« Health Innovation Highlights: December 12, 2019 Issue

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DIRECTOR’S CORNER

Looking Back on the Center's 2019 Highlights

 

Ann Hwang, MD
Director, Center for Consumer Engagement in Health Innovation

As 2019 draws to a close, I’m pleased to share some highlights from the Center’s work. In a year which saw continued attacks on the safety net for low-income people, I am proud of the work we’ve done together to make health care more responsive to the needs of the people it serves – particularly those with the most complex health and social needs.

In the beginning of the year, we laid out five policy areas we are emphasizing in our work: better addressing patients’ and communities’ social needs; incorporating robust consumer engagement; improving coverage and care for beneficiaries who are dually eligible for Medicare and Medicaid; developing sustainable mechanisms for financing long-term care services; and advancing primary care. You can read more here about how we are approaching these five areas of work and why we are focusing our efforts in these areas.

In the spring, we reported on the impact of our work to date through two key reports. The first is “IMPACT! How Consumers Have Shaped Health System Delivery Reform” which captures how a strong consumer and community voice has improved policies and programs for people with complex health and social needs. The second is the evaluation of Consumer Voices for Innovation, our two-year program to engage people with complex needs in shaping health policies and programs. This evaluation showed that over two years, our partners in this program reached nearly 30,000 consumers, trained over 1,000 of those for leadership activities and that programs in every state incorporated changes recommended by consumers.

But some impact can’t be captured in numbers. To tell the power and importance of consumer advocacy, we released a video this summer about families in Tennessee who are working to improve services for people with intellectual and developmental disabilities through their advocacy around a new state Medicaid program.

Over the course of this year and next, we are working with subgrantees in seven states to organize consumers to expand the ways health systems are addressing food, transportation and housing in their communities. And through the support of the Kresge Foundation, we began work this fall with three subgrantees from historically marginalized or disadvantaged communities to train grassroots leaders and pursue state and local policies that increase health care investment in community-driven priorities. This work builds on previous efforts in three communities to engage hospitals through community benefit, and I’m excited to see this next phase of groundbreaking local work unfold.

To end the year, our research director, Marc Cohen, testified before the Senate Finance Committee about the importance of long-term care. Meanwhile, we released findings from focus groups with consumers with complex needs to better understand their experiences with and attitudes about primary care, and the intersection between the primary care relationship and social determinants of health.

And finally, we were thrilled to meet with so many partners in Washington, D.C. in November to share ideas, make connections and strengthen our work together. While in Washington, we had the chance to recognize four individuals who are working tirelessly to improve the health of their communities through the announcement of our 2019 Speak Up for Better Health Awards. This year’s winner, Germán Parodi, is a leading disability rights advocate in Pennsylvania who is working to ensure people with disabilities and older adults have equal access to emergency and disaster resources before, during and after disasters. You can read more about Germán and meet our three outstanding honorees here.

As we approach the end of 2019, I am filled with gratitude for our colleagues, our fellow advocates, our partners and our champions. Thank you for your ongoing commitment to ensuring that our health system meets the needs of vulnerable consumers and communities, even in a time when some of our most fundamental values are under attack. Thank you for being part of the Center family.

I wish you peaceful, restful holidays and look forward to working with you in the new year.

FROM THE CENTER & OUR PARTNERS  

New Report Shares Consumers’ Vision for a Person-Centered Primary Care System

A new Center report presents findings from focus groups conducted to better understand consumer experience with and attitudes about primary care and the intersection between the primary care relationship and social determinants of health. This work focuses on marginalized consumers of health care, including people who are low-income, who come from communities of color, whose primary language is not English, who are elderly and/or who have complex health needs. The report“In Their Words: Consumers’ Vision for A Person-Centered Primary Care System,” presents five aspirations that emerged from the focus groups, amplified with quotes from the group participants.

2019 Speak Up for Better Health Award Winner and Honorees Announced!

The Center announced the winner and honorees of the 2019 Speak Up For Better Health Awards at our public event held on Nov. 20 in Washington, D.C. This year’s winner, Germán Parodi, is a leading disability rights advocate in Pennsylvania who is working to ensure people with disabilities and older adults have equal access to emergency and disaster resources before, during and after disasters. You can read more about Germán and meet our three outstanding honorees here.

Blog Recap: Important Developments in Medicare and Medicaid

This month, two new blog posts from the Center highlighted the importance of continued advocacy around Medicare and Medicaid. Our post on the executive order issued in October raises concerns about the trend toward privatizing the Medicare program through increased enrollment in Medicare Advantage plans over traditional Medicare. The current proposal is vague, but does raise some serious red flags that advocates should keep a close eye on. Our recap of the release of the Kaiser Family Foundation’s annual Medicaid survey lifts up the successes and importance of consumer engagement. It also highlights important advances being made in some state Medicaid programs, along with the continuing and escalating threats to the program in other states.

Massachusetts Partner Helps Highlight Threats of Additional Looming SNAP Cuts

A November article on The Boston Globe’s Boston.com website featured the story of an 80-year-old Massachusetts woman named Jackie – a member of the Massachusetts Senior Action Council, a Center CVI 2.0 program partner – in which she shares her concerns about the administration’s efforts to curtail the Supplemental Nutrition Assistance Program (SNAP), based on utility allowance calculations.

