Health Innovation Highlights: November 18, 2021

Full Edition

November is National Family Caregivers Month

 

Read the stories of family caregivers, and share your own story at #NFCMonth

FROM THE CENTER & OUR PARTNERS

Thank You for Speaking Up!

Thank you to everyone who helped make the nomination process for our 2021 Speak Up for Better Health Award a tremendous success, and to every one of the nominees for their dedicated work over this past very challenging year. We received an impressive array of submissions from across the country that speaks volumes about the dedication, creativity and perseverance of so many people working to improve the health of their communities in what has been an extremely challenging year. Keep an eye out in the coming months to find out our winner and honorees and read about some incredible work happening across the country.

Blogging for Build Back Better

With President Biden’s signing on Monday of the Infrastructure Investment and Jobs Act, all eyes now remain fixed on the House of Representatives, where a vote is awaited this week on the Build Back Better (BBB) Act, currently reported to include approximately $1.75 trillion for a range of provisions comprising the “social infrastructure” components of the president’s agenda. House passage would then send that legislation on to the Senate for action. This seems a good time to revisit two highly informative Community Catalyst blog posts that dig into some specifics of the BBB, as advocates continue to push for speedy congressional action.

An Oct. 21 post, “Multiple Opportunities to Advance Racial Justice in the Build Back Better Act,” by Rachelle Brill, Kavelle Christie, Orla Kennedy and Rachel Rosales, details four specific areas that would advance racial justice and health equity, and therefore advance Community Catalyst’s organizational priorities and vision for the health care system. These include several expansions of access to Medicaid, including a “Direct Coverage Option” to close the Medicaid Coverage Gap, and a historic investment in Home and Community-Based Services (HCBS).

A Nov. 10 post, “The Bipartisan Infrastructure Framework Needs Build Back Better to Succeed,” Eva Marie Stahl, Community Catalyst director, policy & partnerships, re-connects the now-enacted Infrastructure Investment and Jobs Act with BBB – long expected to be voted on simultaneously – and explains why the full promise of the former demands passage of the latter. The post examines three areas of the physical infrastructure bill, explaining why the promise of those investments can only be fully realized with passage of BBB.

New Training Resources to Empower Older Adults and Caregivers to Advocate for Age-Friendly Care

In October, Center Consumer and Community Engagement Consultant Lola Akintobi presented a webinar, "Engaging Older Adults and Family Caregivers for Better Health Using the 4Ms," that introduced a new set of training materials available in both Spanish and English for facilitators who wish to introduce this framework to older adults and caregivers. The Center earlier this year produced a suite of person-facing materials on the Age-Friendly Health System Initiative’s 4Ms: What Matters, Medication, Mind and Mobility.

Improving care for older adults requires not just transforming the health systems where they receive care, but empowering older adults themselves – and their caregivers -- to advocate for the care they want and need. Older adults are the experts on their own health needs and priorities, so it is critical that they are supported and encouraged to talk to their providers about what matters to them. To that end, the Center partnered with Rush University Medical Center’s Geriatric Workforce Enhancement Program (GWEP), to develop a person-facing brochure and poster in both English and Spanish. The 4Ms framework was first developed by the Institute for Healthcare Improvement and The John A. Hartford Foundation as part of their Age-Friendly Health Systems initiative – an evidence-based approach to high quality care for older adults.

How to Achieve a More Equitable “Health Care Measurement Ecosystem”

A new report from ATW Health Solutions and the American Institutes for Research, "Theory of Change for an Equitable Patient Centered Measurement Ecosystem," examines how to implement more equitable, patient-centered measurement in the health care sphere. The report is the result of research with 50 stakeholders, including Center staff.

Patients' and families' perspectives and priorities are often different from those of researchers, providers and payers who have traditionally been involved in establishing the health care measurement ecosystem, and that measurement methods very often have fallen short in including diverse populations. In response to this challenge, the report outlines important steps toward creating patient-centered measurement that are patient-driven, holistic, transparent, comprehensible, timely, and co-created in partnership with patients and caregivers. Interviews with stakeholders surfaced four major areas of focus that, if addressed, can expand the health care measurement ecosystem to become more equitable, and can ultimately support a more equitable health care delivery system:

• Restructure the architecture and design of health care measure development
• Foster stronger partnerships that engage and empower diverse communities and patients
• Ensure that diversity, equity and inclusion are foundational to research, patient engagement and health care delivery, and
• Reshape accountability and influence over funding decisions to center on communities of color and others who experience health disparities.

