Health Innovation Highlights: March 12, 2020

Full Edition

DIRECTOR'S CORNER

Marching Forward

In these days of uncertainty, I wanted to acknowledge how much COVID-19 has disrupted each of our work and lives. As a primary care physician, I am particularly cognizant of how much this illness affects people with complex health and social needs, such as older adults, people with chronic health conditions and people experiencing homelessness. The battle against the novel coronavirus reminds us yet again, in a stark and challenging way, why our goal of universal, affordable, equitable and quality health care for everyone is so important. The health and well-being of each one of us is deeply intertwined with those of everyone in our local – and global – community.  

It is with that sobering reminder that we approach this month, which for all of us at Community Catalyst, is a month of memories and commemoration. We started the month with a remembrance of Rob Restuccia, our founding executive director, who died on March 3 of last year. If you haven’t already, please take a moment to watch this short video with Dara Taylor, director of diversity, equity and inclusion, reflecting on how our organization is moving Rob’s legacy forward. 

This March 23 is also the 10th anniversary of the passage of the Affordable Care Act. A special issue of Health Affairs examines three big questions: did it improve access to care, did it improve health and did it bend the cost curve? (The answers: a resounding yes, probably and don’t know). The ACA also decreased, but did not eliminate, racial and ethnic health disparities in coverage and access. Community Catalyst will be releasing a number of materials related to the ACA anniversary, and how important the law has been for millions across the country – stay tuned. 

We believe the best way to build on Rob’s legacy and to realize the promise of the ACA is to continue the march toward universal, affordable, equitable and quality health care. To that end, we’re pleased to celebrate some important work being done by our team and by partner organizations. 

First, our team is pleased to share our new advocacy guide with recommendations for what to look for when Uber and Lyft want to provide Non-Emergency Medical Transportation services to Medicaid beneficiaries in your state.  

Second, we have created a new web page that lays out our principles and approaches to consumer engagement. We hope this framework for how we see health care organizations meaningfully engaging consumers can help organizations move toward the authentic, transformational engagement that can powerfully change lives and programs.  

From Maine, we share an update on the ongoing efforts of Maine People’s Alliance to expand access for older adults and people with disabilities to the state’s Medicaid Non-Emergency Medical Transportation benefit, as well as their and work to shorten the waiting list time for people seeking access to Home and Community based services in the state. 

Congratulations to Massachusetts Senior Action Council, whose grassroots organizing efforts to close “the SNAP gap” now makes it easier for low-income residents to access food assistance when they enroll in Medicaid.  

From Colorado, check out this article about how providing coverage for regular dialysis treatments for undocumented people saves live and money, featuring the important work of our state advocacy partner, Colorado Health Progress.   

And finally, a heartfelt Congratulations to our longtime partner in Maryland, Vinny DeMarco, President of the Maryland Citizen’s Health Initiative, on being awarded the very meaningful 2020 “Andy Hyman Award for Advocacy” by Grantmakers In Health, which you can read more about below. 

Thank you for all that the important work that you are doing, and please take good care of your own health and the health of your families, communities and colleagues. Like many of you, we are adapting to doing more work remotely and monitoring developments closely. For our advocacy partners, if we can support you in shifting to virtual organizing strategies or if you need to adjust any project activities, please don’t hesitate to contact us.  

As we have always known, we are strongest when we lean on each other and pull together. 

 

 

FROM THE CENTER & OUR PARTNERS

New Advocacy Guide for Ridesharing and Medicaid NEMT 

Medicaid non-emergency medical transportation (NEMT) is a critical benefit for over seven million Americans, ensuring access to more routine services such as medical appointments, substance use disorder/behavioral health care, preventive care, specialist visits, physical therapy/rehabilitation, dialysis and adult day health care. In recent years, ridesharing companies such as Uber and Lyft have started working with states to provide NEMT. While these companies may help states increase the number of transportation providers, and therefore expand access to NEMT overall, there is inherent risk to consumers with complex health and social needs if the service is poorly integrated.

To assist state advocates in engaging on this issue, Rachelle Brill, senior policy analyst, developed a new advocacy guide that lays out five recommendations to ensure a consumer-centered implementation and oversight process for ridesharing companies providing NEMT. 

Medicaid Block Grants Explained in Video and Blog

On Jan. 30, the Centers for Medicare and Medicaid Services announced new guidance for states on shifting to block grants for their Medicaid expansion programs. Center Director of Strategic Policy Michael Miller provides a quick update in a Health Policy Minute video, in which he explains that this is “really just a continuation of their attack on Medicaid expansion in general...to incentivize states to cut eligibility, cut rates and cut benefits.” Additionally, this blog post by Center Program Associate Siena Ruggeri looks at the devastating impacts the adoption of such block grants would have on people with disabilities.

