Economics of Caring: Improving Population Health by Valuing Care Workers: Proceedings of a Workshop (2023)

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Economics of Caring Improving Population Health by Valuing Care Workers Alina Baciu, Rapporteur Roundtable on Population Health Improvement Board on Population Health and Public Health Practice Health and Medicine Division PREPUBLICATION COPY—Uncorrected Proofs Proceedings of a Workshop 

NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by contracts between the National Academy of Sciences and AAMC, BlueShield of California, California Endowment, Kresge Foundation, Nemours, NYU School of Medicine Department of Population Health, The Rippel Foundation, Robert Wood Johnson Foundation, Samueli Institute, Thomas Jefferson University, and Wake Forest Baptist Health/ Stakeholder Health. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/26877 Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2023 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Economics of caring: Improving population health by valuing care workers: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26877. PREPUBLICATION COPY—Uncorrected Proofs 

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institu- tion to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineer- ing to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and ­Medicine at www.nationalacademies.org. PREPUBLICATION COPY—Uncorrected Proofs 

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PLANNING COMMITTEE ON ECONOMIC INNOVATIONS TO SUPPORT HEALTH, EQUITY, AND WELL-BEING1 KOSALI SIMON (Chair), Herman Wells Professor and Associate Vice Provost of Health Sciences, Indiana University O’Neill School of Public and Environmental Affairs, Bloomington, IN DEBBIE CHANG, President and Chief Executive Officer, Blue Shield of California Foundation, San Francisco, CA RITA HAMAD, Director of the Social Policies for Health Equity Research Program (SPHERE) and Associate Professor, University of California San Francisco, San Francisco, CA JASON PURNELL, Vice President, BJC HealthCare; Associate Professor, Brown School at Washington University in St. Louis, St. Louis, MO 1 The National Academies of Sciences, Engineering, and Medicine’s planning ­committees are solely responsible for organizing the workshop, identifying topics, and choosing ­speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution. v PREPUBLICATION COPY—Uncorrected Proofs 

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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1 RAYMOND BAXTER (Co-chair), Trustee, Blue Shield of California Foundation, San Francisco, CA KIRSTEN BIBBINS-DOMINGO (Co-chair until May 2022), Professor and Chair of the Department of Epidemiology and Biostatistics; Lee Goldman, M.D. Endowed Professor of Medicine; Vice Dean for Population Health and Health Equity, University of California, San Francisco, School of Medicine PHILIP M. ALBERTI, Senior Director, Health Equity Research and Policy, Association of American Medical Colleges, Washington, DC DAWN ALLEY, Chief Strategy Officer, Center for Medicare & Medicaid Innovation, Washington, DC DEBBIE I. CHANG, President and Chief Executive Officer, Blue Shield of California Foundation, San Francisco, CA MARC N. GOUREVITCH, Professor and Chair, Department of Population Health, NYU School of Medicine, New York, NY MEG GUERIN-CALVERT, Senior Managing Director and President, Center for Healthcare, Economics and Policy, FTI Consulting, Washington, DC HILARY HEISHMAN, Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ DORA HUGHES, Senior Advisor, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Washington, DC SHERI JOHNSON, Director, Population Health Institute; Associate Professor, Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin–Madison WAYNE JONAS, Executive Director, Integrative Health Programs, H & S Ventures, Samueli Foundation, Alexandria, VA ROBERT M. KAPLAN, Professor, Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, CA MILTON LITTLE, President, United Way of Greater Atlanta, Atlanta, GA PHYLLIS D. MEADOWS, Senior Fellow, Health Program, Kresge Foundation, Troy, MI BOBBY MILSTEIN, Director, ReThink Health, Morristown, NJ 1 The National Academies of Sciences, Engineering, and Medicine’s planning ­committees are solely responsible for organizing the workshop, identifying topics, and choosing ­speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution. vii PREPUBLICATION COPY—Uncorrected Proofs 

JOSÉ T. MONTERO, Director, Center for State, Tribal, Local and Territorial Support; Deputy Director, Centers for Disease Control and Prevention, Atlanta, GA KARA ODOM WALKER, Senior Vice President and Chief Population Health Officer, Nemours, Washington, DC WILLIE OGLESBY, Interim Dean, College of Population Health, Jefferson University, Philadelphia, PA JASON PURNELL, Vice President, Community Health Improvement, BJC HealthCare; Associate Professor, Brown School, Washington University in St. Louis, St. Louis, MO LOURDES J. RODRÍGUEZ, Senior Program Officer, St. David’s Foundation, Austin, TX KOSALI SIMON, Herman B. Wells Endowed Professor, Associate Vice Provost for Health Sciences, Paul H. O’Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN TERRY WILLIAMS, Executive Vice President and Chief Population Corporate & Government Affairs Officer, Atrium Health, Winston-Salem, NC OKTAWIA WOJCIK, Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ HANH CAO YU, Chief Learning Officer, The California Endowment, Oakland, CA Health and Medicine Division Staff ALINA BACIU, Roundtable Director ALEXANDRA ANDRADA, Program Officer AYSHIA COLETRANE, Senior Program Assistant MAGGIE ANDERSON, Research Assistant ROSE M. MARTINEZ, Senior Board Director viii PREPUBLICATION COPY—Uncorrected Proofs 

Reviewers This Proceedings of a Workshop was reviewed in draft form by indi- viduals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineer- ing, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review com- ments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings: ANGELA E. USHER, University of California, Davis Although the reviewer listed above provided constructive comments and suggestions, they were not asked to endorse the content of the pro- ceedings nor did they see the final draft before its release. The review of this proceedings was overseen by ELI Y. ADASHI, Brown University. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully consid- ered. Responsibility for the final content rests entirely with the rapporteur and the National Academies. We also thank staff member MALVERN T. CHIWESHE for reading and providing helpful comments on this manuscript. ix PREPUBLICATION COPY—Uncorrected Proofs 

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Contents ACRONYMS AND ABBREVIATIONS xiii 1 INTRODUCTION 1 2 PERSPECTIVES ON HISTORY, ECONOMIC FORCES, AND CURRENT REALITY 5 3 PERSPECTIVES FROM CARE SECTOR LEADERS 13 4 EXPLORING POLICY STRATEGY AND INNOVATIONS 17 5 PRACTICAL EXERCISE AND CLOSING REFLECTIONS 27 APPENDIXES A References 31 B Biographical Sketches 33 C Workshop Agenda 43 D Readings and Resources 47 xi PREPUBLICATION COPY—Uncorrected Proofs 

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Acronyms and Abbreviations AFL-CIO The American Federation of Labor and Congress of Industrial Organizations BSCF Blue Shield of California Foundation EITC earned income tax credit SEIU Service Employees International Union TANF temporary assistance for needing families UBI universal basic income UCSF University of California, San Francisco WE well-being and equity WIN Well Being in the Nation xiii PREPUBLICATION COPY—Uncorrected Proofs 

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