This past week on PopHealth Week Gregg and I discussed the Annual Medicare Wellness Visit and how it came to be. I have always dabbled in policy and was fortunate enough to participate in the creation of that piece of legislation.
More recently, a small group including Reyn Archer, MD, the former Commissioner of Health for the State of Texas and current Chief of Staff to Congressman Jeff Fortenberry, Doug Goldstein and I have been exploring ideas on community health improvement. One of the key gaps we identified was that if a person or community works to improve their health, the financial benefit accrues to the payer or providers. At the same time, sustainable financing has been a fundamental problem with many of the community health improvement initiatives, such as Blue Zones, The Way to Wellville, the Clinton Health Matters Initiative, Humana’s Bold Goal initiative, which typically have the funds to get started, but after a few years have no source of revenue to continue. We sought to solve these two issues.
While I have been working on a concept I call Havens of Health, a Medicare /Medicaid Health Plan owned by its members; Reyn had come up with the concept of creating Community Shared Savings Accounts as the vehicle to distribute/share funds and provide incentives.
For the past three years we have been working on legislation to do just that, and I am excited to announce that we now have a Bill, H.R. 7038 the “Community Health Improvement, Leadership, and Development Act of 2018” or the “CHILD” Act. The purpose of the bill is:
To give communities the tools to improve their own health outcomes through community-relevant health information and new health supporting incentives and programs funded without further appropriations.
The idea is simple:
- it tasks HHS/CMS with putting together data sets of relevant Medicaid epidemiological and claims health information,
- provides grants to states to carry out localized Community Health Improvement programs which includes the creation of dashboards for the community
- The Community puts together a program to target one or more of these conditions and
- if the program reduces the rates of illness in the community’s Medicaid beneficiaries and/or lowers costs, 70% of the savings would go back to the community.
- These savings would be placed in the Community Savings Account to be overseen by a local board, and “used for promoting the health and wellness of residents of the community.”
This bill has bipartisan support, being co-sponsored by Congressman Jeff Fortenberry (R) and Congresswoman Eddie Bernice Johnson (D), and establishes an incentive for communities to work to improve the health of their residents while also creating a sustainable source of funding for communities to begin to work together on both the clinical and social determinants of health, as some have been doing for a while.
If you’d like more information on H.R. 7038 please contact me.