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Over the past five years, the Center has become a national leader in championing a consumer and community-driven health system that is just and equitable. Help us find someone to lead our next chapter! The ideal candidate for our new director will be mission-driven, entrepreneurial, committed to racial justice and able to serve as a national thought leader on health care delivery and payment reform.

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DIRECTOR’S CORNER

Change in the Air

Caption: At-Home (on Zoom!) with Vice President-Elect Kamala Harris and Her Family | ELLE Exclusive, available at https://www.youtube.com/watch?v=msGlzVDdWBg. 

Renée Markus Hodin
Deputy Director, Center for Consumer Engagement in Health Innovation

We have much to celebrate as we recognize Black History Month and see the Biden-Harris administration begin to make real its campaign promises around health and racial justice.

This year’s Black History Month theme is The Black Family: Representation, Identity, and Diversity. And to examine that theme, we need look no further than to our newly sworn-in Vice President, Kamala Harris. Vice President Harris is the embodiment of Representation, Identity and Diversity. As has been widely reported, she is the first woman, the first Black American and the first Southeast Asian American to serve in the role. Add to that her role as “Momala” to her stepchildren and it’s clear she has a unique view into the many ways that families are diverse and the richness that arises from that diversity. That diversity was on full display at last month’s Inauguration.

But after that inspiring day, the work began. And what a busy few weeks it’s been! On Day 1, suggesting where the administration’s top priorities lie, President Joe Biden signed an Executive Order affirmatively acknowledging the responsibility of every federal department and agency to advance equity, civil rights, racial justice and equal opportunity. By doing so, the administration is explicitly calling out structural racism and taking steps to dismantle it.

On Day 9, continuing his ambitious series of signings, President Biden signed an Executive Order creating a three-month Special Enrollment Period (SEP) starting this month that will allow more Americans to get coverage. As the pandemic rages on, and given that COVID-19 has disproportionately impacted Black and brown communities, this SEP is a vital step to protect people in this moment, as well as to help address longstanding health inequities.

This is a good start for sure. And while there’s so much left to do – both to unwind the harm of the previous administration as well as to create a COVID-19 relief package that advances health justice – we at the Center look forward with the hope that the arc of the moral universe is bending toward justice once again.

FROM THE CENTER & OUR PARTNERS

Community Catalyst Details Legislative Priorities for the Next COVID-19 Relief Package

Last week, Community Catalyst released the second brief in a three-part series focused on actions the new administration must take to promote health equity, Unfinished Business: Legislative Priorities for a 2021 COVID-19 Relief Package. Unfinished Business posits that the COVID-19 relief bill passed in December 2020 was insufficient in addressing the deep structural inequities in our policies and programs, which then result in disparate rates in health opportunity and economic security. This brief details the four key policy domains vital to advancing health justice in the next COVID-19 relief package, including a national vaccine strategy; affordability and coverage; access and quality; and the social factors that affect people’s health. Read the full report here to learn more about the short-term steps to jumpstart a movement to address inequity during the pandemic and beyond.

The new brief follows Undoing the Harm, which identified specific actions the new administration should urgently undertake within its first 100 days.

The State of Person-Centered Care for Older Adults

The Center and the LeadingAge LTSS Center @UMass Boston released a report and infographic in January that provides the first ever look at how person-centered care models are working (or not) for older adults.

The authors analyzed the 2014 and 2016 Health and Retirement Study, finding roughly one-third of older adults reporting that their preferences were only rarely or sometimes taken into account and that results varied greatly by race.

When preferences are ignored, older adults are more likely to forgo medical care and report lower satisfaction. New efforts are needed to strengthen and advance person-centered care, particularly for Black and brown people and those with low incomes. We hope these resources provide a wake-up call and guidance about the need to continue reforming the care of older adults.

Calling for a Renewed Commitment to Community Partnership to Address Racial Inequities

A new blog post co-authored by Center Deputy Director Renée Markus Hodin and four other experts in consumer engagement and/or health transformation addresses the ways in which the health care sector can take concrete actions to advance the work of improving health equity and combatting disparities, especially the racial inequities made evident by COVID-19. As health care organizations continue to struggle with the challenges presented by the pandemic, some may see consumer and community engagement as ranking low in the list of priorities, at least until the pandemic is over. However, the authors point out that now more than ever, it is crucial that health systems find meaningful ways to stay connected to the people they serve, while also prioritizing person-centered care. This is especially critical in light of COVID-19’s disproportionate impact on Black and brown people and low-income communities. The blog post points to a set of case studies and a change package developed by the Center and the Health Care Transformation Task Force (HCTTF) to help forward-thinking organizations with this important undertaking.