Senior Agenda Coalition of Rhode Island Hosts 13th Annual Senior Conference and Expo

Center partner Senior Agenda Coalition of Rhode Island held their 13th Annual Senior Conference and Expo on Oct. 27, in person, after a 23-month hiatus due to COVID-19. The conference convened 150 participants, 22 exhibitors and a full slate of presenters. The conference included a Legislative Leaders Forum with Rhode Island Senate President Dominick Ruggerio and Speaker of the House K. Joseph Shekarchi, in which the Coalition asked them to support expending American Rescue Plan Act (ARPA) federal funds to raise salaries of all direct care workers for older adults. They are requesting a raise to $15/hour as soon as possible, and an increase in the rate to $16/hour beginning July 2022. A final panel discussion on “Who Will Care for the Baby Boomers?” focused on raising awareness about the physically challenging and emotionally draining work done by Certified Nurse Assistants in caring for older adults at home or in a nursing facility.

The conference keynote speaker, state Sen. Maryellen Goodwin (pictured above) shared a powerful story of how she and her siblings cared for their mother who was the victim of a severe stroke, for seven years. Hers is just one of thousands of Rhode Island families caring for older adults who need support.  

A video recording of the conference is available here.  

Center Staff Members Featured in Two Upcoming Webinars

On Nov. 30, Center Research Director Marc A. Cohen will participate as a panelist on a webinar presented by The American Society on Aging, “Hebrew SeniorLife’s R3 Initiative – Right Care, Right Place, Right Time: Effectively Integrating Senior Care and Housing.” The R3 initiative takes a population health approach to supporting older adults living in congregate housing. A prevention focused, place-based team is deployed to develop relationships with residents, link them with services and create clear lines of communication between housing staff and healthcare providers. Marc led the evaluation of this innovative program, which will be described in detail during the webinar. Please visit this page for more details about this program and to register.

On Dec. 14, Center Deputy Director Renée Markus Hodin will moderate a panel discussion on a webinar presented in collaboration with The Lewin Group. The webinar will feature speakers from health plans serving individuals dually eligible for Medicare and Medicaid, who will share strategies related to engaging hard-to-reach members during the COVID-19 pandemic. The COVID-19 pandemic, which has made in-person engagement much more difficult and exacerbated health and social needs, has made reaching these members both more pressing and more challenging.

This panel discussion will offer promising practices for locating and engaging these members, especially in light of the COVID-19 pandemic. Panelists will share challenges and innovative strategies for engaging members in care coordination, addressing social needs, and providing education and outreach related to the COVID-19 vaccine. Please visit this page for more details about this program and to register.

NOTEWORTHY NEWS & RESOURCES

Online Tool Helps Medicare-Medicaid Beneficiaries Evaluate their Health Care Options

In California and Ohio, The National Council on Aging (NCOA) is offering a powerful tool that helps individuals who are dually eligible for Medicare and Medicaid make more informed decisions about which health plans best meet their needs. Originally developed for California by The SCAN Foundation, NCOA has adopted the My Care, My Choice tool and plans to make it available to beneficiaries and Medicare counselors in other states through a grant from the U.S. Administration for Community Living (ACL), starting first with Ohio.

How Unmet Need for HCBS Impacts Health and Community Living Outcomes

A new study in the Disability and Health Journal examines the association between unmet need for home and community-based services (HCBS) and health and community living outcomes in a multi-state, multi-program sample of Medicaid HCBS users. Results from the study demonstrate that unmet need for HCBS is consistently and significantly associated with poor health and community living outcomes among Medicaid users.

