Improving Older Adults ’ Health: Creating Solutions With—Not For—Them
With the best of intentions, foundations and nonprofit organizations often design and support programs based on what they think the people they serve need and want. But in the end, they discover they have designed solutions that miss the mark—their programs aren’t used, and they don’t get the outcomes that they expected.
So at the Health Foundation for Western and Central New York, we wanted to find out what was possible when we created solutions with people, rather than for them.
That’s why we launched Aging by Design, a multiyear initiative to improve the health of older adults, which uses a process called Design...
Source: Health Affairs Blog - August 29, 2017 Category: Health Management Authors: Katharine McLaughlin and Diane Oyler Tags: Featured GrantWatch Organization and Delivery Aging Design Thinking Health Care Delivery Health Philanthropy Health Promotion and Disease PreventionGW Innovation older adults Social Determinants of Health Source Type: blogs
Helping Patients Make More Informed Postacute Care Choices
Conclusion
Selecting the right postacute provider is a complex choice, frequently made under difficult circumstances, with meaningful consequences for the patient and the broader health care system. This complexity will likely increase for patients as reform efforts continue to push integration between acute and postacute providers, possibly creating financial incentives to influence patient choice in ways that may or may not be consistent with their preferences. If consumers are to play an active role in the evolving postacute care choice environment, it is essential that they be well-positioned to make good decisions. Un...
Source: Health Affairs Blog - August 29, 2017 Category: Health Management Authors: Brian E. McGarry and David Grabowski Tags: Featured Innovations in Care Delivery Medicare Quality consumer choices Nursing Home Compare post-acute care post-acute providers Source Type: blogs
An Untapped Opportunity For Health Care Progress: Redesigning Care For High-Need Patients
While uncertainty and debate about health care reform remains, there is near-universal agreement on the need to improve care delivery and health outcomes and decrease the rate at which spending continues to grow. An underrecognized but crucial component to achieving these goals is redesigning care for “high-need patients”—in other words, the small cohort of patients with complex needs who represent the greatest usage of the health care system.
Currently, 1 percent of patients account for more than 20 percent of health care expenditures, and 5 percent account for nearly half of the nation’s spending on health ca...
Source: Health Affairs Blog - August 28, 2017 Category: Health Management Authors: Peter Long Tags: Innovations in Care Delivery Population Health Quality 21st Century Cures Alternative Payment Models Chronic Care high-need patients social services Source Type: blogs
ACA Round-Up: Last Bare County Covered, Oklahoma Waiver Application Complete, And More
The Ohio Department of Insurance announced on August 24, 2017 that CareSource has agreed to offer exchange coverage in Paulding County, Ohio, the last “bare county” in the country. Of course, insurers have until September 27 to make a final decision as to whether they will participate in the exchanges for 2018; if the administration announced tomorrow that it would no longer reimburse insurers for reducing cost sharing as insurers are required to do under the Affordable Care Act, we could see a lot of bare counties quite quickly.
Barring further developments, however, exchange coverage will now be available in every pa...
Source: Health Affairs Blog - August 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage 1332 waivers MacArthur Amendment Oklahoma Source Type: blogs
Variation In End-Of-Life Care Is An Open Invitation For Accountable Care Organization Innovation
Conclusion
In short, in a market that is moving away from paying for care based solely on the quantity provided, the EOL care realm remains a largely unventured but promising area for ACO innovation. The variation in hospice use means that there are delivery inefficiencies that, if corrected, could generate both clinical and financial improvements, which are precisely the types of advances rewarded in the ACO reimbursement structure. Furthermore, hospice inclusion in Medicare ACOs finally provides a platform and the incentives to learn more about local hospice markets, rethink how palliative care should be used to improve ...
