Health Innovation Highlights: October 17, 2018

Full Edition

FROM THE CENTER & OUR PARTNERS

New Center Resources on Hospital/Community Organization Partnerships              

Federal community benefit requirements for non-profit hospitals present a key opportunity for hospitals and health systems to work with grassroots and community-based organizations and two new Center resources offer important guiding principles for anyone interested in using community benefit to improve community health:

Building Local Capacity to Engage Hospitals is a collection of case studies that offer lessons and strategies for building mutually beneficial partnerships. Follow the stories, successes and challenges of three community-based organizations and coalitions as they build skills and partnerships with local hospitals to address social and economic challenges impacting the health of local residents – and learn how you can apply this to your own work.

Hospital Community Benefit Dashboard outlines five core principles and indicators that hospital community benefit staff and community organizations can use to evaluate and strengthen a hospital’s current community benefit practices, with a focus on achieving health equity and meaningful community engagement.

Center Submits Comments on Massachusetts Duals Proposal

Today, the Center submitted comments to the Medicare-Medicaid Coordination Office on a proposal from the Commonwealth of Massachusetts for a new “Dual Demonstration 2.0” that would include both the One Care demonstration for dually eligible individuals under age 65, and the Senior Care Options Dual Eligible Special Needs Plan (D-SNP) program for dually eligible individuals ages 65 and older. The Center emphasized the need to keep the goals of improved care, health outcomes and quality of life as the guiding principle of any new demonstration and expressed concerns over passive enrollment, lock-in periods as well as a variety of financing changes.  

NEMT Resources on the Center’s Website

Accessing the Center’s resources on Non-Emergency Medical Transportation (NEMT) just got a whole lot easier! NEMT now has its own webpage on the Center’s site, which includes a primer on this Medicaid transportation benefit, access to the Center’s NEMT brief (developed in collaboration with our partners at Justice in Aging) and information about how to access technical assistance from the Center on NEMT issues.

To learn more about this topic, please register for the webinar on NEMT that the Center is conducting in collaboration with our friends at the National Center for Complex Health and Social Needs. The webinar will be presented on Oct. 29  from 1:30 – 3:00 EDT. Please join us!

NOTEWORTHY NEWS & RESOURCES

Massachusetts’ Commonwealth Care Alliance Achieves Results Through Investments in the Social Determinants of Health

An article in Politico profiles Commonwealth Care Alliance (CCA), outlining the innovative health delivery system’s successes achieved through its participation in two demonstration projects to better integrate and coordinate Medicare and Medicaid services for dually eligible individuals. CCA’s experience and results show that investing in preventive care is the key to lowering costs for patients with complex health care needs. CCA’s model includes providing home visits to persons with complex health and social needs, and using a caseworker to coordinate all needed medical care and ancillary services. It also focuses first on caring for members’ basic needs, such as food and housing. These strategies are showing results: between 2011 and 2017, hospital admissions for the program’s older adult participants dropped by 27 percent, and it is projected that the program could save Medicare and Medicaid nearly $100 million per year by 2022.

Aligning ACOs and Bundled Payments to Improve Care, Lower Costs 

ACOs and bundled payments are both touted as innovative mechanisms to achieve high-quality, low-cost health care, but they can often appear at odds with one another. In view of this tension, it is becoming increasingly clear that these two mechanisms will need to be aligned in order to take advantage of each model’s full potential for producing value-based care. An article in NEJM Catalyst lays out how such an alignment could help provider organizations meet the rising expectations of federal policymakers while providing an opportunity for health care providers and payers to work in unison toward improving patient outcomes and managing costs.

American Academy of Pediatrics Breaks Ground with Statement on Providing Culturally Competent Care to Transgender Kids and Adolescents

As described in a New York Times article, the American Academy of Pediatrics put out its first-ever policy statement to guide providers of medical care for children and adolescents who are transgender or may be questioning their gender identity. The authors of the statement said the acadmey’s decision to craft the statement came as a direct response to queries from pediatricians, parents and patients, seeking guidance on how to provide culturally competent support to young people, with the goal of  “creating a system where all children feel they have access to supportive and nonjudgmental care.”

The statement puts forward a model of “gender-affirmative care,” based in the idea that “variations in gender identity and expression are normal aspects of human diversity,” and that mental health problems in these children arise from stigma and negative experiences, and can be prevented by a supportive family and environment – including health care.

STATE HIGHLIGHTS

Illinois

Illinois garnered a perfect score by a leading mental health research center for its treatment and parity law innovations. The Well Being Trust issued a report earlier this month with state-by-state ratings provided by the Kennedy-Satcher Center for Mental Health Equity measuring mental health and addiction treatment parity laws across the country. Illinois earned a 100 percent score according to the report, Tennessee came in second with a 79 percent rating, while 43 other states earned a score of less than 50 percent. A new law in Illinois made all the difference in the ratings: Public Act 100-1024, which goes into effect Jan. 1, 2019, requires insurers to cover mental health, substance use disorder treatment and physical health services at the same level of cost-sharing, making access more equitable and transparent for consumers.

Maine

All eyes are on Maine as November nears and the state’s Ballot Question 1 offers residents a vote on universal home care. The ballot initiative proposes a 3.8 percent tax on wages over $128,400 for individual filers to cover the cost of providing home care services to every resident in the state needing them, at no out of pocket cost. There are currently around 5,600 Mainers receiving home care services through Medicaid, but many residents in middle class income brackets are left out of services by state income eligibility guidelines. These residents are particularly vulnerable because the high cost of long-term care insurance and hourly rates for providers are often out of reach. Estimates suggest that more than 21,000 people would become newly eligible for services if the initiative passes.

Minnesota

Minnesota’s history of health care innovation was profiled in a new United States of Care brief focused on the growing health care voter base across the country and ways to leverage interest in these issues into influence at the polls. In particular, the brief explores Minnesota’s long history of bipartisan cooperation on health care issues and opportunities for moving the needle on health care agendas in future election cycles. Modernizing health care information-sharing capacity, drug pricing, mental health and substance use disorder treatment access, rural health access and health equity are identified as priority issues for the state. The brief also suggests some framing questions that challenge legislators to think about the larger social and economic impact of health related policies.

KEY DATES

Wednesday, Oct. 24 (3-4 p.m. Eastern) - Webinar: Medical Professionals with Disabilities, presented by the Administration for Community Living. Please register for the webinar.  

Monday, Oct. 29 (1:30-3 p.m. Eastern) - Webinar: NEMT at the Crossroads: Protecting and Improving a Critical Medicaid Program, presented by The National Center for Complex Health and Social Needs in partnership with the Center for Consumer Engagement in Health Innovation. Please register for the webinar.    

Tuesday, Oct. 30 (2:30-3:30 p.m. Eastern) - Webinar: Addressing Social Determinants of Health in Medicaid Managed Care, presented by Manatt Health. Please register for the webinar.  

Tuesday, Nov. 6 (2:30-4 p.m. Eastern) - Webinar: Promising Practices for Meeting the Needs of Dually Eligible Older Adults with Schizophrenia, presented by the Centers for Medicare and Medicaid. Please register for the webinar. 

Tuesday, Nov. 14 (1-2 p.m. Eastern) - Webinar: Changes to the “Public Charge” Rule and the Impact on Older Adults, presented by Justice in Aging. Please register for the webinar.