Health Innovation Highlights: March 7, 2018

Full Edition

DIRECTOR'S CORNER

What’s Next for Health System Improvement: Four New Initiatives to Watch

Ann Hwang, MD

Director, Center for Consumer Engagement in Health Innovation

It’s been a busy few months for health care advocacy, given the numerous health care-related provisions in the budget deal to keep the government open and the release of the president’s proposed budget which contains cuts to health and social services. But amidst all of the political commotion, we’ve seen several bipartisan (and one nonpartisan) initiatives form to promote proactive approaches to improve health care delivery. Here are four efforts that are on our radar screen:

 

Senator Cassidy’s Bipartisan Workgroup on Healthcare Transparency

Announced: March 1

Who’s involved: Sens. Cassidy (R-LA), Young (R-IN), Grassley (R-IA), Bennet (D-CO), Carper (D-DE) and McCaskill (D-MO)

What is it: The group announced they are seeking stakeholders’ feedback to help craft legislation to make health care market pricing more transparent. The workgroup is interested in information that consumers have, or should have, on prices, transparency and cost. Responses are due March 23.

Why pay attention: Though it’s early, this seems to be an area where there could be some good, consensus-driven improvements.

Bottom line: Focusing on a relatively narrow topic gives this effort some chance to score a few small “wins,” but it’s unlikely to change health care as we know it.

 

Governors’ Bipartisan Blueprint for Improving Our Nation’s Health System Performance

Announced: Feb. 23

Who’s involved: Govs. Hickenlooper (D-CO), Kasich (R-OH), Sandoval (R-NV), Walker (I-AK) and Wolf (D-PA)

What is it: Guiding principles focused on affordability, insurance market stability, state flexibility and innovation, and regulatory relief. Strategies include a focus on value, primary care, accountability for “end to end” cost, consumer incentives, competition and Medicaid innovation. We’re intrigued by a mention of incorporating social determinants of health and measuring health and social outcomes in Medicaid.

Why pay attention: Hickenlooper and Kasich have spearheaded multiple bipartisan efforts by governors in the past year on healthcare, including Medicaid and CHIP financing. They’ve been able to rally other governors to their cause and have pull on both sides of the aisle, so we may see some of these ideas crop up in state or federal initiatives.

Bottom line: Kasich and Hickenlooper continue a productive partnership, while dispelling rumors of a bipartisan 2020 presidential ticket.

 

United States of Care

Announced: Feb. 6

Who’s involved: Former CMS Administrator Andy Slavitt and an impressive roster of over 50 big names

What is it: A new group founded on three principles: every American should have an affordable regular source of care for themselves and their families; all Americans should be protected from financial devastation because of illness or injury; and policies to achieve these aims must be fiscally responsible and win the political support needed to ensure long-term stability. The group plans a series of listening events before coming up with policy specifics.

Why pay attention: Lots of buzz (inside the beltway anyway).

Bottom line: Many details TBD, but we’re rooting for them.

 

New Healthcare Company Formed by Berkshire Hathaway, Amazon and JP Morgan

Announced: Jan. 30

Who’s involved: Three corporate titans, who together have 1.2 million employees

What is it: The three companies are forming an independent health care company for their American employees. They will focus first on technology as a way to provide simplified, affordable access to medical services. It’s still to be seen whether they have the scale and skill to tackle the challenges of transforming the health care system.

Why pay attention: These three companies, particularly Amazon, are known as industry disruptors.

Bottom line: What happens when an unstoppable force (industry disruptors fired up about healthcare costs) meets an immovable object (the healthcare-industrial complex)? We’re about to find out…

What do you think is next for these four initiatives - smooth sailing or icebergs? Tweet us @CCEHI to share your thoughts!

FROM THE CENTER & OUR PARTNERS

U.S. Treasury Hears from Center’s Research Director [corrected]

Center Research Director Dr. Marc Cohen gave a presentation to the Department of the Treasury on the long term care insurance market. During the presentation, Dr. Cohen characterized the current long-term care insurance market, and discussed prospects for growth.

