March, 2017 vol. 1 - In This Issue:
An ongoing theme in this digest emphasizes that access to care and active engagement of patients and caregivers are a "must" to fully transform healthcare delivery. The events surrounding a proposed replacement of the ACA raise strong concerns that the patient will be returned to a position on the periphery, rather than the ultimate consumer and decision maker of that care. Many articles caught my eye this week and all are worth a read and worth sharing with your "favorite" lawmaker. ASAP.

Changes in Primary Care Access Between 2012 and 2016 for New Patients With Medicaid and Private Coverage

Millions of uninsured adults in the United States have gained health insurance under the Affordable Care Act since major coverage provisions of the act were implemented in 2014, including federal funding for an extension of Medicaid eligibility to nonelderly and low-income adults in some states. Anticipating heightened demand, policymakers launched concurrent initiatives to strengthen primary care delivery, such as raising Medicaid reimbursement to Medicare levels for certain primary care providers in 2013 and 2014, increasing funds for federally qualified health centers and expanding the penetration of Medicaid managed care.   

Access to Care in Cancer: Barriers and Challenges

In the current climate of health care reimbursement, coverage reform and escalating health care costs, navigating cancer care becomes increasingly complex for patients and caregivers.

Given the truly fluid marketplace and many payment and care models being established without critical engagement or information from the patient, it is imperative to assess the ongoing reality of patient access to comprehensive, quality cancer care; care that includes biomedical as well as psychosocial care .

Oregon's Medicaid Reform And Transition To Global Budgets Were Associated With Reductions In Expenditures

In 2012 Oregon initiated an ambitious delivery system reform, moving the majority of its Medicaid enrollees into sixteen coordinated care organizations, a type of Medicaid accountable care organization. Using claims data, we assessed measures of access, appropriateness of care, utilization, and expenditures for five service areas (evaluation and management, imaging, procedures, tests, and inpatient facility care), comparing Oregon to the neighboring state of Washington. Overall, the transformation into coordinated care organizations was associated with a 7 percent relative reduction in expenditures across the sum of these services, attributable primarily to reductions in inpatient utilization. The change to coordinated care organizations also demonstrated reductions in avoidable emergency department visits and improvements in some measures of appropriateness of care, but also exhibited reductions in primary care visits, a potential area of concern. Oregon's coordinated care organizations could provide lessons for controlling health care spending for other state Medicaid programs.

How to Get Patients to Take More Control of Their Medical Decisions

For years, people have been urged be more active in their own care. Now providers are giving them better tools to make that happen.

For years, patients have been hearing the same message from the health-care industry: Get involved.  They're told they need to do more to monitor their chronic conditions. They are directed to be more active in deciding what treatments to have, or whether to treat a condition at all.

That has proved easier said than done. For some people, it's a matter of feeling intimidated: Better to let the doctors decide. Some are overwhelmed by the choices they have to make about their care, which seem to get more complex every year. At the same time, many doctors are reluctant to change old ways of working.  

HIMSS 2017: ONC, CMS leaders call for more emphasis on patient engagement in health information technology

Federal healthcare leaders urged the health IT community to turn its attention back to the patient when solving some of the ongoing challenges surrounding interoperability and making healthcare data and information useful to patients and caregivers.

During a special session at HIMSS 2017, Jon White, M.D., the acting national coordinator for health information technology at the Office of the National Coordinator for Health IT (ONC), and Kate Goodrich, M.D., the chief medical officer the Centers for Medicare & Medicaid Services (CMS) and director of the Center for Clinical Standards and Quality, discussed a range of issues from MACRA implementation and the Quality Payment Program to interoperability and the new administration's priorities for health IT.     

Top Hospital CEOs Predict A Brave New World Of Patient Engagement

The National Academy of Medicine recently released its updated description of patient centered care and framed it as " planned, delivered, managed, and continuously improved in active partnership with patients and their families to ensure integration of their health and health care goals, preferences, and values." To explore how hospital CEOs view the role of patient engaged care in transforming our healthcare system and driving down costs, I interviewed industry leaders:
  • Dr. Steven J. Corwin, president and CEO, NewYork-Presbyterian
  • Dr. Susan Frampton, president, Planetree
  • Dr. Redonda G. Miller, president and CEO, The Johns Hopkins Hospital
  • Joel Seligman, president and CEO, Northern Westchester 

When Evidence Says No, but Doctors Say Yes

Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver. The result is an epidemic of unnecessary and unhelpful treatments.

First, listen to the story with the happy ending: At 61, the executive was in excellent health. His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come.

Passion + Quality = Change That Matters
I embrace the powerful opportunities in our evolving health care landscape. I founded Momentum Health Strategies to be a catalyst for change through continuous learning, diverse engagement and thoughtful policy and practice initiatives. I deliver innovative, strategic thinking and a passion for improving the patient experience. My personal drive and dedication to high-quality results will help you navigate the competitive terrain you face and convert your vision to action.

Momentum Health Strategies

Jennifer L Bright, MPA
(703) 628 - 0534