Health Innovation Highlights: January 16, 2020

Full Edition

DIRECTOR’S CORNER

New Year, New Possibilities

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

2020 will undoubtedly be a momentous year for health care advocacy, and especially for those of us focused on person-centered care for those with the most complex health and social needs.

In the new year, the Center continues our work on five policy areas: (1) better addressing patients’ and communities’ social needs; (2) building stronger consumer engagement; (3) improving coverage and care for beneficiaries who are dually eligible for Medicare and Medicaid; (4) developing sustainable mechanisms for financing long-term care services; and (5) advancing primary care. You can read more here about how we are approaching these five areas of work.

As we kick off the year, I’m pleased to share a new issue brief making the case for greater health plan investment in housing and community development. In the coming weeks, stay tuned for new materials, including key questions state advocates should be asking as their Medicaid programs look to address social determinants of health, as well as a tool to identify policy levers to address social determinants of health in your community.

Even as we look for opportunities to improve the health care system, we are keeping an eye on developments in the Texas v. U.S. lawsuit, which threatens to repeal the Affordable Care Act. Check out this blog to learn how a final adverse ruling in this case would negatively affect people with complex health and social needs.  

In these challenging times, it’s important to celebrate the bright spots and important work that is happening in communities and states across the country. Take a look at this blog about Speak Up for Better Health honoree Elizabeth Wills-O’Gilvie’s work to improve access to healthy foods. And, join us in celebrating Speak Up for Better Health honoree Sherman Pines, who was honored by his hometown of Newport, Rhode Island, proclaiming January 8, 2020 as Sherman Pines Day! Congratulations to Sherman and to the Rhode Island Organizing Project for their work in building consumer leadership and improving the health of older adults.

We also share two blog posts from our Alabama partners Alabama Arise and the Bay Area Women Coalition, describing their hard and important work of helping steer Alabama’s Medicaid program to better address consumer and community needs. Read about how their work is paying off, both in the state’s long-term care reform and in its primary care transformation effort.

Despite continued attacks and challenges, I’m encouraged by the growing possibilities for health care to better meet the needs of consumers, patients, families, caregivers and communities, and excited to partner with all of you in this work over the coming year!

FROM THE CENTER & OUR PARTNERS  

New Issue Brief Explores Opportunities for Health Plan Investment in Affordable Housing and Community Development

A new issue brief, produced as part of our Social Investment Initiative, aims to unlock health plan resources that can be invested in increasing the availability of safe and affordable housing and community development. In the brief, made possible with support from the Kresge Foundation, we lay out the case for health plans making these kinds of investments. Additionally, we provide background on the regulatory and financial landscape influencing plans’ ability to make social investments, analyze the feasibility of investment, outline investment options and feature three examples of health plans that have committed significant resources to housing and community development.

Blog Recap: Alabama's Progress on Medicaid Reform

Two new blog posts from Center Partner Alabama Arise highlight how a strong consumer voice has led to important developments in the state's Medicaid program. The first post highlights the organization’s achievements in the state’s long-term care program and the second recognizes how Alabama Arise and its partner, the Bay Area Women Coalition, have brought community voices into the Medicaid program.

Podcast: Finding the Consumer Voice with Ann Hwang and Mark Rukavina

Center Director Ann Hwang and Business Development Manager Mark Rukavina appeared on Day Health Strategies' "Unlocking Accountable Care" podcast series. In the episode, Ann and Mark discuss their journeys to Community Catalyst and how that has influenced their perspectives on the importance of consumer engagement. Ann highlights how the Center’s grant activities support consumer engagement in health policy and Mark reflects on the Center’s consulting work with health systems that are seeking to bring consumers into the fold.

Speaking Up for Better Health: Food as a Human Right

In the second blog post in our series highlighting the work of the four people recognized by the Center's 2019 "Speak Up for Better Health Award" contest, we take a look at Elizabeth Wills-O'Gilvie's work improving access to fresh produce in her community of Springfield, MA. Wills-O'Gilvie is the chair of the Gardening The Community board and sits on the steering committee of the Springfield Food Policy Council.

“Sherman Pines Day” Proclaimed in Newport, Rhode Island! 