We’re Hiring!

The Center is seeking a new Program Associate! The position is full-time, located in Boston and will provide programmatic and research assistance. Join our team!

NOTEWORTHY NEWS & RESOURCES

Older Adults Get engAGED

The National Association of Area Agencies on Aging (n4a) has launched a searchable database of resources for consumers to promote community engagement and active lifestyles for older adults. engAGED: The National Resource Center for Engaging Older Adults is a one-stop hub for information about innovations in engagement, resources for older adults and advocates, and hot topics in aging policy. The resource center is part of n4a’s work to develop a national strategy for increasing resources and access to services for aging populations in order to keep older adults engaged in their communities and in activities that promote longer, healthier, happier lives. Organizations serving older adults can also submit their resources for inclusion in the database here.

Identifying the Social Determinants of Comorbidity

A new study published in the journal, Medical Care, illustrates the relationship between income and comorbidity. According to research conducted by the Department of Health Behavior and Policy at Virginia Commonwealth University and supported by the Commonwealth Fund, patients with behavioral health problems are also likely to have co-occurring chronic conditions like diabetes, heart disease and cancer. This double whammy results in higher costs and, for low-income patients, it often means disproportionately higher annual spending than patients with higher incomes. Researchers suggest greater access to crisis stabilization units in low-income communities may reduce these disparities.

New Issue of Health Affairs Tackles Health Equity

The new edition of Health Affairs is centered around health equity and has a number of articles of interest to the work that we and our partners do, including the difficulties in accessing housing for people with disabilities, community organizing and health equity, advancing health equity through performance measurement and payment, and more.

If MMP Supplemental Benefits had a Popularity Contest, the Winner Would Be Dental

The Medicare-Medicaid Coordination office has released an analysis of supplemental benefits offered by Medicare-Medicaid plans in CY 2018. The analysis uses comparative charts to describe the number of supplemental benefits offered in each of the nine states participating in capitated model demonstrations and the percentage of plans in each state offering at least one supplemental benefit.

According to this data:

  • Supplemental dental benefits were those most frequently offered per plan, followed by Health and Wellness Services and Supplemental Part D prescription drug benefit cost-sharing reductions.
  • In California, Illinois, Ohio and Texas, at least half of all Medicare-Medicaid Plans (MMPs) offer supplemental dental benefits.
  • Supplemental Health and Wellness services benefits were available with every MMP in South Carolina and Texas and in at least half of MMPs in California, Illinois, Massachusetts, Michigan and Ohio.
  • South Carolina, Massachusetts, and Rhode Island offer Supplemental Part D prescription drug benefits in all MMPs, and Illinois, Ohio, and Texas offered supplemental Part D benefits in 80 percent of plans.

The analysis also provides an overview of numerous other supplemental benefits like vision, long term-services and supports, rehabilitation services, home and community based services, and more.

STATE HIGHLIGHTS

Idaho

In a surprise move, the Idaho Legislature sent Gov. Otter’s bill to allow residents with complex medical needs to access Medicaid coverage back to committee last week. Under the bill, approximately 2,000-2,500 Idahoans who require expensive treatment for complex medical conditions like cancer, hemophilia or cystic fibrosis would be eligible to move from the state exchange pool to Medicaid while another 38,000 low-income and otherwise vulnerable residents would become eligible for federal subsidies for private insurance. The target end for the legislative session is March 23, so stay tuned for further developments.

Michigan

Crain’s Detroit Business reported that Michigan will consider a proposal to transition the state’s $2.8 billion Medicaid nursing home and long-term care services programs into managed care. An initial review by the state Department of Health and Human Services is expected to begin by July 1. The state’s long-term care programs include nursing homes but also a host of other programs such as MI Health Link and PACE, which are programs serving Medicare-Medicaid beneficiaries.

New Jersey

The Rutgers University Center for State Health Policy, working with housing experts and Medicaid officials, will begin a project to identify opportunities to generate Medicaid savings and improve patient outcomes among Medicaid enrollees who use homeless services. Supported by The Nicholson Foundation, researchers will link data from the Homeless Management Information System and the Medicaid Management Information System in this study to identify enrollees and if savings can be generated.