Confronting Racism in Health Care

Amid a national reckoning on racial justice and the pandemic’s disproportionate impact on Black and brown people, many leaders from U.S. health systems have explicitly named racism as a public health threat and pledged to identify and reverse racist policies and practices in their institutions. For a publication by The Commonwealth Fund, the authors spoke to these health system leaders to understand how they are following up on their proclamations. Efforts range from examining patient experiences and the use of race in clinical diagnoses to changing hiring, promotion and recruitment policies.

Recommendations for CMMI’s Future Direction

In a new issue brief, Health Management Associates offers recommendations for new directions that can be taken by the Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation (CMMI) – the Innovation Center – based on an upcoming review of demonstrations that has been announced by CMMI’s new leadership. This brief follows up on an earlier issue brief that examined the Innovation Center’s progress over the last decade, and how that informs possibilities for their future direction.

Since it’s founding, CMMI has tested new models of providing care with the twin goals of reducing Medicare, Medicaid and Children’s Health Insurance Program (CHIP) program spending and improving the quality of that care.

STATE HIGHLIGHTS

Alabama

The Centers for Medicare & Medicaid Services (CMS) approved last month Alabama’s Community Waiver Program, an 1115 demonstration which will potentially expand access to home and community-based services (HCBS), especially for individuals with intellectual disabilities. The program will operate concurrently with Alabama’s 1915(c) waiver to ease HCBS waiting lists.

Maryland

The Maryland Department of Health announced earlier this month that through the American Rescue Plan Act (ARPA), the state will increase Medicaid rates for home and community-based services (HCBS) providers. The state has been directed by the General Assembly to spend at least 75 percent of federal ARPA reinvestment dollars for a one-time-only provider rate increase. The following rate increases will take place:

  • A 5.5 percent rate increase for most HCBS developmental disability providers
  • A 5.4 percent rate increase for most HCBS behavioral health and applied behavior analysis (ABA) providers
  • A 5.2 percent rate increase for community-based long-term services and support providers

Oregon

The Oregon Health Authority (OHA) published final policy concept papers for the state’s upcoming Section 1115 Demonstration waiver renewal. OHA plans on using this waiver to advance health equity by maximizing equitable access to coverage, streamlining coverage transitions, moving to a value-based global budget and focusing on community-led equity investments. A public comment period will begin on Dec. 7 once OHA releases the draft application to the Centers for Medicare & Medicaid Services in early December.

South Carolina

The Medicare-Medicaid Coordination Office (MMCO) finalized contract amendments to South Carolina’s duals demonstration program’s three-way contract. The summary of changes can be found here.

KEY DATES

 Friday, Nov. 19 (12-1:30 p.m. Eastern) - Webinar: Elevating Dementia Caregiving as a Public Health Priority, presented by The BOLD Public Health Center of Excellence on Dementia Caregiving (PHCOE-DC), National Alliance for Caregiving and The John A. Hartford Foundation. Please register for the webinar.  

Tuesday, Nov. 30 (1-2 p.m. Eastern) - Webinar: Hebrew SeniorLife’s R3 Initiative–Right Care, Right Place, Right Time: Effectively Integrating Senior Care and Housing, presented by the American Society on Aging. Please register for the webinar.  

Wednesday, Dec. 1 (1-2 p.m. Eastern) - Webinar: Families Aging with Mental Health and Substance Use, presented by the Rush Center for Excellence in Aging. Please register for the webinar.  

Wednesday, Dec. 1 (2-3:15 p.m. Eastern) - Webinar: Advancing Equity for Older Adults, Part 2: Putting Strategies into Practice, presented by the National Center on Law & Elder Rights. Please register for the webinar.  

Tuesday, Dec. 7 (12-1 p.m. Eastern) - Webinar: Making the Value Case for Complex Care, presented by The Playbook for Better Care for People With Complex Needs. Please register for the webinar. 

Tuesday, Dec. 14 (12-1:30 p.m. Eastern) - Webinar: Locating and Engaging Hard-To-Reach Members During COVID-19: A Panel Discussion, presented by Resources for Integrated Care in collaboration with the Center for Consumer Engagement in Health Innovation at Community Catalyst. Please register for the webinar.