« September 2015 Issue

Value Advocacy Project Turns Lens from Coverage to Care

There is little doubt since the passage of the ACA we have seen a tremendous decrease in the number of uninsured Americans. While many state advocates are still fighting (and winning!) battles to expand Medicaid and close the coverage gap, Community Catalyst, and the health advocacy network as a whole, has begun to place a greater emphasis on “health system transformation,” addressing the problems consumers face when they utilize their health insurance and interact with the health system.

While Community Catalyst outlined many of our health system transformation priorities in Path to a People-Centered Health System, a new initiative from the Robert Wood Johnson Foundation called the Value Advocacy Project (VAP) is allowing some of our state advocacy partners to jumpstart the next generation of health care reform in their own communities. The projects in New York, Pennsylvania, Ohio, Minnesota, California and Washington will seek to increase the value of health care in their communities by improving health outcomes and lowering health care costs, especially for populations that have disproportionately poor health outcomes.

This is certainly no easy task as health system transformation encompasses a wide range of potential opportunities - everything from cost to accessibility to addressing health disparities and the millions of mitigating factors in between. Additionally, it will require engaging all stakeholders in the system – providers, payers, policy makers and patients and their families – to increase quality of care and improve health outcomes. Often times, the biggest obstacle to improving the health care system is identifying where the best opportunities for significant intervention and progress are. That’s why state partners in New York (Community Service Society) and Minnesota (TakeAction Minnesota) are using a portion of their grant to identify health system transformation action areas in their states and to begin building the capacity among statewide and local consumer advocacy groups to tackle these issues.

A true transformation of the health system that makes it more responsive to the needs of those it serves will require flexibility and outside-the-box thinking and approaches to using existing services. Advocates in Pennsylvania (PHAN) and Ohio (UHCAN Ohio) are using flexibility within the Medicaid program to address social determinants of health, factors outside of health care that impact people’s health. PHAN is focusing on improving patient-centered medical homes, which provide care coordination for Medicaid beneficiaries living with chronic health conditions and leveraging state Medicaid dollars to establish permanent supportive housing for the most vulnerable populations. While Ohio advocates are looking to influence the recently awarded federal State Innovation Model Implementation Grant, which will move a significant portion of Ohioans into patient-centered medical homes. As the model for the statewide patient-centered medical homes is being developed, UHCAN Ohio is working to ensure that the model is representative of the population and that the needs of communities with disproportionate health outcomes will be positioned to benefit from the implementation of the model.

Meanwhile, our partners in California (Health Access California & California Pan-Ethnic Health Network) are turning their attention to the cost and value areas of health system transformation through the Medicaid waiver process, advocating for an All Payer Claims Database (which compiles claims data from public and private payers  to increase transparency and allow for total cost of care analysis) and moving to a value-based model of compensation that rewards health outcomes. Their experiences will hopefully be assisted by Minnesota advocates who are also pursuing value-based care reform for a subset of immigrants with high health needs.

Washington advocates (Washington CAN! & NoHLA), like Ohio, are looking to inject the consumer voice into newly created health systems. The state recently created Accountable Communities of Health (ACH), which aim to promote greater collaboration to coordinate care to reduce costs and increase equity. Washington advocates will be raising the consumer voice in implementation of these new care systems by activating their grassroots network for outreach, organizing and engagement of low-income consumers accessing Accountable Communities of Health to increase the consumer participation and effectiveness of the programs.

All of these projects represent a small portion of the larger next generation of consumer health advocacy. Community Catalyst will work hand in hand with state partners to ensure they have the tools and resources they need to be successful. The knowledge and experience gained from our Value Advocacy Project grantees will easily plug into an already robust network of state advocates across the country who serve as a perpetual source of inspiration, resource and guidance for the national health care reform movement. 

Jack Cardinal, Communications Manager

O N   T H E   W I R E

Community Catalyst Board member, Anthony D. So, MD, MPA, a leading expert in access to health technologies, innovation and public health practice, has been named director of the Johns Hopkins Center for a Livable Future (CLF) and will be the inaugural Robert S. Lawrence Professor in the Department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health. Dr. So will assume full-time leadership of the CLF on Jan. 1, 2016.

Voices for Better Health received a three-year $1.5 million grant from the John A. Hartford Foundation to continue its work to develop geriatric provider collaborations as part of efforts to design better systems of care for people on both Medicare and Medicaid. The project will also bring geriatric expertise to Community Catalyst’s health system transformation work.

Rob Restuccia, executive director, and Douglas Jacobs, MD/MPH candidate at University of California, San Francisco and Harvard School of Public Health, joined forces to write a blog post on Health Affairs addressing discrimination in the health insurance system.

Michael Miller, Director of Strategic Policy, spoke to Modern Healthcare about states increasing hospital assessments to help fund Medicaid expansion.

David Jordan, director of the Dental Access Project, was featured in the Association of Health Care Journalists’ blog Covering Health applauding CODA’s decision to begin the accreditation process for dental therapist training programs.

Renée Markus Hodin, director of Voices for Better Health, talked about moving forward with dual eligible demonstration programs in POLITICO Pro (subscription needed). 

Join us in welcoming new staff members:  Ben Koller, Program Associate; Megan Wood, State Advocacy Manager; Lauren Banks, State Advocacy Manager; Elizabeth Kinnard, Program Associate; Yaquelin Cordon, Accountant Associate; Also, congratulations are in order for our recently promoted staff members:  Carrie Rogers, Program Manager/State Advocacy Manager; Rachelle Rubinow, Policy Analyst; Michelle Craig, Manager Outreach & Training.

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