The Center for State Health Policy has also published a report on the results of the State Health Innovation Plan for the New Jersey State Innovation Model (SIM) project, a $3 million design grant from the Center for Medicare & Medicaid Innovation. The report found that the SIM project had robust stakeholder engagement, was able to condense numerous quality metrics into a core set of recommendations for the state, supported critical Medicaid Accountable Care Organization activities, and more. You can find the full report here.

Pennsylvania

Last month, the Pennsylvania Department of Human Services (DHS) highlighted an initiative focused on seniors and individuals with physical disabilities as part of Gov. Wolf’s proposed budget for fiscal year 2018-2019. Under the proposal, the commonwealth would support Community HealthChoices (CHC), DHS’ managed care program for long-term services and supports, with over $69 million for the fiscal year. DHS launched CHC in the southwest region at the beginning of the year and will continue a phased rollout throughout the commonwealth through Jan. 1, 2020.

Washington

Health Management Associates reported that the Washington State Health Care Authority released its Integrated Managed Care Request for Proposals. This new program will provide 1.6 million Medicaid enrollees with both physical and behavioral health services. Managed Care Organizations that will be selected will be responsible for providing the full continuum of physical and behavioral health, including primary care, pharmacy, mental health and SUD treatment, to Medicaid enrollees. Proposals are due on April 12.

In other news, the Washington State Health Care Authority has approved all nine Accountable Communities of Health (ACH) Medicaid Transformation Project Plans. The Medicaid Transformation Project is the state’s Section 1115 waiver, approved by CMS in 2017. Under the waiver, the first initiative involves transforming Medicaid delivery in each Regional Service Area through ACHs. The newly approved Project Plans look to improve the overall health of Medicaid beneficiaries in several ways, including by tackling the opioid crisis and integrating behavioral health.

KEY DATES

Wednesday, March 14 (2-3 p.m. Eastern) – Webinar: Supporting Participants with Complex Behavioral Health Needs, presented by The CMS Medicare-Medicaid Coordination Office, in collaboration with The Lewin Group. This is part of the Disability-Competent Care Webinar Series. Register here.

Wednesday, March 21 (2-3 p.m. Eastern) – Webinar: Interdisciplinary Team Building, Management, and Communication, presented by The CMS Medicare-Medicaid Coordination Office, in collaboration with The Lewin Group. This is part of the Disability-Competent Care Webinar Series. Register here.

Wednesday, March 28 (2-3 p.m. Eastern) – Webinar: Managing Transitions with Adults with Disabilities, presented by The CMS Medicare-Medicaid Coordination Office, in collaboration with The Lewin Group. This is part of the Disability-Competent Care Webinar Series. Register here.

Thursday, March 22 - Submission deadline for Health Leads’ Collaborative to Advance Social Health Integration (CASHI). The collaborative will embark on an interactive, 18-month learning program with up to 20 health care organizations from across the nation committed to expanding effective social health strategies and is designed for executive leadership and primary care teams at hospitals and health centers providing care to underserved communities. Additional information on CASHI, including links to apply, is available here.

Monday, April 2 through April 30 – The Kresge Foundation will be accepting applications during April for its Emerging Leaders in Public Health (ELPH) initiative. ELPH is an ongoing leadership development initiative launched in 2014 as a way to equip local public health officers with knowledge and skills to lead in today’s changing health care environment. More information is available here.

Wednesday, April 4 (2-3 p.m. Eastern) – Webinar: Building Partnerships: Health Plans And Community-Based Organizations, presented by The CMS Medicare-Medicaid Coordination Office, in collaboration with The Lewin Group. This is part of the Disability-Competent Care Webinar Series. Register here.

Monday, April 16 – Deadline for submission of applications for 2018-2019 Health and Aging Policy Fellows program, to begin October 2018. The program aims to create a cadre of leaders who will serve as change agents in health and aging policy to ultimately improve the health care of older adults. Full program and application information here.