Health Innovation Highlights: July 10, 2019

Full Edition

DIRECTOR'S CORNER

Celebrating Consumer Leadership!

 

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

This month, we are thrilled to announce the Center’s second annual Speak Up for Better Health award! This prize recognizes extraordinary people working to improve their health and the health of their communities. We see in our work every day the consumer champions whose lives and actions demonstrate the power that each of us has to make better health possible for all of us.

This year’s award will recognize people who are working to address the social, environmental and economic factors – e.g., housing, transportation or nutrition – that play a crucial role in our health. We will select a grand prize winner and up to three additional honorees. The grand prize includes $500 and the opportunity to travel to the award ceremony in Washington, D.C. on Nov. 20. Nominations are due Sept. 6. Please nominate a consumer champion today!

I am particularly thrilled that last year’s winner, Elena Hung, is joining this year’s wonderful panel of judges. Elena co-founded the advocacy organization Little Lobbyists at a friend’s kitchen table, as she says, “by accident.” It was June 2017, and she was terrified the Affordable Care Act would be repealed, leaving families like her’s, whose children have complex medical needs, defenseless and at risk of bankruptcy. She and her dedicated partners built Little Lobbyists into a powerful voice for children with complex medical needs. She will be joining Tara Oakman, senior program officer, the Robert Wood Johnson Foundation, Barbara Petee, executive director, the Root Cause Coalition, Soma Saha, vice president, Institute for Healthcare Improvement and Loel Solomon, vice president for community health, Kaiser Permanente, to help us select our honorees.

Read below for other exciting developments this month, including our Health Affairs blog about engaging consumers in a way that is transformational, not transactional; an article with Center Senior Advisor Gregg Warshaw reporting the results of a survey of American Geriatrics Society members about patient and family engagement in geriatrics care settings; and Center Research Director Marc Cohen’s work to address the long-term care crisis facing our country. We are also pleased to share the work of our partners in Pennsylvania to improve vitally important transportation services for Medicaid enrollees, and in Idaho to improve mental health and substance use treatment services.

FROM THE CENTER & PARTNERS      

Health Affairs Blog Post Describes Transformational Power of Investing in Consumer Engagement

Center Director Ann Hwang, MD, authored a post for the “Grantwatch” feature of the Health Affairs blog, entitled “Building Consumer Engagement In Health Care: From Transactional To Transformational.” In the post, Ann describes the deep investment the Center has made in the transformational model of engagement, discussing the recently completed evaluation of the Center’s two-year Consumer Voices for Innovation (CVI) program and the exciting prospects ahead for the next phase, CVI 2.0, with its focus on the social determinants of health. The guiding goal of both CVI phases is partnering with state-based organizations to support them in engaging, organizing and building the leadership skills of consumers who are low-income, from communities of color, older adults, or people – or caregivers for people – with disabilities.

Describing this approach, Ann writes, “The transformational model strategically and deliberately builds the power of consumers, not solely as individuals but as part of a collective movement that is organized and sustained. It is longitudinal and built on relationships that are grounded in trust and respect, and it emphasizes shared resources and decision making.”

Study Panel Co-chaired by Center Research Director Releases Report on State-Based Social Insurance Programs

Center Research Director Marc Cohen, PhD, participated in a June 24 event at the National Press Club in Washington, D.C. to release a new study from the National Academy of Social Insurance (NASI) that grew out of its project: “Designing State-Based Social Insurance Programs for Paid Leave, Affordable Child Care, and Long-Term Services and Supports (LTSS).” Cohen, who is also co-director of the LeadingAge LTSS Center @UMass Boston, co-chaired the study panel with Heidi Hartmann, president of the Institute for Women’s Policy Research. Speakers at the event presented the policy options identified in the report and discussed their implications for families, workers, states and the economy

You can read the full report here, which highlights the different policy options that states might implement to pool the costs of care across the lifespan, enabling families to access and afford the care they need to and live well at every stage of life. This project was conducted with support from Caring Across Generations and the Ford Foundation.