 

Center and HCTTF to Host Webinar on Consumer Engagement at the Organizational Level 

On March 24, the Center and its partner, The Health Care Transformation Task Force (HCTTF), will host a webinar on health care system strategies to engage patients and their families in governance and operational decision-making. The webinar will feature health system and patient speakers from each of three organizations featured in a set of case studies released last month: HRHCare, Children’s Mercy Kansas City, and Trinity Health. Each participant will discuss how these systems’ patient engagement structures have improved the care experience for patients.  

Mass Senior Action Council Helps Win Simplified Access to SNAP Benefits   

The Massachusetts Senior Action Council’s (MSAC) grassroots leadership has been a powerful force creating meaningful policy change in Massachusetts since 1981 and their current work to improve access to SNAP benefits for seniors is beginning to pay off. As of March 1, all older adults newly applying for MassHealth (Medicaid) now use an application that also includes a simplified SNAP application. While the combined application is still cumbersome and daunting at 43 pages, this is the first step of many towards building a more integrated enrollment and eligibility process for need-based programs. MSAC will be partnering with the state agencies to ensure that seniors' needs are considered and their voices heard at every step of implementation.

Maine People’s Alliance Pushes Ahead on NEMT and HCBS Campaigns  

Our partners at Maine People’s Alliance (MPA) are paving the path toward helping older adults and those with disabilities in Maine address years of problems in the Medicaid transportation program. On Feb. 11, ten MPA members lobbied lawmakers on LD1142, which would expand access to non-medical transportation for Section 19 Medicaid beneficiaries. Half of the lobby team were people who would directly benefit from the bill.  Among the proposals under consideration is a pilot program to give seniors and disabled Mainers $1,000 per year for non-medical transportation.

Another vital issue MPA is working on is the serious backlog in access to home and community based services (HCBS) for Maine residents. Nearly 2,000 adults in Maine with disabilities have been waitlisted for HCBS. MPA volunteer lobbyists hand-labeled and delivered 180 postcards to legislators regarding a bill to reduce and eventually eliminate chronic MaineCare waiver waiting lists for HCBS. 

Longtime Maryland Partner Vinny DeMarco to Receive “Andy Hyman Award for Advocacy” 

We are thrilled to announce that longtime Center friend and partner Vinny DeMarco, president of the Maryland Citizen’s Health Initiative (MCHI), will receive Grantmakers In Health’s (GIH) 2020 Andy Hyman Award for Advocacy. The award pays tribute to advocacy grantees who embody Andy Hyman’s commitment to principled action, passionate leadership to advance social change, and dedication to making progress in policy and practice despite challenging political environments, all of which is a perfect description of Vinny!  

Vinny and MCHI were key Center partners even before the Center officially launched, working with us to ensure that Maryland’s unique hospital payment system becomes ever more responsive to the needs of consumers. We are so excited for and proud of Vinny and hope you will  join us in congratulating him! The Andy Hyman Award will be presented on June 19 at the GIH Annual Conference on Health Philanthropy in Minneapolis, MN.

The Center Is Hiring: Consumer and Community Engagement Consultant 

The Center is seeking applicants for the position of Consumer and Community Engagement Consultant. The person in this position will provide consulting services to clients including health plans and providers, hospitals, state agencies and others serving vulnerable populations (e.g., frail older adults, people with disabilities, children with special health care needs). In particular, this dynamic person will provide clients with training and coaching services that will help them develop and implement effective systems of consumer and community engagement in health care. The ultimate goal of our consulting services is to improve health care services and the overall health of people with complex needs, particularly those from historically excluded or underrepresented populations.  

This full-time position is within Community Catalyst’s Center for Consumer Engagement in Health Innovation. The mission of the Center is to promote the engagement of consumers with complex health and social needs in health care payment and delivery system transformation. Our consulting services are one of the many ways that we realize this mission. Additional information is available at www.healthinnovation.org.

NOTEWORTHY NEWS & FEATURES

NASHP: States Are Advancing Healthy Food Policies in 2020 

A recent National Academy for State Health Policy (NASHP) blog post highlights the diversity of state efforts to support food security, a key social determinant of health. Generally speaking, states are taking a multi-sector approach to ensure greater access to nutritious food. Those efforts include Virginia, Michigan and North Carolina’s requirements for Medicaid managed care contractors to coordinate access to healthy foods, as well as medically-tailored meals programs in New York, California, and Massachusetts.

