Gathering Light: Year-End Reflections

  | by Ann Hwang, MD   |  SHARE f t

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This final 2016 edition of Health Innovation Highlights comes to you on the Winter Solstice. For those of us in the Northern Hemisphere, today we experience the inflection point from the days getting shorter, to the gift of a few more minutes of daylight each passing day through winter and spring. In other words, we enter a phase of “gathering light,” even as we prepare for our coldest months.

In these coldest months, we face threats to health coverage, access, innovation and quality. Along with our colleagues here at Community Catalyst and in coalition with health care and social and economic justice groups nationwide, we are fighting efforts to take away health care, particularly from those who are most vulnerable, like older adults, individuals with disabilities, and those with complex health and social needs.

As we prepare for the year ahead, I’d like to spend a few moments during this holiday season to reflect on the many things for which we are grateful. We’ve been blessed to have had the chance to celebrate many successes – not just of the Center, but our partners as well – in our mission to elevate the consumer voice as the key to health system innovation.

A few highlights from our first trip around the sun:

Launching the Center: At our January launch, Dr. Donald Berwick called on all of us to think about health beyond the traditional enclaves of the health care system and in the context of communities. He observed, “The new news is that to achieve health and justice, we have to reconsider and redesign the very fabric of what we call health care today.” His words, and the insights shared by panelists John Arnold, Amy Berman, Stuart Butler, Robert Crittenden and L. Toni Lewis, gave us our marching orders to create a health care system that better meets the needs of all.

Supporting Maryland’s Faith Community Health Network: In February, the Maryland Citizens’ Health Initiative, a longtime Community Catalyst partner, in collaboration with LifeBridge Health and faith leaders from throughout the state, launched the Maryland Faith Community Health Network with a training retreat for participating clergy and lay leaders. The concept is simple and effective – connect liaisons from participating congregations with congregants who are in the hospital to help them get the most out of their inpatient care and get the services and assistance they need once they are discharged.

Helping consumers prepare for Managed Long-Term Services and Supports in southwestern Pennsylvania: In June, we were welcomed to Pittsburgh by the Jewish Healthcare Foundation to lead a training for community and consumer groups. We were honored to play a role in helping these groups prepare for and engage in the launch of the Community HealthChoices program. We believe that the active engagement of consumers and community members will be critical to ensure that this program ultimately provides better, more coordinated care to Medicaid beneficiaries who need long-term services and supports.

Documenting best practices in consumer engagement in Medicaid ACOs: Medicaid accountable care organizations (ACOs) are an increasingly popular option for improving the quality of care and health outcomes while containing health care costs. But if Medicaid ACOs are to be successful, members and communities served by these programs must have a voice in their design, implementation and ongoing oversight. We dug into program documents and debriefed consumer advocates engaged in the design and rollout of these new programs to learn about what is working and what isn’t, and to identify ways that health care organizations can encourage meaningful consumer engagement.

Fighting to improve transportation services for low-income individuals: We have been hearing consumer horror stories from partners across the country about non-emergency medical transportation (NEMT). NEMT is a critical service that helps Medicaid beneficiaries without access to transportation get to doctors’ appointments, dialysis and cancer treatment. We have heard about children with compromised immune systems sharing transportation with sick individuals, patients with kidney failure who can’t get to their dialysis treatments and elderly people who are abandoned for hours at the doctor’s office. To address this issue, we are coordinating consumer organizations that are working to improve NEMT in their states. We also worked with our friends at Justice in Aging on a brief that highlights recommendations that policymakers and advocates can adopt to improve NEMT across the country.

Protecting care for people with disabilities in Massachusetts: In Massachusetts, advocates for people with disabilities scored a significant win when MassHealth, the state’s Medicaid program, backed off its proposed limits on personal care attendant hours. Disability advocates organized to raise awareness about how harmful the proposed limits could have been for the elderly and people with disabilities, who depend on personal care attendants to help them live with independence and dignity. While the fight is not over – the state loosened its restrictions but didn’t eliminate them entirely – the work of the advocates, on a very short timeline and in the midst of many other battles, was impressive indeed.

Bridging the gaps between health and housing: Every day, doctors and nurses care for people with serious illness who live in shelters, on the streets or in unsafe housing. And we know that unless we address these patients’ need for safe and secure housing, they will be back to the emergency room and hospital again and again with ever-worsening (and more expensive) conditions. In Pennsylvania, our partner Pennsylvania Health Access Network launched a collaborative Housing as Health campaign that brings together a statewide coalition of physical and behavioral health care providers, social services, housing-related entities, faith and community groups, advocates, and people enrolled in Medicaid to build a case for supportive housing services. Our state partners have been successful in elevating the issue of housing as a social determinant of health that should be prioritized by educating communities and policymakers, sharing the impact and savings of supportive housing services and sharing personal stories that illustrate the importance of their campaign.

Building the consumer voice in Rhode Island’s dual eligible demonstration project: In Rhode Island, advocates played a major role in the creation of a new Implementation Council to guide the state’s dual eligible demonstration project. Our state partners, Rhode Island Organizing Project (RIOP) and Senior Agenda Coalition, were instrumental  in everything from the drafting of the bylaws, to training of consumers as they take their places on the council. We hope that these strong consumer voices will help steer this demonstration toward truly person-centered care.

The “lights” that I’ve gathered here – and so many more that space doesn’t allow for – illustrate the dedication, passion and commitment of the consumers, consumer health advocates, providers, health care leaders, and others we at the Center have had the honor to encounter, learn from and collaborate with in our first year. Even as we confront the challenges ahead, I know that we will continue to gather light, on our journey to consumer-centered care.  In this holiday season, I wish you peace and light in the year to come.