The NASI study panel convened 29 experts across many care fields to develop the intellectual infrastructure of the study, and identify best practices for policy makers interested in putting forward social insurance-based approaches. Cohen focused his efforts on the LTSS and program integration aspects of the study. The study provides a roadmap of options states might use to tailor a program to its goals, preferences and constraints with regard to breadth of coverage, benefit generosity and funding approach.

Community Catalyst and Center Strategic Policy Director Michael Miller also served on the study panel.

Center Partners in Idaho and Pennsylvania Making News

Two of our state partner organizations and their work have been featured in news articles recently. Check out these highlights from the Idaho Behavioral Health Alliance (IBHA) and Pennsylvania Health Action Network (PHAN):

  • The IBHA is a collection of stakeholders, led by advocates at Idaho Voices for Children, working to engage consumers in behavioral health advocacy across the state. Established in 2017 as a project of the Robert Wood Johnson Foundation-funded Consumer Advocacy for Transformation (CAT) grant program, coalition members have been pushing the state to establish behavioral health parity laws and enforcement structures to ensure that treatment for mental health and substance use disorders are integral components of Idaho’s rapidly changing health insurance landscape. As part of these efforts, the IBHA has utilized its significant advocacy reach to attract some important champions. Last month, IBHA member and former state legislator, Kathie Garrett, made the case for enforcing health parity laws and meaningfully investing in addressing the behavioral health crisis ravaging their state in a guest opinion column in the Idaho Statesman.

Diagnosing the Gaps in Geriatric Patient Engagement

In a special article published in the Journal of the American Geriatrics Society (AGS) [abstract only, full article requires subscription or payment], Center Director Ann Hwang, MD, and Center Senior Advisor Gregg Warshaw, MD, present results from a survey about patient and family engagement within geriatrics care settings, and discuss opportunities to increase or improve engagement. As in other sectors of the health care system, meaningfully engaging older adult patients and their families to understand and respond to their perspectives and needs is a necessity for improving care.

Working with the AGS, the Center surveyed AGS members about engagement practices in their clinical work sites. Twenty-eight percent of respondents reported that their work site has a patient advisory council. Respondents also identified barriers to more widespread engagement. Additional investments in service funding and staff time, as well as training, transportation and other supports for consumers, will likely help expand patient and family engagement in geriatrics care settings.

Upcoming Webinar: Culturally Competent Direct Care: Meeting the LTSS Needs of Diverse Dually Eligible Beneficiaries

On July 25, the Center will be presenting a webinar in collaboration with the Medicare-Medicaid Coordination Office and The Lewin Group, “Culturally Competent Direct Care: Meeting the LTSS Needs of Diverse Dually Eligible Beneficiaries.” This webinar will discuss strategies for providing direct care services with cultural sensitivity, as well as training elements for direct care workers to achieve cultural competence. The webinar is scheduled for Thursday, July 25 from 12:30-2 p.m. EST. Click here for more information and to register.

NOTEWORTHY NEWS & FEATURES

New Study Examines Consumers' Views on Social Determinants of Health

A new study from the Anthem Public Policy Institute illustrates how consumers view the social determinants of health. The study found that individuals focus more on intermediary social determinants, such as social isolation and food access, rather than structural factors like economic stability. These intermediary social determinants may be more easily modifiable than the structural factors more frequently focused on by academics and popular media.

Briefs: Partnering with Community Health Workers

Resources for Integrated Care has released three short briefs for plans and providers on partnering with community health workers.  The briefs describe skills and techniques of successful community health workers, highlight organizational components that led to success of the Camden Coalition, and Molina’s promising practices for recruiting and training community health workers. 

American Hospital Association Makes the Case for Investment in Housing

The American Hospital Association (AHA) and NORC at the University of Chicago have collaborated to learn how hospitals are investing in affordable housing through the Accelerating Investments for Healthy Communities initiative, led by the Center for Community Investment and funded by the Robert Wood Johnson Foundation. The AHA has released an issue brief outlining the progress made in phase one of the initiative. Two major themes arose during this initial assessment of participating hospitals and health systems: a mission-driven commitment to address health equity and social determinants and strategic alignment with payment and care models.

