Manatt Health’s Post

A recent study with EPI member Dr. Burton Singer, in collaboration with researchers from @YaleSPH, explores the #PublicHealth risks that changes in #healthcare coverage can pose. Read the paper to learn more about their findings: https://lnkd.in/gdcTuzpu.

Very excited to partner with Oliver Wyman on this important SDoH/Health Equity initiative. I invite you to read further for interesting insights into the strong coorelations between HealthWise Data's predictions of health and wellness and patient outcomes. #healthequity #sdoh

Health Equity has evolved from an admirable goal for hospitals to a MUST HAVE imperative. Beyond Health Equity compliance MANDATES by the IRS, new policies from Medicaid and Medicare (CMS) will impact the hundreds of $ millions of  reimbursements, and hospital systems need rich socioeconomic data in order to meet these needs. The NEW CMS requirements for hospital systems to take effect this year, include: Health Equity Assessments: Published plans for overcoming health disparities and improving outcomes. Data Collection: Expanded patient demographics to better understand Social Determinants of Health (SDOH). Revenue Cycle Management: Reimbursement changes that provide premiums for treating patients from underserved populations combined with penalties for patients readmitted to the hospital within 72 hours. If you are a healthcare leader charged with measuring health equity, we’re here to help. #HealthEquity

As we enter the new year, leaders predict the biggest challenges and opportunities facing the healthcare industry in 2024. Stakeholders question the outsized role of the EHR in patient care - is it here for the long term? The US continues to grapple with the reality of racial disparities in maternal healthcare and its effect on outcomes. Plus, as the maternal health crisis becomes more acute, the industry considers how to respond, with some states expanding Medicaid services. Read more ⤵️

North Carolina Medicaid’s Health Opportunities Pilot Program is “among the nation’s most expansive Medicaid programs to address health-related social needs, including housing.” In the Housing And Health issue, Katie Huber of Duke University and coauthors offer a mixed methods analysis of the pilot. Among the findings, the researchers identify four critical themes: the housing landscape varies within and across Health Opportunities Pilots regions; defining and pricing housing services in Medicaid is complex; successful implementation of housing services involves engaging diverse stakeholders; and housing is the most expensive Health Opportunities Pilots service domain. The authors conclude that findings from this program could inform other state and federal initiatives. Ready the full study: https://hubs.la/Q02k305_0

The Centers for Medicare & Medicaid Services' Innovation Center (CMMI) has awarded #Connecticut $12 million over five years to participate in a new, healthcare transformation model: the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model). The AHEAD Model focuses on improving population health, advancing health equity by reducing disparities in health outcomes and curbing healthcare cost growth. Hospitals will be offered opportunities to participate in global budget payment models and participating community health centers and primary care practices will receive incentives to promote person-centered care. https://buff.ly/3W802sN

While Humana posted major financial and mega-merger losses, Elevance’s Carelon division seemed to be crushing it. The difference is fundamentally Medicare vs Medicaid innovation. This graphic from the new Health Management Associates report on VBP enablers and providers shows there’s much more room for growth in Medicaid. Hmm…why are these two companies experiencing such different outcomes? Could it be that a company focused on behavioral health is actually better for cost-saving than one focused just on the care of seniors…? While population health management is important to outcomes and costs, betting the farm on a specific population instead of structural needs across populations might just be the wrong answer. #mentalhealthishealth

Regulatory roundup: CMS offers new state care model to increase health equity, access to care; Humana sues CMS over final RADV rule; and more

In their latest article, Oliver Wyman Actuarial shares how they leveraged HealthWise Data's insights to fuel their study into how #SDOH drives health outcomes and disparities:

Health is not just about individual choices or medical interventions. It's influenced by the social and environmental conditions we live in. Social Determinants of Health (SDoH) encompass various domains that impact our overall well-being. Education Access & Quality, Economic Stability, Social and Community Context, Health Care Access & Quality, and Neighborhood/Built Environment are the key domains within SDoH. Each plays a vital role in shaping community health. To address the significance of SDoH, the Centers for Medicare and Medicaid Services (CMS) have proposed the CY 2024 Medicare Physician Fee Schedule. This rule aims to enhance healthcare providers' ability to manage patients with social risk factors and improve health outcomes. In our latest article, we shed light on the importance of SDoH and advocate for the integration of SDoH considerations in provider/payer contracts. By appropriately compensating providers for managing patients with social risk factors, we can drive better health outcomes and reduce the total cost of care. Read it here> https://lnkd.in/gy4m4vdH #OWActuarial #SocialDeterminantsOfHealth #ManagedMedicaid