Source: Health Affairs Blog - August 25, 2017 Category: Health Management Authors: Julia Driessen and Turner West Tags: End of Life & Serious Illness Medicare Quality Accountable Care Organizations Medicare hospice benefit palliative care services Source Type: blogs
Tribal Partnerships: A Health Foundation Balances Relationships And Results With Native American Communities
The chairman of the tribal council pointed to the rusting van and the community garden gone to seed. Outsiders often come here with good intentions, he observed, but when they leave, our Tribe is no better off. This encounter has framed all of Empire Health Foundation’s (EHF’s) subsequent work with Native American partners in profound ways.
We work for this health foundation in Eastern Washington, the goal of which is to make measurable improvements in our region’s health. Given the profound disparities in health outcomes between Native Americans and the general population, this has inevitably led us to focus on ...
Source: Health Affairs Blog - August 24, 2017 Category: Health Management Authors: Brian Myers and Mike Yeaton Tags: GrantWatch American Indians Disparities Health Philanthropy Native Americans Nonmedical Determinants patient activation Social Determinants of Health tribes Washington State Source Type: blogs
Iowa Waiver Application Presents Crucial Decision Point For Administration; Judge Rebuffs EEOC On ADA/GINA Rules
On August 21, 2017, Iowa submitted its application for a 1332 Stopgap Measure innovation waiver to the Departments of Health and Human Services and Treasury. An earlier version of this application was discussed at length in this blog in June. Although the most recent version of the application has cleaned up some of the procedural defects in the earlier submission, the substantive legal defects and practical problems posed by the proposal remain substantial. Many of the questions raised by earlier drafts also remain unanswered.
Section 1332 of the Affordable Care Act permits states to apply for waivers of certain provision...
Source: Health Affairs Blog - August 24, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Following the ACA Insurance and Coverage 1332 waivers Americans With Disabilities Act cost-sharing reduction payments Genetic Information Nondiscrimination Act Source Type: blogs
To Combat ‘Information Blocking,’ Look To HIPAA
Back in 2009, when the Health Information Technology for Economic and Clinical Health (HITECH) Act became law, US taxpayers committed $300 million to seed nationwide health information exchange. Taxpayers also agreed to pay what turned out to be $35 billion in incentive payments for physicians and hospitals to adopt and “meaningfully use” electronic health records (EHRs). In implementing the meaningful-use program, the Centers for Medicare and Medicaid Services (CMS) required eligible providers and hospitals to attest to certain activities, including engaging in health information exchange and providing their patients ...
Source: Health Affairs Blog - August 24, 2017 Category: Health Management Authors: Lucia C. Savage Tags: Health IT 21st Century Cures electronic health records HIPAA information blocking medical data privacy Source Type: blogs
Making Smoking Cessation Work For People With Mental Illnesses And Other Vulnerable Populations
The prevalence of cigarette smoking among adults is now at a modern low of 15 percent, and youth rates are also down for high school seniors, with only 3.4 percent smoking daily. Yet this is not a time to become complacent and move on to other public health problems. As many as 40 million people still smoke, and half of them will die prematurely as a result. Furthermore, smoking rates remain high among the most vulnerable populations, such as people with mental illnesses or substance use disorders, necessitating policies and strategies targeted specifically at them, as well as support for tobacco control at the federal, st...
Source: Health Affairs Blog - August 23, 2017 Category: Health Management Authors: Steven Schroeder Tags: Featured Health Equity Population Health Public Health Behavioral Health Mental Illness smoking cessation Substance Use Disorders vulnerable populations Source Type: blogs
Did Medicaid Expansion Cause The Opioid Epidemic? There ’s Little Evidence That It Did.
Conclusion
Some Medicaid recipients who gained coverage under the ACA may have become addicted to opioids, but we find little evidence that Medicaid expansion caused aggregate drug-related death rates to increase. Future research on the opioid epidemic should develop approaches that untangle the effects of Medicaid expansion from pre-existing economic trends and the spread of accessible illegal drugs. That said, by addressing the causes of addiction and promoting appropriate treatment, Medicaid could be an important tool for policy makers in the fight against opioid abuse. In January 2016, the Centers for Medicare and Medi...