New Study on Paid Home Care Finds Those with Greatest Needs Are Least Able to Afford It

A new study published in Health Affairs finds that most older adults have enough financial resources – only if all available resources were devoted to long-term services and supports (LTSS) needs – to fund more than a year of paid home care. However, the study also finds that older adults with significant LTSS needs – single adults and individuals age eighty-five and older ­­– are least likely to be able to afford it.

Findings suggest that better LTSS financing options would enable people to obtain paid home care in their own home, rather than moving into nursing homes or enrolling in Medicaid. The authors also conclude that, “Paid home care could become less affordable if growing labor shortages raise future costs.”

STATE HIGHLIGHTS

California

The California Department of Health Care Services published June 2019 enrollment data for the Cal MediConnect dual eligible demonstration program. The enrollment dashboard includes information on enrollment and demographics, quality withhold summary, completed health risk assessments, grievances and appeals, behavioral health services, and long term services and supports. The dashboard is available here.

Massachusetts

Last month, the Massachusetts Executive Office of Health and Human Services (EOHHS) released a list of six health plans that submitted bids for the state’s One Care Dual Demonstration 2.0:

  1. Boston Medical Center HealthNet Plan
  2. Commonwealth Care Alliance (already a One Care plan)
  3. Fallon Health
  4. Senior Whole Health
  5. Tufts Health Plan (already a One Care plan)
  6. United Healthcare Community Plan

EOHHS intends to award contracts to at least three plans, but no more than five. More information about One Care 2.0 can be found here.

New Jersey

The New Jersey Health Care Quality Institute published a Road Map to build on the potential of community-based coalitions, formerly known as Medicaid Accountable Care Organizations (ACOs) to improve care for people with complex health and social needs. The Road Map proposes a vision for the state-certified Medicaid ACOs in Camden, Trenton and Newark, and one “look-alike” Medicaid ACO serving Paterson to evolve into coordinated Regional Health Hubs (“Hub Model”).  The proposed model is intended to allow existing ACOs to continue to grow and to enhance the environment to develop new Hubs. The Hub model aims to embrace the successful elements of ACOs: bringing together competing interests, analyzing patient level data to inform care decisions, and serving as the hub where community and clinical intersect to achieve the population health.

South Carolina

The South Carolina Department of Health and Humans Services (SCDHHS) posted two new items about Healthy Connections Prime, the state’s dual eligible demonstration program.

  1. Program Update: this update provides an overview of the importance of Person-Centered Program Design & Family Caregivers in the Healthy Connections Prime demonstration. The overview emphasizes the importance of support provided by family caregivers and includes four program design domains: assessment and care planning, benefit design, training and quality improvement which are essential functions proved by the Medicare-Medicaid Plan (MMP) care coordinators.

  2. Stakeholder Update: SCDHHS provided a June update on the Healthy Connections Prime demonstration. A few of those updates are:
    1. County Coverage Expansion: Healthy Connections Prime MMPs have expanded their coverage to new counties. For a full listing of coverage area by plan, please see this document.
    2. Program Coverage Model Expansion: the state created a document comparing coverage between the various program types that exist for the South Carolina Dual Eligible population.
    3. Institutional Respite FAQs: the state has released an FAQ document for providers seeking more information on how to provide institutional respite care to Healthy Connections Prime members.
    4. Enrollment Data: the State posted 2018 complete enrollment data, the first six months of 2019 enrollment data and data on eligible populations for the demonstration.

KEY  DATES

Thursday, July 25 (12:30-2 p.m. Eastern) - Webinar: Culturally Competent Direct Care: Meeting the LTSS Needs of Diverse Dually Eligible Beneficiaries, presented by The Lewin Group in Collaboration with the Center for Consumer Engagement in Health Innovation. Please register for the webinar.

Tuesday, July 30 (11:30 a.m. – 1 p.m. Eastern) - Webinar: Diagnosing and Treating Dementia – Current Best Practices, presented by The Lewin Group. Please register for the webinar.

Wednesday, July 31 (2 – 2:30 p.m. Eastern) – Question and Answer Session: Disability-Competent Care Conversation on Access with ADANN (Americans with Disabilities Act National Network), presented by The Lewin Group in collaboration with ADANN. Please register for the webinar.