Tag Archives: The CHILD Act

Interview on the “Unlocking Accountable Care” Podcast

I was recently  a guest on the Unlocking Accountable Care Podcast to discuss community efforts to improve health and H.R. 660 The Community Health Improvement and Leadership Development Act of 2019 – 2020.  You can listen to the podcast here.

Thanks to the folks at Day Health Strategies for providing me with this opportunity.

 

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A Frustrating Day at a Community Health Improvement Program

A few months ago, I attended a community health annual event associated with one of the many initiatives started by a large organization to bring together groups and begin implementing programs to improve the health of the community.

 

At this particular event after a couple of years of meetings and work, there were a number of presentations by the organization, community groups, the local government and a review of work done to date. It was a Kumbaya moment. Near the end of the day when people were asking questions, a gentleman next to me stood up, he worked in one of the poorest neighborhoods in the city and oversaw a local effort in that community.

He said and I’m paraphrasing.

 

I look at our community and see it has the exact same issues today we had 50 years ago. Nothing has changed, nothing has been done and we look just the same. You tell us to exercise but we have no sidewalks, no parks, the nearest gym is 3 miles away, we have no transportation, no access to healthy foods…

and well you know the rest of the issues he raised. He was clearly frustrated and has every right to be.

At that point a young woman stood up, Continue reading

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H.R. 7038 has been Reintroduced as H.R. 660 The CHILD Act – Incenting Communities to Improve the Health of Their Medicaid Beneficiaries

I’m updating this post to let you know that the bill has been reintroduced as H.R. 660 in the 116th session of Congress.  The new link to the bill is here.  We are looking for sponsors and support.

Thanks

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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