Source: Health Affairs Blog - August 23, 2017 Category: Health Management Authors: Andrew Goodman-Bacon and Emma Sandoe Tags: Following the ACA Medicaid and CHIP Public Health Quality Medicaid expansion opioid epidemic Source Type: blogs
Funding For Local Public Health: A Renewed Path For Critical Infrastructure
Discussion
Ultimately, it will take creative approaches to finance public health 3.0 and fulfill the attributes and principles described above. Taking the health system down a different path where public health contributes to value-based health, will require a broad national consensus among stakeholders. Here are some potential structures for innovative funding of public health in the 3.0 era:
1. Federal incentives for building local public health capacity
The federal government can take a stronger role in incentivizing states to invest more in public health capacity by creating a matching requirement for many federal publ...
Source: Health Affairs Blog - August 22, 2017 Category: Health Management Authors: Jeffrey Levi and Karen DeSalvo Tags: Costs and Spending Population Health Public Health Quality Social Determinants of Health Source Type: blogs
Solving The Problem Of Bipartisan Health Care Reform
After the Senate Republicans repeatedly failed to obtain a majority for any health care bill, a bipartisan effort at health care reform has emerged in the House. The effort is led by the so-called Problem Solvers, a group of 43 Representatives, divided roughly equally between Democrats and Republicans.
The legislative goals of this bipartisan group are short-term and sensible: to stabilize the state insurance exchanges, reduce the burdens on small employers, and mitigate the impact of higher premiums on individuals. While avoiding the over-heated politics of revamping Medicaid, the group wants to accomplish its goals witho...
Source: Health Affairs Blog - August 22, 2017 Category: Health Management Authors: Robert Pozen Tags: Following the ACA Insurance and Coverage Medicare ACA reform bipartisanship health savings accounts IPAB Source Type: blogs
The IRS Is Still Enforcing The Individual Mandate, Despite What Many Taxpayers Believe
There has been considerable speculation since President Trump’s Inauguration Day Affordable Care Act Executive Order as to whether the Internal Revenue Service is in fact enforcing the individual and employer mandates. The IRS website has insisted that the mandates are still in force, despite the Executive Order and despite the fact that the IRS decided not to implement for 2016 tax filings a program rejecting “silent returns” that did not indicate compliance with individual mandate requirements.
There is evidence, however, that many taxpayers do not believe it. An April report from the Treasury Inspector General for...
Source: Health Affairs Blog - August 21, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage individual mandate Source Type: blogs
IRS Releases Draft Forms For 2017 ACA Reporting
The Internal Revenue Service has released drafts of the forms it will use for Affordable Care Act reporting for 2017, including form 1095-A (used by exchanges); forms 1094-B, and 1095-B, (used by insurers and other entities that offer coverage); forms 1094-C, and 1095-C (used by large employers); and draft instructions for the 1095-A.
The IRS has also released a draft of form 8962, which is used for reconciling advance premium tax credits an individual receives with the actual tax credits to which an individual is entitled at the time of filing, and of form 8965, which is used for claiming exemptions from the individual ma...
Source: Health Affairs Blog - August 21, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Source Type: blogs
The Opioid Commission: Ringing The Right Alarm To Respond To The Overdose Epidemic
The 20-year opioid overdose epidemic confronting our nation has continued unabated largely because of an uncoordinated response that has over emphasized supply-side interventions (i.e. prescriber guidelines, Prescription Drug Monitoring Programs, law enforcement) rather than dramatically increasing access to evidence-based treatment as occurred in other Western nations with great success. The White House’s Opioid Commission (chaired by Governor Chris Christie, R-NJ) in declaring a national emergency and breaking with this failed tradition offers much hope for stemming the overdose death rate.
The Opioid Commission’s in...
Source: Health Affairs Blog - August 21, 2017 Category: Health Management Authors: Arthur Robin Williams and Adam Bisaga Tags: Featured Public Health Quality Opioid Addiction opioid epidemic Source Type: blogs
