Health Innovation Highlights: January 14, 2021

Full Edition

DIRECTOR’S CORNER

Soberly Recalibrating In a New Year

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

In each of my holiday cards this year, I wrote some version of the following: “Good Riddance, 2020!” To be clear, I was under no illusions that when the clock struck midnight and 2021 began that all suddenly would be well. Still, the recent approval of the Pfizer and Moderna COVID-19 vaccines offered enormous and legitimate hope. And, through November and December, the courts’ drumbeat of rejections of the validity of a slew of groundless election fraud claims provided a glimpse of hope that we were putting the 2020 election well behind us and moving forward. We could, I thought, begin to shift our focus to improving health and health care and to redoubling our efforts to address the racial inequities that continue to tear at the fabric of our society.

To say that the first two weeks of 2021 have failed to live up to this promise is an understatement of epic proportions. The number of COVID-19 cases and deaths – no doubt fueled by holiday gatherings – has surged to new heights in nearly every part of the country. As of this writing, there have been nearly 23 million documented COVID-19 cases and over 380,000 deaths in the U.S. from the virus, and the daily count continues to rise at alarming rates, particularly in hot spots such as Los Angeles County. Indeed, that county’s public health chief just reported that the virus kills someone there every eight minutes. And the disproportionate impact of the virus on Black and brown communities continues unabated.     

As if these grim COVID-19 statistics weren’t enough to temper my vision for a better 2021, last week we all witnessed the vicious white supremacist attack on the United States Capitol as Congress was assembled to discharge their proscribed Constitutional duty. As Community Catalyst’s press release stated, “[this was an] attack on our country, incited by a president who refuses to accept that millions of voters chose to stand together and fight for each other in electing new leaders who support racial justice, good health for all, and an equitable society.”

To be sure, these are dark days. But still, we at the Center choose to remain hopeful and determined. Hopeful that we will overcome the flawed vaccination rollout and get more shots in arms, prioritizing those groups at highest risk. Determined that we stay fully engaged in combatting persistent structural racism in order to build a just society. And hopeful because, beginning Jan. 20, a new administration will provide leadership in creating a health system that provides equitable access to high-quality health care and good health for all.

FROM THE CENTER & OUR PARTNERS

Colorado Advocates’ Documentary Focuses on "The Essentials"

A new documentary, produced by our Colorado partners at the Center for Health Progress (CHP), “The Essentials,” features the stories of four immigrants dealing with life during the pandemic in three communities. Their stories demonstrate the burden shouldered by immigrant communities during a global pandemic, while also quietly revealing their immense resilience and tenacity. The film reflects CHP’s commitment to addressing the historical and structural barriers that lead to inequitable access to the health care system. The emergence of COVID-19 laid bare how the resulting inequities affect a critical segment of the population – immigrants and undocumented workers. “The Essentials” originally premiered in November for a private virtual audience of members, supporters and policymakers, but it is now available subtitled in both English and Spanish to the public online.

CNN Report: MSAC Highlights SNAP Barriers During COVID-19 

Photo Caption: Richard Smith, 74, a resident of Lynn, MA, and MSAC member, shared his story about barriers to SNAP on CNN.

Despite being one of the wealthiest nations, America has persistent food insecurity concerns, hovering at just over 10% of the population affected in 2019. With the economy shaken by COVID-19, however, that number more than doubled in 2020, with roughly 23% of households now facing food shortages. And the pandemic has created additional barriers for Supplemental Nutrition Assistance Program (SNAP) beneficiaries. 

These barriers were highlighted by Richard Smith, a member of the grassroots-led Massachusetts Senior Action Council, on a recent CNN segment. SNAP limits on home delivery have meant that Smith, like many other older adults with disabilities, has had to risk exposure to the virus in order to get groceries. And while a federal pilot program has expanded home delivery in a few states, including Massachusetts, barriers such as higher prices at participating stores, delivery fees, technical issues and lack of internet access, have prevented many SNAP beneficiaries from using their benefits safely and effectively.

Resources/Events from the NORC Medicaid MCO Learning Hub

Center partner the NORC Medicaid Managed Care Organization (MCO) Learning Hub is committed to providing information on ways to address health equity and transform health care to MCOs, consumer groups, state Medicaid leaders and other stakeholders. Their latest publications include:

Finally, the Learning Hub is hosting a webinar on MCO approaches to meeting the growing housing and social determinants of health needs of their members. Scheduled for Feb. 2 from 2-3 p.m. ET, this webinar will feature representatives from UnitedHealthcare, CVS Health and CareSource who will discuss their housing investment goals, funding strategies and community partnerships for providing support to affordable housing residents. The presentations will be followed by a facilitated discussion and Q&A with the audience. Register here to attend.