This blog post is part of an ongoing, collaborative project between the Center and the HCTTF, funded by the Robert Wood Johnson Foundation. The other authors are Joshua Traylor, a director for the Health Care Transformation Task Force; Hala Durrah an independent patient family engagement consultant and Founder of Patient Advocates Transforming Healthcare; Pam Dardess, vice president for strategic initiatives & operations at the Institute for Patient- and Family-Centered Care; and Thomas Leyden, director of Blue Cross Blue Shield of Michigan’s Value Partnerships program.

Member Engagement and Plan Governance Resources

Center partner Resources for Integrated Care has issued three new resources related to membership engagement for health plan governance. These tip sheets are the fruition of work involved in the

 (ICCoP), a learning community that included 13 different plans serving individuals dually eligible for Medicare and Medicaid. They sought to incorporate meaningful member feedback into an organizational governance structure, with the ultimate goal of beneficiaries receiving more integrated and coordinated care. The first tip sheet, Engaging Members in Plan Governance During COVID-19: Tips for Health Plans, was created by the Center and the subsequent tip sheets, Encouraging Member Participation in Governance: Spotlight on Innovative Stipends and Incentives and Recruiting, Refreshing, and Retaining Council Membership: Tips for Health Plans resulted from lessons learned through the ICCoP.

Helping Older Adults Take Charge of their Health

Join the Center for a webinar on Tuesday, March 9 from 1 – 2 pm EST to learn about educational materials that older adults and caregivers co-designed that address the Age Friendly Health System Initiative’s 4Ms – Medication, Mobility, Mind and What Matters. Presenters include the Center’s Carol Regan and a representative from Rush Medical Center GWEP (Geriatric Workforce Enhancement Program) – Catch-On. Materials will soon be available in English and Spanish on the Center’s website for use by community-based organizations and others who advocate for better care for older adults. To register, click here.

NOTEWORTHY NEWS & FEATURES

What Works to Improve Care for Dual Eligible Individuals: An Evidence and Resource Review

The Better Care Playbook released an evidence and resource review on Medicare-Medicaid integration including promising strategies for implementing integrated care program and delivery models. The review highlights data on the needs of dually-eligible individuals and discusses several studies which demonstrate the success of models integrating Medicare and Medicaid in creating better health outcomes for dually eligible individuals. It also provides a list of implementation and technical assistance resources for advancing integration targeted toward health plans and providers, as well as state Medicaid agencies. A more detailed list of resources is included in the accompanying reference guide.

Spotlight on Health Equity and Racial Justice

Several new resources illuminate racial inequities in our health system and offer strategies for addressing those inequities in order to achieve racial justice.

• In a Generations article, the American Society on Aging reports on the disproportionate impact of COVID-19 on people of color, older adults, and their caregivers and calls for a racial justice response that emphasizes systemic solutions. The article outlines 10 racial equity strategies to integrate into the country’s national response and serve as recommendations for leaders in aging services, the private sector, federal and state lawmakers. Some of the highlighted racial equity strategies include collecting stronger racial disparity data on COVID-19, transforming the direct care workforce, and ensuring an equitable distribution of vaccines and treatment which address people of color’s historical mistrust in the system.
• The Center for Health Care Strategies and the Institute for Medicaid Innovation authored a report which identifies six connected strategies to guide payers, including Medicaid agencies and managed care organizations, in developing equity-focused value-based payment approaches to mitigate health disparities at the state and local level. The six strategies include: (1) articulating an equity goal; (2) assessing the payment and care delivery environment; (3) selecting performance measures; (4) setting performance targets; (5) designing the payment approach; and (6) addressing operational challenges.
• The Root Cause Coalition published a report with results from a questionnaire that surveyed Americans on their perspectives and attitudes toward addressing the social determinants of health and achieving health equity. Most consumers reported not knowing or not understanding the terms “social determinants of health” or “health equity.” However, when presented with definitions a majority of consumers in the survey believe it is important to address the social determinants of health and deem economic stability in particular as one of the most central factors to health.

