Health Innovation Highlights: September 12, 2019

Full Edition

DIRECTOR’S CORNER

Fall Energy and New Beginnings

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

At this season of new beginnings, we’re readying a fall lineup with insights, inspiration and information to help support a strong consumer and community voice in health care.

This week, we’re excited to be welcoming Emily Stewart as the new executive director of Community Catalyst. Emily has led effective health policy and advocacy strategies, including ones related to health care delivery reform. We’re thrilled to have her leading Community Catalyst forward!

In the communications sphere, yesterday Community Catalyst debuted its new weekly health advocacy and policy digest, At the Corner of State and Federal! Please check it out and sign up if you didn’t receive it. (Past subscribers to the now-discontinued daily news clips roundup, OnMessage, were automatically subscribed to the new weekly email.)

At the Center this month, Research Director Marc Cohen is quoted in The Boston Globe about the importance of long-term care for older adults.

And I’m looking forward to an upcoming webinar hosted by SIREN, the Social Interventions Research & Evaluation Network, that will explore how state Medicaid programs are working to better address patients’ social needs.

Stay tuned in the next few weeks for additional content, including a video about how consumers in Tennessee, with support from our state partner organizations, are working to improve care for people with intellectual and developmental disabilities.

Happy fall!

FROM THE CENTER & OUR PARTNERS

Center Research Director: States Stepping Up to Address Spiraling Long-Term Care Cost

Long-term care costs are going up and the population is getting older. As gridlock at the national level prevents even modest measures to rein in costs and provide middle- and low-income families with supports that could help them care for their loved ones as they age, The Boston Globe reports that a number of states are becoming laboratories for payment reform for long-term care services. Many states – including California and Michigan – are considering a model passed in Washington state to levy a payroll tax to help subsidize in-home care for all residents. Other states are looking to Hawaii’s model of providing family caregivers already in the workforce stipends to help cover the cost of homecare aides. Last November, advocates in Maine placed a referendum on the ballot to fully cover in-home care services with no out of pocket costs, and though the measure was defeated, advocates are still looking for ways to push states to do more. “A lot of states have concluded that the cost of doing nothing now exceeds the cost of doing something,” concludes Marc Cohen, Center research director and gerontology professor and researcher at the University of Massachusetts Boston, as quoted in the article.

Upcoming SIREN Webinar: Opportunities and Tensions in Community-Based Organization – Health Care Collaborations to Address Patients’ Social Needs

Join SIREN (Social Interventions Research and Evaluation Network) on Tuesday, Sept. 24 from 12-1 p.m. (Eastern) for a free webinar exploring recent research on health care collaborations between systems and community-based organizations that seek to address patients’ social needs. The webinar will provide several examples of state Medicaid agency collaborations with community partners, and will discuss several ways states are working to overcome barriers to effective partnerships.

SIREN, where Center Director Ann Hwang is a National Advisory Committee Member, is a national leader in bringing health care practitioners and advocates evidence to support, and solutions to address, identified social risks in health care systems. The webinar is sponsored by Blue Cross Blue Shield of California and Massachusetts. Click here for more information and to register.

NOTEWORTHY NEWS & RESOURCES

Office of Minority Health Releases New Data Brief on Access to Health Care for Dual Eligible Beneficiaries with Disabilities

The Office of Minority Health at the Centers for Medicare and Medicaid Services has released a new data brief, “Does Disability Affect Access to Health Care for Dual Eligible Beneficiaries?” This brief describes research findings from a review of nearly 275,000 responses to the Nationwide Adult Medicaid Consumer Assessment of Healthcare Providers and Systems (NAM CAHPS). Key findings include that dual eligible beneficiaries with at least one disability were more likely to report that they were unable to get necessary medical care, tests or treatments than dual eligibles with no disability (14 percent versus 10 percent) and that transportation is a key barrier to care.

Starving Seniors: How America Fails to Feed its Older Adults

A growing number of older adults in the United States are experiencing food insecurity, and the problem is particularly acute in the South and Southwest, according to an article in Kaiser Health News. Government relief is currently falling short and is only set to become more inadequate pending changes to the Supplemental Nutrition Assistance Program (SNAP) under Trump administration proposals. The article details what millions of older adults are already facing, reporting that “[n]early 8percent of Americans 60 and older were ‘food insecure’ in 2017.” The article also lays out the implications of inaction on food insecurity. For instance, food insecurity affects older adults' overall health and well-being by exacerbating disease and preventing healing after an injury.

