Tag Archives: The Clinton Health Matters Initiative

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.


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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Humana Bold Goal Launched in Jacksonville, Florida – a Call to Action

This is the longer original piece with all the links and images that  was the genesis for the Florida Times Union commentary.

This past month I had the opportunity to participate during Humana’s  half-day Bold Goal launch conference in Jacksonville, Florida (the county seat is Jacksonville and there has been a consolidated government of Duval County since 1968, so some refer to the broader county).  The conference had excellent presentations and I was honored to be included with a distinguished group of panelists from the Health Department, hospitals, providers of care and the Duval County Medical Society. It was nice to be involved in an event and try to play a role in improving the health in the community in which I live.

There are other efforts ongoing to improve community health in Jacksonville, including the Clinton Health Matters Initiative, which has focused on solving the hunger issues and a number of hospitals have launched their own efforts as part of the Community Health Assessment and Improvement Plan. While these programs and others in the community may have made some progress, Jacksonville still faces major health issues and our quality measures are poor:

Some of the major barriers we face include:

  • we tend to say we need more data or another study,
  • we have not been very innovative, and
  • we have little accountability.

As far as data goes, there are plenty of studies available in addition to those cited above. Here are just a few more interesting ones: Continue reading

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Interview at ASAP conference Sao Paulo Brazil, April 2016

While presenting and attending the ASAP 2016 Population Health Forum, I was interviewed about population health. Topics touched upon include value based care and payments, what should Brazil look to do and incentives.  You can watch it here:


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Startups, Hype and Theranos – Some Musings

Let me begin by saying that I have never built a company into the league of Theranos and I hope that they or another company has and or does develop new technologies and approaches that improve lab testing, service delivery, quality and/or costs. Healthcare delivery certainly needs a lot of improvements and not just in the lab area.  On the other hand I do have start-up experience, having bootstrapped a company in the healthcare industry pulling in ideas from existing services and modifying them to create a moderate but successful service company of which I was the majority owner for about a decade.

As such I have been intrigued by what is happening with Theranos and looking at it from a more person-centric view, trying to understand how it could have gotten to where it apparently is.  I use the term “apparently” because nobody outside Theranos knows for sure and I’m certain that even within Theranos only a few and perhaps one person really knows.

Here are a few key stories if you’re not up to speed basically in reverse chronological order:

At Theranos, Many Strategies and Snags Wall Street Journal
Theranos Wellness Centers aren’t using “Nanotainers” at This Time  TechCrunch
Theranos Founder Faces a Test of Technology, and Reputation NY Times
Letter to the editor: Theranos Responds  Fortune
Wall Street Journal: Letter to the Editor Theranos
How Theranos Misled Me Fortune
Theranos CEO: Company Is in a ‘Pause Period’  Wall Street Journal
U.S. Probes Theranos Complaints Wall Street Journal
Theranos CEO Calls WSJ a Tabloid at WSJ’s Own Conference Wired
Theranos: A hot company takes fire CNBC
Statement from Theranos  Theranos
Hot Startup Theranos Has Struggled With Its Blood-Test Technology Wall Street Journal


Let’s look at some possibilities about Elizabeth Holmes, Theranos and her thinking:

  • The technology that Theranos has developed is close to complete and they will soon put all questions and naysayers to pasture by Theranos releasing data which shows that the technology works, is scalable and can be done as they have announced. Elizabeth Holmes is shown to be correct. Congratulations.
  • The technology doesn’t work and Elizabeth Holmes got caught up in the hype.  Lets face it most companies hype their products to some extent, from the outright selling of vaporware, through “yes our product does that”, selling something they haven’t completed yet or agreeing to a time frame that is very tight. It’s hype, but in most cases it’s a calculated risk that the company can modify, create or launch the product or service to meet the clients demands. Although I will say, I’ve seen many a company, particularly silicon valley healthcare companies, throwing a lot of, let me say, bravado into their pitches.  In any case, it’s important to peel back the exterior veneer and see if there is hardwood underneath the shine.

So now imagine you are Elizabeth Holmes founder and CEO of a company that is the darling of everybody, the media ogles over you, your face is on magazine covers, you’re on television,  politicians praise you, President Clinton has you onstage at the Clinton Health Matters Initiative, you’ve spent a decade of your life building this, you’ve raised a ton of money and you’re a billionaire on paper! You look around and as a young, perhaps inexperienced businessperson say to yourself  “What do I do now? My product doesn’t work, I have all these people counting on me, I have built all this expectation, raised all this money, how do I unwind this hype? Can I tell anyone?” Perhaps her answer under the pressure is  “Nope I’m going to just keep running and hyping and hope I can catch up, I’m sure the fix is just around the next corner.” And there you have it, there is no easy way off that barreling train.

  • And the last option,  The technology doesn’t work and Elizabeth Holmes knows it and has understood for years, she’s the pied piper, the Emperor with no clothes. Well, I really don’t want to delve into that one.

Lesson, you really need to closely monitor how far out in front your sales and marketing are from your reality. I still say that in a good business the back-end (operations and services) needs to match the front end (marketing and sales). Without one you will certainly die and without the other you may never grow; but if they are far out of whack, particularly on the marketing side, you can ride the growth curve as new clients come on or you raise enough capital before the experienced clients drop you for not delivering.

You can run for a while, but in the end the market will figure it out.

I guess with Theranos we’ll just have to wait and see. There’s a lot riding on them, jobs, dollars, new ideas and perhaps a little ego.


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Last day for Early Bird Registration to the PHA Forum 2014

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Whether you’re a population health provider, an ACO, provider group, health system, employer, health plan, have products or services used to support population health management or an investment firm interested in the space, you need to attend the Population Health Alliance Forum 2014 in Scottsdale Arizona December 10 – 12. At the Forum you’ll get real world information on what’s worked and what hasn’t. You’ll hear from programs and PHM services in Medicare, Medicaid, employer groups and the military.

The Forum is bringing together great speakers like Rain Henderson, CEO, Clinton Health Matters Initiative, Esther Dyson, founder of the Way to Wellville, Brian Klepper, CEO, NBCH, David Nash, MD, Dean of the School of Population Health at Jefferson and Kaveh Safavi, Global Managing Director of Health, Accenture.

Add to that great tracks on Analytics to Action, Excelling in Engagement, Powerful PHM Strategies, and Tech Touch: Strategies in mhealth and Apps.

For Employers looking at wellness and other population health programs we are offering the Workplace Healthcare and Benefits Institute, on December 10, and if you register for this as an employer, you can attend the rest of the conference at no additional cost.

The Forum is an incredible opportunity to learn and Network with leaders in the population health space. In fact today is the last day for early bird registration so now is the time to sign up. You can learn more about the Forum here and register by clicking on the Logo below:

PHA Forum Logo

And have you seen the hotel? Think December…. think Scottsdale, great place, great time of year,

Fairmont Princess, Scottsdale, AZ

Fairmont Princess, Scottsdale, AZ

Hope to see you there.

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