NOTEWORTHY NEWS & FEATURES

Moving Ahead Together: Integrating HIV/AIDS & Aging Services

Grantmakers in Aging, as part of their “Moving Ahead Together Initiative,” published a detailed framework of recommendations for strengthening the integration of HIV/AIDS and aging services. The document highlights how the HIV/AIDS services network and aging services network are siloed, leading to gaps in care for the increasing number of older adults living with HIV in the United States. It goes on to provide recommendations to integrate these services through increased understanding, more customized programs, closer cross-sector connection and stronger policymaking. To review a high-level, at-a-glance overview of the framework, see here.

Rethinking Care for Older Adults

The Convergence Center for Policy Resolution released a report on recommendations for transforming the system of care for older adults. With support from the John A. Hartford Foundation, Convergence brought together almost 50 experts on care for older adults in a series of meetings to brainstorm practice and policy changes needed to improve care for older adults. Recommendations identified in these meetings are included in the report and cover opportunities for older adults to remain in their home and alternative business and financing models.

CMS Issues New Roadmap for States to Address the Social Determinants of Health in Medicaid and CHIP

The Centers for Medicare & Medicaid Services (CMS) issued guidance to states for using existing flexibilities under federal law to address the social determinants of health (SDOH) in Medicaid and the Children’s Health Insurance Program (CHIP) with the goal of improving beneficiary outcomes, reducing health disparities and lowering overall costs. Among the services and supports that states can cover under current law are housing-related services and supports, non-medical transportation, home-delivered meals, educational services and employment supports. CMS also noted that value-based care arrangements could provide states with better opportunities to address SDOH.

NASHP: States’ Use of Flexibilities and Emergency Waivers to Support HCBS in Response to COVID-19

The National Academy for State Health Policy (NASHP) developed an interactive map tracking each state’s new flexibilities in Appendix K and emergency waivers, which allow them to modify their home- and community-based services (HCBS) for older adults and their family caregivers during the COVID-19 crisis. The tool includes information on flexibilities in modified 1915 (c) and 1115 waivers and in COVID-19 Public Health Emergency Demonstration 1115 waivers.

Caring for the Future: The Power and Potential of America’s Direct Care Workforce

A new report by PHI provides a comprehensive analysis of the direct care workforce and its critical role in the long-term care system in the U.S. The report offers eight concrete recommendations for policymakers, employers, advocates and other long-term care leaders on how to improve jobs for this rapidly growing workforce.

STATE HIGHLIGHTS

Indiana

The South Bend Tribune reported last month that Indiana has promised to reform the state’s nursing home system in the upcoming 2021 legislative session. Experts suggest five key areas: instituting stringent minimum staffing requirements; limiting the redirection of federal funds away from nursing homes; increasing transparency related to the allocation of federal funds; expanding access and funding for at-home care; and hiring more ombudsmen.

Montana

The National Academy for State Health Policy (NASHP) writes on a report completed by Montana’s Legislative Audit Division which found that 47 nonprofit hospitals received $146 million in tax exemptions in 2016 but only 4% of community benefit spending actually improved the health of the state’s residents.

Nevada

The Nevada Department of Health and Human Services Division of Health Care Financing and Policy (DHCFP) announced that Medicare Advantage plans Anthem, Centene, CVS/Aetna and United HealthCare will begin participating in Nevada’s Dual Eligible Special Needs Plan (D-SNP) program, effective Jan. 1, 2021. Each plan will offer seven mandatory services including dental, vision, hearing aids, non-emergency medical transportation, nursing hotline, telehealth and post-acute care meal services.

New York

Community Service Society released a report investigating 55 of New York’s charitable hospitals, which sued nearly 4,000 New Yorkers for medical debt during the first nine months of the COVID-19 pandemic. The report found that hospitals with aggressive collections practices received more Indigent Care Pool funds than they report in financial assistance to patients. However, even prior to the pandemic, hospitals were found to be suing patients at the same rate with 8,000 lawsuits in 2019 and 7,000 lawsuits in 2018.

South Carolina

The South Carolina Department of Health and Human Services posted a stakeholder update on the Health Connections Prime program, the state’s duals demonstration program. Key updates include expansion of the demonstration to two new counties in the state, community outreach updates on educating consumers about the program and program data updates related to enrollment.

Texas

The Medicare-Medicaid Coordination Office re-executed the three-way contract with the Texas Health and Human Services Commission and Medicare-Medicaid plans extending the state’s dual demonstration program for one year with the option to renew in 2022 and 2023. The updated contract is available here.

KEY DATES