Older Adults Without Help of Family or Friends Struggle to Get Vaccines

An article by Kaiser Health News details the divide between older adults with friends and family and those without, in access to the COVID-19 vaccine. Those who can drive, or who have family members or friends to help them, have the ability to travel further and are getting vaccine appointments. On the other hand, those without social supports face limited availability nearby. These barriers disproportionately impact older adults who are Black and Hispanic, non-native English speakers, low-income, and/or seriously ill or homebound. These findings come at a time when preliminary evidence already shows that Black individuals are being vaccinated at a far lower rate than white individuals.

Finding and Analyzing Medicaid Quality Measures

The National Health Law Program produced a brief with tools that enable advocates to find the major sources of state and plan-level Medicaid quality data, to learn how to evaluate and compare results, and to use those skills to improve data transparency and to push states to hold plans accountable to their mission: to manage care effectively and efficiently. The brief is part of a broader series intended to help advocates find and use Medicaid managed care oversight and quality data to bolster their advocacy.

STATE HIGHLIGHTS

California

Last month, the Department of Health Care Services (DHCS) released a revised California Advancing and Innovating Medi-Cal (CalAIM) proposal in conjunction with the Governor’s budget release. CalAIM is intended to leverage Medicaid as a tool to help address the complex challenges that California’s most vulnerable residents face. As a part of CalAIM, the DHCS is also establishing a CalAIM Managed Long-Term Services and Supports (MLTSS) Duals Integration Workgroup. The goal of the workgroup is to collaborate with stakeholders on the transition of Cal MediConnect (CMC) to a statewide MLTSS and Dual Eligible Special Needs Plan (D-SNP) aligned enrollment structure. 

Illinois

Late last year, the Illinois Department of Healthcare and Family Services proposed a new equity-centric plan to transform health care in the state. If implemented, the proposed plan will provide resources to pilot projects and planning grants to address both health care and social determinants of health, stress the importance of collaboration between community-based organizations and one unrelated health care provider, and make certain that health equity is central in each project.

Pennsylvania

Last month, Pennsylvania’s Interagency Health Reform Council (IHRC), created by an executive order signed by Gov. Tom Wolf, released a set of recommendations aimed at addressing health care costs, access and equity in the state’s health care system. Key recommendations include:

• Creating a Health Value Commission to Institute Health Care Cost Benchmarking
• Addressing Health Equity – defined as everyone having a fair and just opportunity to be healthier
• Integrating Social Services into the Delivery of Health Care

Additional recommendations with details are in the IHRC’s report.

South Carolina

The South Carolina Department of Health and Human Services announced that the Healthy Connections Prime program, the state’s duals demonstration, has extended contracts with current health plans for an additional three years. In addition, three new health plans will enter the demonstration program: Healthy Blue by Blue Choice of South Carolina, Humana and United Healthcare.

KEY DATES

Wednesday, Feb. 17 (1-2 p.m. Eastern) - Webinar: Older Adults and the Mental Health Effects of Covid-19, presented by the National Council on Aging. Please register for the webinar.  

Wednesday, Feb. 17 (6-7 p.m. Eastern) - Webinar: Fruit of America's Poisonous Tree: The Political Determinants of Health and Opportunities to Optimize Health, a talk by Daniel Dawes, J.D., presented by the GW Kahan Health Law Initiative. Please register for the webinar.  

Thursday, Feb. 18 (2-3 p.m. Eastern) - Webinar: Functional Assessment Standardized Items (FASI): Steps Toward Adoption, presented by the Centers for Medicare and Medicaid Services. Please register for the webinar.  

Friday, Feb. 19 (2-4 p.m. Eastern) - Webinar: Older Adults and COVID-19: Implications for Aging Policy and Practice, presented by The New School, UMass Boston, and Journal of Aging & Social Policy. Please register for the webinar.

Thursday, Feb. 25 (3-4 p.m. Eastern) - Webinar: Best Practices and Strategies for Tele-Social Care, co-presented by The Center for Health & Social Care Integration and the National Center for Complex Health and Social Needs. Please register for the webinar.  

Tuesday, March 9 (1-2 p.m. Eastern) - Webinar: Helping Older Adults Take Charge of their Health, presented by the Center for Consumer Engagement in Health Innovation and Rush Medical Center GWEP. Please register for the webinar.  

Thursday, April 15 - Application Deadline:  Applications due for the Health & Aging Policy Fellows Program (2021-22). Please click here for an overview of the fellowship, including program tracks, eligibility and selection criteria, and application information.