We are delighted to share that 2019 “Speak Up for Better Health Award” honoree Sherman Pines was proudly recognized by his hometown of Newport, RI, when Mayor Jamie Bova issued a proclamation declaring January 8, 2020 as “Sherman Pines Day” in the city! The proclamation (which cited his Center award) elevated Sherman’s tireless efforts to improve the lives of older adults and people with disabilities, both in his local community and through his involvement at the state level. Congratulations to Sherman and to the Rhode Island Organizing Project for their work in building consumer leadership and improving the health of Rhode Islanders!

 

NOTEWORTHY NEWS & RESOURCES

First in the Nation: Washington State’s Long-Term Care Trust Act

The state of Washington is leading the way in helping to support long-term care for older adults as they age, a process detailed in a new Millbank Memorial Fund opinion piece. The Long-Term Care Trust Act responds to the crisis-level lack of long-term services and supports (LTSS) that forces older adults to spend themselves into poverty and their adult children to step in as unpaid full-time caregivers. Starting in 2022, Washington workers will pay a small payroll deduction that funds a long-term care safety net benefit for older adults who would otherwise be ineligible for LTSS care. The first-in-the-nation program offers an innovative state-based solution to our nationwide long-term care crisis.

New Database for Family Caregivers of Those Living with Dementia

Benjamin Rose Institute on Aging, Family Caregiver Alliance and The Gerontological Society of America have created "Best Practice Caregiving," an online resource for organizations that support family members and friends caring for people living with dementia. This free online database of vetted, proven dementia caregiving programs provides organizations that serve family caregivers a searchable, interactive, data-rich resource to compare and select from more than 40 evidence-based programs across the country. The database provides detailed information on each program's:

  • focus (e.g., reducing stress, understanding dementia, planning care, skill-building, health and wellness);
  • delivery method (online, in-person, telephone);
  • evidence base & research findings;
  • implementation requirements and real-world experiences of organizations that are using the program; and
  • contact information.

How States Addressed Health-Related Social and Economic Factors in 2019

A blog post from the National Academy for State Health Policy offers a roundup of the ways states addressed a wide range of social and economic factors that impacted Americans’ health in 2019. Featured initiatives include a perinatal navigator program designed to lower infant mortality in Indiana as well as Minnesota’s Community Solutions Fund, which provides grant dollars for children’s health care issues. The blog post also includes snapshots of various state approaches to housing insecurity, early childhood education and environmental protections as social determinants of health.

New Resources on Duals: Building a Culturally Competent Direct Care Workforce and Engaging Members in Care 

Many consumers with complex needs rely on direct care workers to provide long-term services and supports (LTSS) to facilitate daily living. Culturally competent LTSS workers, providers and administrators are essential to ensuring LTSS users receive dignified and respectful care. Resources for Integrated Care (RIC) has developed a series of three briefs to help LTSS providers build a workforce capable of providing culturally competent care to a diverse population of dually eligible individuals. The topics covered are: Organizational Cultural Competence; Training Culturally Competent Direct Care Workers; and Recruiting and Retaining a Diverse Direct Care Workforce.

RIC also released two additional resources aimed at helping providers and plans better engage dually eligible individuals in their own care: a short “spotlight” resource, Identifying Successful Member Engagement Strategies Through Rapid-Cycle Improvement; and a “Tip Sheet” on Wellness Rewards And Incentives Programs: Tips For Medicare-Medicaid Plans.

RCT Results on Camden Core Model Show No Reduction in 180-Day Hospital Readmission Rates

As reported in a Kaiser Health News article, the most recent edition of the New England Journal of Medicine contained the disappointing results of a four-year randomized controlled trial of the Camden Core Model, the signature care management program of the Camden Coalition of Healthcare Providers. Under this trial, the two randomized groups were comprised of patients ranging in age between 18-80, described in the study as "...superutilizers of the health care system – persons with medically and socially complex needs who have frequent hospital admissions." One group received intensive social and medical assistance from Camden staff after leaving the hospital while the other received usual follow-up care. In the end, researchers found no effect; there were similar 180-day readmission rates between the two groups.

