Tag Archives: HHS

Alternative Payment Models: Yeah or Nay?

So where do we go with our healthcare system under the new administration? Will we move to Alternative Payment bundled-paymentsModels or will FFS continue? A recent study showed that bundled payments for orthopedic joint replacement appeared to be working at lowering costs while maintaining quality.

At the same time, it seems that Dr. Tom Price, the nominee for Secretary of HHS is not a fan of bundled payment.

Along with Gregg Masters and Doug Goldstein, we’ll be exploring some of these and many other issues about the next phase of healthcare reform during the coming months on PopHealth Week.

Let us know what you think.

 

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PopHealth Week is a Production of Health Innovation Media and Accountable Health, LLC.

 

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Upcoming Webinar: Why Health Literacy Matters to Your Business

October is Health Literacy Month, a time for organizations and individuals to promote the importance of understandable health information.

Please join me as I moderate a panel on  Why Health Literacy Matters to Your Business during a free webinar from EdLogics featuring top experts from across the country.

The panel includes:

  • Tommy G. Thompson, Former U.S. Secretary of Health and Human Services and former Governor of Wisconsin

Join us as we explore the strong connection between health literacy, health outcomes, and healthcare costs – and learn what you can do to make a difference.

Date: Wednesday, Oct 26, 2:30-3:45 pm EDT

Register Now

 

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A Bill You Can Understand: One Page, One Line, One Price

At the recent Health Datapalooza conferenceSylvia Burwell, the HHS Secretary announced a new initiative, A Bill you Can Understand, :

a challenge to encourage health care organizations, designers, developers, digital tech companies and other innovators to design a medical bill that’s simpler, cleaner, and easier for patients to understand, and to improve patients’ experience of the overall medical billing process.

This is a laudable if perhaps slightly misdirected effort.

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Medicaid – a Community Based Approach to Fixing the Issue

Medicaid, a program for low-income Americans, is one of the largest health programs in the country and is  jointly administered by the Federal Government and the States.  With passage of the Affordable Care Act, Medicaid in many states will be adding millions of new beneficiaries to a program that is typically the first or second largest line item in the State’s budget.

It’s well-known that Medicaid has always struggled with poor payment and provider networks, managed care plans that sometimes work, and  ever-increasing  expenditures.  A recent study released by Gallup points to another problem known for years by those involved with Medicaid but which the current Medicaid system has little or no ability to address; the ever-increasing rate of preventable chronic diseases.

The Gallup Wellbeing Survey documents  the issue clearly if you look at the data for Diabetes, Obesity, High Blood Pressure or High Cholesterol. The reported rates of  these conditions are higher than just about any other group surveyed and the rate of Obesity is the highest of any group.   Medicaid beneficiaries  also report very high rates of smoking, exercise less often and are less likely to eat fruits and vegetables. As the article points out, there is a link between poor health and poverty. We have heard of the issues of “food deserts” and  getting exercise or feeling safe doing outdoor activities is not always possible in certain neighborhoods. Furthermore, access to physicians and other health services are a problem that has been well documented in many Medicaid programs.

To begin to solve this issue we must make a concerted effort to integrate Prevention into the Medicaid programs and expand our thinking about what it takes to “create health” versus what we do to “treat illness.” Medicaid today is structured to treat illness; you get sick, you go the doctor, you get treated, the doctor gets paid, and as is often the case in Medicaid, this does not occur well at any point in the process for a myriad of reasons.    But more importantly why should we be accepting of a higher rate of preventable chronic diseases, the costs of which will continue to grow and impact state budgets, while we narrowly focus on improving Medicaid’s “care system?”

The time is now, before we add millions of new beneficiaries, to revamp Medicaid to create a  comprehensive program targeting the lifestyle issues that create these higher rates of preventable chronic diseases while continuing efforts to improve the sick care system.  The way to do this is not to start by adding more funding to Medicaid but to lead by having Medicaid convene a community in which it operates, invite the beneficiaries, not for profit organizations, schools, religious institutions, providers,  government agencies and employers and develop a broad-based plan to address the issues impacting these lifestyle related diseases.

There are a myriad of disparate resources available throughout these communities that if harnessed, focused and integrated could create the synergies needed to improve upon the communities health and reverse these trends. These groups need to be brought together,  held accountable for their results and incentivized by offering a percentage of the savings. This type of Accountable Health system would create a healthier community.

To learn more or set up this process in your state or local community, contact me.

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