MACPAC Inventory of Evaluations and Issue Brief on Integrated Care Programs for Duals

Earlier this summer, the Medicaid and CHIP Payment and Access Commission (MACPAC) published an inventory of evaluations and an accompanying issue brief summarizing the key findings from an analysis of how several types of integrated care programs for dual eligibles have affected spending, quality, health outcomes and access. The evaluations covered models such as the Program of All-Inclusive Care for the Elderly (PACE), the Financial Alignment Initiative (FAI), the Medicare Advantage dual eligible special needs plans (D-SNPs) and managed long-term services and supports programs. In its issue brief, MACPAC concluded that it is difficult to draw definitive conclusions about the effectiveness of integrated care models, given the limited number of studies for each model type.

New Brief Examines Information-Sharing by D-SNPs in Three States to Improve Care Transitions

A new brief from the Integrated Care Resource Center examines the approaches used by Oregon, Pennsylvania and Tennessee to develop and implement information-sharing processes for Dual Eligible Special Needs Plans (D-SNPs) that support care transitions. The brief aims to help stakeholders learn how to meet the new D-SNP contracting requirements while improving care for dually eligible individuals. It includes examples of contract language and strategies to encourage plan collaboration around information sharing.

STATE HIGHLIGHTS

California

Last month, the Centers for Medicare & Medicaid Services (CMS) released a summary of 2017 quality withhold results for Cal MediConnect (CMC) plans. CMC is the state’s dual eligible demonstration program. Results show that CMC plans met 75 percent of all withhold measures – 83 percent of CMS core measures and 63 percent of California state-specific measures. On average, plans collected 98 percent of their withhold amounts.

CMS has released a summary of six other states’ summaries of 2017 quality withhold results in the dual eligible demonstration programs. Those summaries can be found here.

Massachusetts

This summer, MassHealth, the Massachusetts Medicaid program – along with the Centers for Medicare & Medicaid Services (CMS) and the commonwealth’s One Care dual eligible demonstration plans – executed an addendum to the Three-Way Contract that extends the commonwealth’s demonstration period by one year, through Dec. 31, 2020. One Care serves dual eligible adults aged 18-64.

In related news, CMS released a summary of 2017 quality withhold results for the One Care plans. On average, the two plans in the One Care program collected 100 percent of their withhold amounts, meeting 88 percent of all withhold measures.

CMS has released a summary of six other states’ summaries of 2017 quality withhold results in the dual eligible demonstration programs. Those summaries can be found here.

Michigan

This summer, the Michigan Medicaid program, the Centers for Medicare & Medicaid Services (CMS), and the MI Health Link dual eligible demonstration health plans executed an addendum to the Three-Way Contract governing the program. A summary of the changes to the revised contract are outlined here.

In related news, CMS released a summary of 2017 quality withhold results for the MI Health Link plans. Results show that plans met 87 percent of all withhold measures and collected, on average, 93 percent of their withhold amounts.

CMS has released a summary of six other states’ summaries of 2017 quality withhold results in the dual eligible demonstration programs. Those summaries can be found here.

New York

The Wall Street Journal reports that the New York Department of Health is actively pursuing a Delivery System Reform Incentive Payment (DSRIP) waiver renewal from CMS. One of the goals of DSRIP, which is set to expire in March 2020, was to achieve a 25 percent reduction in avoidable hospital use over five years. A report from the state health department found that in the last four years, there has been a 21 percent reduction in potentially preventable admissions and an 18 percent reduction in the number of avoidable hospital readmissions for populations served through DSRIP.

Ohio

This summer, the Ohio Department of Medicaid, the Centers for Medicare & Medicaid Services (CMS), and the MyCare Ohio dual eligible demonstration health plans executed an addendum to the Three-Way Contract, extending the demonstration another three years to 2022. A summary of the other changes to the revised contract are outlined here.

In related news, CMS released a summary of 2017 quality withhold results for the MyCare Ohio health plans. Results show that plans met 87 percent of all withhold measures and collected, on average, 95percent of their withhold amounts.

CMS has released a summary of six other states’ summaries of 2017 quality withhold results in the dual eligible demonstration programs. Those summaries can be found here.

KEY DATES

Tuesday, Sept. 24 (12 - 1 p.m. Eastern) - Webinar: Opportunities and Tensions in Community Based Organization – Health Care Collaborations to Address Patients’ Social Needs, presented by SIREN (Social Interventions Research and Evaluation Network). Please register for the webinar.