In a blog post commenting on the study’s release, Camden Coalition CEO Kathleen Noonan  discusses the implications of these findings, how they will inform the organization’s ongoing work, and urges continued collaboration to build “strong cross-sector ecosystems of complex care in every community” that is needed to  support people with very complex needs.

 

STATE HIGHLIGHTS

Massachusetts

Last month, the Massachusetts Health Policy Commission issued a request for proposals seeking providers and community-based organizations to collaborate on the social determinants of health as part of the state’s Moving Massachusetts Upstream initiative. The initiative is a partnership across Massachusetts state agencies including the HPC, the Department of Public Health (DPH), the Office of the Attorney General, the Executive Office of Elder Affairs, and the Executive Office of Health and Human Services. The goal is to engage in policy alignment activities and make investments to support health care system–community collaborations to more effectively address the “upstream” causes of poor health outcomes and health inequity. The state plans to give out three to four awards, up to $650,000 each, over approximately three years. Responses are due by February 21, 2020.

In other news, the Executive Office of Health and Human Services announced its selection of five organizations to proceed to contract negotiations to participate as One Care Plans. One Care is the state’s dual eligible demonstration project serving people with disabilities, ages 21-64. The selected organizations are: 

  • Boston Medical Center HealthNet Plan
  • Commonwealth Care Alliance
  • Fallon Community Health Plan
  • Tufts Health Public Plans
  • UnitedHealthcare Community Plan

These organizations will now advance to contract negotiations and readiness review processes with MassHealth and CMS. The new contracts are expected to begin January 2021.

Pennsylvania

In December, the Pennsylvania Department of Human Services announced the Medical Assistance Transportation Program (MATP) will delay moving to a statewide brokerage model for 18 months to conduct a deeper study and analysis of how the MATP can be improved. While the program is currently run by counties or transit agencies,  a 2018 budget provision mandated the program would instead be contracted out to a private company on a regional basis (a “brokerage model”). However, after a recently conducted study, the Wolf Administration said that a private brokerage model may not be the right solution. Also contributing to the delay was opposition from county officials and state public transit agencies, who were set to lose dollars. These factorsprompted Secretaries from the Department of Human Services, the Department of Aging and the Department of Transportation to delay any changes for an additional 18 months while they study existing county programs.

Rhode Island

In early January, the Rhode Island Executive Office of Healthand Human Services released a request for information regarding the development of a new payment and delivery system model that coordinates care for dual eligible Medicare and Medicaid members. The state is considering issuing a request for proposals to serve dual eligibles under a Medicare-Medicaid Plan (MMP) or a Dual Eligible Special Needs Plan (D-SNP) model. Responses are due on February 3.

KEY DATES

Tuesday, Jan. 21 (4-5 p.m. Eastern) - Webinar: Developing the Road Map to Improve Data on the Health of People with IDD, presented by American Association on Intellectual and Developmental Disabilities. Please register for the webinar.  

Wednesday, Jan. 22 (1:30-2:45 p.m. Eastern) - Webinar: Meaningful Stakeholder Engagement: A Collaborative Approach to Programs for People with Intellectual and Development Disabilities and Their Families, presented by the Administration for Community Living and the Centers for Medicare & Medicaid Services. Please register for the webinar.

Thursday, Jan. 23 (3-4:30 p.m. Eastern) - Webinar: Just Wanna Live My Best Life – Shaping Medicaid HCBS to Fit the Individual Priorities of Self-Advocates, presented by the Administration for Community Living and the Centers for Medicare & Medicaid Services. Please register for the webinar.

Wednesday, Jan. 29 (1-2 p.m. Eastern) - Webinar: Integrating Health and Social Care to Improve the Nation’s Health - An Interdisciplinary Committee’s Consensus Findings and Recommendations, presented by the Aging and Disability Business Institute and the American Society on Aging. Please register for the webinar.

Tuesday, Feb. 4 (12-1 p.m. Eastern) - Webinar:  Putting Patient-Centered Measurement Principles Into Practice, presented by the American Institutes for Research. Please register for the webinar.

Wednesday, Apr. 15 - Application Deadline: Applications due for the Health & Aging Policy Fellows Program (2020-21). Please click here for an overview of the fellowship, including program tracks and eligibility and selection criteria.