Financing That Rewards Better Health and Well-Being Proceedings of a Workshop–in Brief (2021) / Chapter Skim
Currently Skimming:
Financing That Rewards Better Health and Well-Being: Proceedings of a Workshopin Brief
Financing That Rewards Better Health and Well-Being: Proceedings of a Workshopin Brief
Pages 1-12
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
The objectives included identifying examples of care delivery and payment models that are focused on patient outcomes and advancing health equity, considering barriers and opportunities to scaling effective integrated payment models and approaches, and discussing strategies for transforming health financing to improve equity and individual and population health. This Proceedings of a Workshop -- in Brief highlights the presentations and discussions that occurred throughout the workshop series.2 Suggestions from individual speakers are summarized in Box 1.
|
From page 2... ...
• Leverage state, local, and federal funding opportunities to experiment, authorize, assess, and extend care delivery and financing innovations. (Alley, Backus, Birch, Chomilo, Ibarra, Fowler, Kinzer, Lewis, Mann, Nichols)
|
From page 3... ...
The goal of the workshop series was to explore health financing mechanisms that could make possible this kind of care so that the population and each individual reaches their full potential for health and well-being. ENVISIONING AN INTEGRATED HEALTH CARE DELIVERY AND FINANCING SYSTEM The Future of Health Financing for Improved Health Outcomes In an opening discussion, Mandy Cohen from the North Carolina Department of Health and Human Services and Timothy Ferris from the National Health Service touched on many of the major themes that arose during the first of three meetings in the series, in which speakers envisioned an integrated health care delivery and financing system.
|
From page 4... ...
Payment Models for Advancing Health Equity and Community Health Nathan Chomilo from the Minnesota Department of Human Services described the Minnesota Medicaid Integrated Health Partnership (IHP) program's goal of improving the health of Medicaid and MinnesotaCare6 enrollees by lower 5 See https://capgi.urban.org/wp-content/uploads/2020/08/CAPGI-Fact-Sheet-8-13-2020.pdf (accessed July 27, 2021)
|
From page 5... ...
In addition, Chomilo discussed the importance of embedding health equity and addressing structural racism explicitly in the IHPs, stating, "Addressing structural racism and promoting anti-racism is essential to really addressing health equity." In addition, Chomilo concluded, "We want to ensure that the financial incentives are aligned with our efforts around health equity and institutional racism so that we don't continue to see gaps persist." Asaf Bitton from Ariadne Labs and Harvard Medical School pointed out that primary care is a focal point for achieving health equity and community health. As a recent member of the National Academies' Committee on Implementing High-Quality Primary Care, Bitton emphasized one of the report's five objectives for making high-quality primary care available for everyone in the United States: to "pay for primary care teams to care for people, not doctors to deliver services" (NASEM, 2021, p.
|
From page 6... ...
Since 2014, the amount that a hospital is able to earn through inpatient and outpatient charges has been set at the beginning of the year, thereby incentivizing reductions in preventable admissions and greater control of the total cost of care as well as improving individual and population health outcomes. In 2019, this model was extended beyond hospitals to encompass the entire health care delivery system, with an emphasis on a statewide primary care program, care redesign, a robust health information exchange, and population health.
|
From page 7... ...
The model aims to improve population health outcomes by increasing access to primary care, decreasing deaths due to drug overdose and suicide, and reducing the prevalence and morbidity of chronic disease. Backus described the signature innovation of the model as "committing to payment change as a lever for improving population health outcomes in addition to those population health strategies and public health strategies that we would typically think of in our state." The state's model aligns payer programs, including those of Medicare, Medicaid, and commercial payers, around a statewide care organization built on a foundation of advanced primary care and integrated care, including patient-centered medical homes, community health teams, and care coordination to integrate health and community services.
|
From page 8... ...
In striving for lower costs, better outcomes, and better consumer and provider experiences, HCA has financially integrated physical and behavioral health to support a life-stage approach to health, developed an innovative value-based purchasing model for hepatitis C therapies, and created and implemented a first-in-the-nation public option available on Washington's health insurance exchange. It has also established a Health Care Cost Transparency Board and utilized Medicaid waivers and various grants to design innovative payment models and build the infrastructure necessary to support care redesign.8 Birch also described Washington State's efforts to break down the silos between social services and health care programs and to pay for population health on a broad scale.
|
From page 9... ...
Accelerating Transformative Financing Approaches Emily Brower from Trinity Health reinforced the importance of reducing frictional and transactional costs between clinicians and payers and highlighted the utility of transparency, primary care centricity, and population-based payment models in accelerating transformation toward whole-person care, equitable population health outcomes, improved patient and clinician experiences, and reduced per-capita costs. Transparency -- notably, through standard fee schedules -- can create a level playing field that enables health care providers to collaborate without competitive concerns, focus their energies on improving health outcomes, and reduce unnecessary care utilization and waste.
|
From page 10... ...
If we're going to help improve health and well-being in our country, we're going to have to shift resources toward people who are vulnerable and have lower incomes." Alongside this, Berwick explained, is the need to shift the ratio of per-capita spending on health care and social services to mirror international examples in which better results are achieved with a much lower percentage of the GDP spent on health care. "The ideal medical loss ratio9 in American health care is 100 percent," and the financial manipulation and intermediation that does not add value to the system needs to be put to rest, Berwick observed.
|
From page 11... ...
2016. Variation in health outcomes: The role of spending on social services, public health, and health care, 2000–09.
|
From page 12... ...
STAFF: Jennifer Lalitha Flaubert, Samira Abbas, and Sharyl Nass, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine; Jennifer Lee, Michael Cocchiola, and Michael McGinnis, Leadership Consortium, National Academy of Medicine. SPONSORS: This workshop was partially supported by the George Family Foundation, Nemours, Samueli Foundation, Well Being Trust, and Whole Health Institute.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.