Tag Archives: Social Determinants of Health

H.R. 7038 The CHILD Act – Incenting Communities to Improve the Health of Their Medicaid Beneficiaries

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.

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John D. Bower School of Population Health

JDB LogoI’m honored to have been appointed as Graduate Faculty at the John D. Bower School of Population Health at the University of Mississippi Medical Center.

The School is one of the few schools of Population Health in the nation and “their mission is to educate leaders who will transform health care delivery and the health of Mississippians.

This really resonated with me as I had previously done work in Mississippi when Specialty Disease Management Services Inc. (SDM) was involved in the Medicaid disease management initiative as a subcontractor to McKesson Health Solutions.  SDM provided on the ground RNs and community care coordinators located throughout the state seeking to improve the health and care for Medicaid beneficiaries with asthma, diabetes heart failure and COPD. I also have in-laws in Leland, Mississippi in the heart of the Delta.

beech,-bettina1The school is led by Dr. Bettina Beech, their Dean, who is a dynamo building the school and truly working to embed the schools expertise into the state by getting involved in programs to leverage population health in an effort to improve the health of all Mississippians.  Her areas of scientific inquiry focus on the role of nutritional factors in the primary and secondary prevention of obesity and type 2 diabetes, with a particular focus on child health disparities.

The School has three departments, Continue reading

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Running to the Ball: the Shiny Object of Social Determinants of Health

Social Determinants of Health (SDoH) are all the rage, we see it discussed by hospitals, physicians, IT companies, health plans, academia, community non-profits, government, and the list goes on and on.  It’s amazing how rapidly addressing SDoH has sprung up as “the solution”, and it may in fact be.  But before we get too excited we need to consider that approaches to solve SDoH need to be operationalized and who does what, how the approaches are overseen, and accountability will make or break the outcomes.

The current behavior of the majority of sectors reminds me of a kid’s soccer game.  If Soccer Kidsyou’ve ever watched one you’ve no doubt seen a mass of children tightly arranged around the ball, each one trying to kick it, while 98% of the field is wide open.

Effective teams spread out, each one playing their role, in their assigned space while being held accountable.

If we’re not careful, Continue reading

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Where is the Elon Musk of Healthcare?

In April of this year I presented at the University of Mississippi Center , School of FG spacex,-moonshotsanddiabetesPopulation Health. A description of that presentation is on LinkedIn:

SpaceX, Moonshots and Diabetes in Mississippi

 

Musk Falcon Heavy Cut

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PopHealth Week Now Available on iTunes

You can now download all of the episodes of PopHealth Week on iTunes. Future episodes will be added as they are recorded.  Please have a listen, subscribe and rate the show.

Here is the link:

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PopHealth Week on iTunes

 

PopHealth Week is a production of Health Innovation Media.

 

 

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