2020 Status of Health Equity Report 

The Root Cause Coalition, an organization comprised of 75+ health systems, hospital associations, foundations, businesses, national and community nonprofits, health insurers, academic institutions and policy centers, released its 2020 Status of Health Equity Report, which details the way forward on social determinants of health interventions. Based on interviews with Root Cause members around the country and a national survey of primary care providers, the report identifies several key finding . First, while primary care providers saw the importance of addressing health disparities, they lacked the resources and integrated community resources to effectively address them in a clinical setting. Second, the current funding model for community-based organizations (CBOs) is unsustainable, and the next step is CBOs demonstrating value so that health systems can shift payment models to fund the services CBOs provide. The report also identified three actionable strategies: 

  • Scale innovative solutions to drive a new and sustainable model of care that improves health outcomes as it ensures health equity through actions such as connecting clinical and community non-clinical services through technology 
  • Align communities and advance authentic collaboration to address the root causes of health inequities 
  • Engage and learn from communities most affected by inequities of health and social conditions 

State Efforts to Integrate Care for Dually Eligible Beneficiaries: 2020 Update

A new Center for Health Care Strategies brief provides updates on states that operate Medicare-Medicaid integrated care model demonstrations. It offers insight into the factors that allowed for state investment and successful implementation of demonstration models. This resource provides valuable considerations for states looking to implement demonstration models to benefit their dually eligible beneficiaries. 

Collaborating to Make Public Health Age-Friendly 

A recent blog post from The John A. Hartford Foundation provides an update on the Age-Friendly Public Health Systems initiative, which provides a framework for utilizing public health to promote healthier aging. In Florida, for example, health systems and community partners are using this framework to improve their collaboration, particularly in the area of data sharing. Because of this increased collaboration, the state department of health created aging profiles of each of the state’s counties, allowing community organizations a stronger understanding of the needs of their older adults. The blog also highlights similar efforts that are underway in other states. 

Addressing Social Determinants: Scaling Up Partnerships with Community-Based Organization Networks 

Community-based organizations are trusted resources in the aging and disability community and have become a critical tool in supporting consumers with complex care needs. A Health Affairs blog post outlines the next steps for better addressing the social needs of consumers by scaling collaborations between community-based organizations and health systems. The post calls for the establishment a system of CBO networks, with hubs at local, state and multi-state levels, coordinated by the Administration for Community Living (ACL). On March 4, the ACL hosted a day-long meeting to discuss these strategies.

STATE HIGHLIGHTS 

California 

Late last month, the California Department of Health Care Services (DHCS) released a revised policy memo regarding “Expanding Access to Integrated Care for Dual Eligible Californians” based on stakeholder feedback. The memo outlines the department’s transition plan for dual eligibles and the Coordinated Care Initiative within the California Advancing and Innovating Medi-Cal (CalAIM) initiative to improve the quality of life and health outcomes of the Medi-Cal (Medicaid) population by implementing broad delivery system, program and payment reform across the program. DHCS shared this revised memo plus additional materials on the transition at a convening late last month. Materials from that meeting are available here.  

New York 

Last month, the Centers for Medicare & Medicaid Services informed the state of New York that its request to extend the New York Delivery System Reform Incentive Payment (DSRIP) waiver for four additional years is denied. The extension would have covered operations through March 2021 and allowed the state to use $625 million in unspent funds from its original $7.4 billion program. The second phase, stretching into March 2024, sought an additional $8 billion in federal funding. The waiver is scheduled to end in March. 

KEY DATES

Thursday, March 19 (3-4:30 p.m. Eastern) - Webinar: Empowering Adults Through Supported Decision Making -The Role of Families, Guardians, Caregivers, and Others in Supporting Individuals Receiving HCBS, presented by the Administration for Community Living and CMS. Please register for the webinar.  

Tuesday, March 24 (3-4 pm Eastern) - Webinar: Beyond Surveys: How Health Systems Engage Patients, presented by the Center for Consumer Engagement in Health Innovation and the Health Care Transformation Task Force. Please register for the webinar.


Monday, March 30 (1-2:30 p.m. Eastern) - Webinar: The PAE Attention Framework: Understanding the Ingredients for Successful Stakeholder Engagement, presented by National Center on Advancing Person-Centered Practices (NCAPPS). Please register for the webinar.

Tuesday, March 31 (1-2:30 pm Eastern) - Webinar: What’s Next? The Value of Evidence from the Camden Coalition and CareMore Health to Inform Complex Care Program Design, presented by The Playbook: Better Care for People With Complex Needs. Please register for the webinar.

Wednesday, Apr. 8 - Application Deadline: submissions for "Putting Care at the Center 2020" meeting, presented by the National Center for Complex Health and Social Needs. Please click here for an more information.

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.