Among the Trump administration’s recently released proposed rules for SNAP is one that would change the way utility costs, such as heating and cooling, are calculated. While the USDA estimates benefits will be cut for 19 percent of households nationwide and increased for 16 percent, those cuts would primarily affect cold northern states where heating costs are high. Older adults and low-income working families would be disproportionately affected. Speaking for thousands of people across Massachusetts who depend on SNAP to help meet their nutritional needs, “It’s just going to be tightening the belt more,” Jackie said of the proposed cuts. “And I don’t know how much more I can tighten it.”

NOTEWORTHY NEWS & RESOURCES

Supporters of Medicaid Transportation Coverage Seek Congress’ Help

In response to the Centers for Medicare and Medicaid Services (CMS) signaling that it will consider loosening requirements that state Medicaid programs provide non-emergency medical transportation (NEMT), state advocates are imploring Congress to intervene to prevent a rollback in this vital benefit. While advocates initially expected these rollbacks to be delayed until 2021, CMS is now quickly moving forward with the proposed plan. The loosened regulations would make NEMT an optional benefit, which could have a devastating impact on consumers who rely on this benefit for independent daily living and access to their health care providers.

Video on Member Advisory Councils: Listening to the Voices of Dually Eligible Beneficiaries

A video created by Resources for Integrated Care (RIC) highlights meaningful consumer engagement through member advisory councils. The video includes interviews with members, a caregiver, health plan staff and health plan executive leadership sharing their perspectives on successful member advisory councils. These councils are one valuable way health plans can engage consumers who are dually eligible for Medicare and Medicaid in plan governance.

Among the three plans featured in the video is CareSource Ohio, whose member advisory council was trained by Community Catalyst and our partners at Ohio Consumer Voices for Integrated Care. Representatives from all three featured plans were speakers in RIC’s member engagement webinar series earlier this year. 

Making the Case for Medicare-Medicaid Integration by Medicaid Agencies

ADvancing States, in partnership with the Center for Health Care Strategies, released a brief that highlights the value of integrated care for state Medicaid agencies. The brief features insights from state leaders who have launched integrated programs and provides evidence for investing in state infrastructure to build more integrated systems of care for consumers dually eligible for Medicare and Medicaid. It also covers the current landscape of integrated care models and presents policy findings on the value of integration.

Envisioning the Future of Home Care: Trends and Opportunities in Workforce Policy and Practice

The Paraprofessional Healthcare Institute (PHI) recently released a report that takes a comprehensive look at the home care workforce and provides a detailed vision for improving home care access and quality. This report brings attention to the growing unmet needs of the home care workforce, which provides more paid support than any other segment of the home and community-based services workforce. Sustainable long-term care remains a priority for the Center, and this research provides the crucial job quality, payment, training, technology and home care recommendations needed to improve outcomes for the 15 million adults who need some degree of personal assistance.

STATE HIGHLIGHTS

Arizona

The Arizona Health Care Cost Containment System (AHCCCS) launched the Whole Person Care Initiative (WPCI) last month to explore technology that will facilitate screening for social risk factors and referral of members to community resources. The focus will include transitional housing, non-medical transportation and peer support programs.

Florida

The state launched a five-year housing assistance program for homeless Medicaid beneficiaries in Central Florida battling serious mental illness or addiction to help them get — and keep — housing. The Orlando Sentinel reports that the program, launched Dec. 1, will help cover wrap-around services like counseling, transitional housing services, tenancy sustaining services and mobile crisis management teams that respond in mental-health emergencies and one-time payments for moving expenses.

Maine

The Press Herald reports that the state of Maine will undergo several changes to improve its Medicaid transportation system. The idea is to consolidate various transportation services, including non-emergency medical transportation, under one umbrella. After a rough start in 2013 when the state switched from a fee-for-service system run by nonprofits to a private brokerage system, the state made a number of improvements to avoid consumers missing medical appointments. The governor is now pushing for further reforms to the system and has convened a working group to come up with recommendations. The working group has already suggested standardized safety and performance standards for all ride services, such as on-time performance and background checks on drivers.

New Jersey

New legislation was introduced that would replace the New Jersey Medicaid Accountable Care Organization (ACO) demonstration project with a Regional Health Hub Program, which would designate existing Medicaid ACOs and look-alike organizations as Regional Health Hubs. The 3-year ACO program was started in 2015 and given a one-year extension. This bill would require the state’s Department of Human Services to establish the Program and to designate and certify Regional Health Hubs in appropriate areas of the state.

North Carolina

The News & Observer reports that the North Carolina Department of Health and Human Services suspended the state’s transition to Medicaid managed care due to lack of action by the Assembly on the budget. The transition was scheduled to start Feb. 1, 2020. Approximately 70,000 Medicaid members have already enrolled in one of the five Medicaid managed care plans contracted by the state but now the change will not happen and beneficiaries will stay in fee-for-service.

Pennsylvania

Last month, the state released results of a study on the impact of supportive housing programs on long-term health and health care spending among Medicaid recipients experiencing homelessness. The study was conducted by the University of Pittsburgh Medicaid Research Center of 5,859 individuals enrolled in Medicaid between 2011 and 2016. Among the population studied, 90 percent had a minimum of two chronic health conditions, and 43 percent had seven or more. After introducing permanent supportive housing services, spending stabilized and declined. The study also found that by the third year after beginning permanent supportive housing, total Medicaid spending fell by an average of $162 per person, or 13 percent, each month.

KEY DATES