “To The Point” blog on improving care for people who are enrolled in both Medicare and Medicaid (dual eligibles), as well as an article in the American Journal of Managed Care about how the Medicare Star ratings system – a “report card” for Medicare health plans – measures patient-centered care.

And if you’re having trouble keeping up with all of the news related to care for dual eligibles, you’re not alone! In the past few weeks, we’ve seen new rules for the Program of All-Inclusive Care for the Elderly (PACE), read new evaluation reports for the Financial Alignment Initiative demonstrations in Texas and Massachusetts, and submitted comments on a proposal by the Center for Medicare and Medicaid Innovation to create regional organizations to serve Medicare beneficiaries, including dual eligibles.

To help make sense of what’s happening in policies affecting the dually eligible population, we’ll be co-hosting a webinar on June 20 with The Commonwealth Fund, Melanie Bella from Cityblock Health, Cheryl Phillips from the SNP Alliance, and Michelle Herman-Soper from the Center for Healthcare Strategies. You can register here.

Finally, policy change – the bad kind. It’s important to recognize that all of our work to improve care is happening in a context of ongoing attacks on access to health care and social services, particularly for people with complex health and social needs. I want to highlight three harmful recent proposals and the current efforts to fight them:

  1. Redefining Poverty: The White House Office of Management and Budget proposes to reduce the number of people defined as “poor” by changing the inflation measure used to periodically update the poverty level. This change would make it harder to qualify for Medicaid, Medicare Part D Extra Help, SNAP, and other basic needs programs and would reduce the amount of Supplemental Security Income benefits people receive. See this blog post from Community Catalyst and read more here. Comments are due June 21.

  2. Evicting Immigrant Families: Earlier this month, the Department of Housing & Urban Development issued a proposed rule that would force 25,000 families with mixed immigration statuses in public housing and Section 8 programs to separate or face eviction. These housing assistance programs support 1.9 million older adults who would otherwise be unable to afford the cost of shelter. If enacted, this proposed rule could cause many of them, both U.S. citizens and noncitizens, to become homeless. Read more here. Comments are due July 9.

  3. Allowing Discrimination in Health Care Programs: At the end of May, the Department of Health & Human Services issued a proposed rule rolling back protections against discrimination in health care programs, established in Section 1557 of the Affordable Care Act. The proposal threatens the rights of LGBTQ people, rolls back protections for older adults with limited English proficiency and limits the way that victims of any type of discrimination can seek redress under the law. See Community Catalyst’s statement. The due date for comments will be announced when the proposed rule is published in the Federal Register.

What do you see happening in consumer leadership and in policy change that is important for person-centered care for people with complex needs? Tweet us at @CCEHI or email us at healthinnovation@communitycatalyst.org.