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What role can randomized evaluations play in evaluating the impact of Medicaid? A new op-ed in Health Affairs from J-PAL North America Co-Scientific Director Amy Finkelstein and former Connecticut Medicaid Director Gui Woolston shows how Medicaid offices can rigorously evaluate their programs using randomized evaluations to improve program effectiveness and impact. The authors propose two approaches and five actionable steps that Medicaid offices can take to begin the evaluation process. https://lnkd.in/dGizuhqX Want to evaluate your program? J-PAL North America is ready to support any Medicaid offices interested in conducting randomized evaluations of their programs.

In their new Forefront article, Jeffrey Schiff, Clara Filice, and Christopher Chen from AcademyHealth, MassHealth, and Washington State Health Care Authority discuss how the time is ripe to reexamine what the past 15 years of investment in Medicaid quality measurements has yielded and to identify opportunities to better measure what matters to Medicaid members. "The innovative efforts to develop the National Quality Strategy—coupled with the implementation of mandatory reporting for the Medicaid Child Core Set, the behavioral health measures of the Adult Core Set, and the Health Home Core Set—have reignited longstanding interest in measure selection, standardization, and alignment across CMS programs.or this ambitious vision for quality to come to fruition for all citizens served by CMS, particular attention to measurement for the Medicaid (note 1) and CHIP programs must be front and center. These programs serve one in five Americans and 40 percent of all children. The time is ripe to reexamine what the past 15 years of investment in Medicaid quality measurements has yielded and to identify opportunities to better measure what matters to Medicaid members." Read the full article here: https://bit.ly/3TaAMj3

Home Health Care News (HHCN) wrote about Medicaid and hospital-at-home, interviewing Dr. Bruce Leff (Johns Hopkins) as well as Drs. Michael Chin and Charles Pu from MassHealth (Medicaid in the state of Massachusetts). The article says: "Chin and Pu believe believe that if all Medicaid state programs covered hospital at home, it would be a major accelerant for increased implementation and access to care. 'Medicaid is one of the two largest government payers in the U.S., and to have this payment alignment, across both Medicare and Medicaid, would really make this care accessible to a much larger swath of the population, including underserved populations,' Pu said. That said, there are also larger consequences if more state Medicaid agencies choose to not engage with hospital at home, according to Leff. 'I think if Medicaid programs do not start to engage in hospital-at-home, then they are actually exacerbating inequity in health care delivery...They’re making it more difficult for health systems to engage in a health care model that can help people. The lack of engagement of Medicaid programs affects not only Medicaid beneficiaries, but it affects non-Medicaid beneficiaries as well, to the extent that Medicaid is a major player in the health care delivery environment. What they do, and how they do it, signals to other payers and to health systems.'" Read more here: https://lnkd.in/gZms5Ncw. #hospitalathome #decentralized #healthcareinnovation

On March 26, speakers representing Medicaid agencies, MCOs, and HRSN-focused tech perspectives convened to share their experiences in supporting innovative tech strategies to better meet the needs of #Medicaid enrollees. Play back this Center for Health Care Strategies webinar that spotlighted the work of the Medicaid Innovation Collaborative, an initiative to improve the health and well-being of Medicaid populations by identifying and implementing tech-enabled solutions through public-private partnerships. https://bit.ly/3P2chDE

Addressing Social Determinants of Health (SDOH) is pivotal in providing effective and equitable healthcare. The Centers for Medicate and Medicaid Services have rolled out a new model, the Making Care Primary (MCP) Model, which does just that. This model emphasizes integrated and coordinated primary care to improve health outcomes and addresses SDOH by leveraging community connections to meet health-related social needs, promoting whole-person care. We’re excited to see efforts on all fronts- from government to health providers, to community organizations- to address SDOH and foster health equity! https://lnkd.in/e3mfxX_x #Medicaid #SDOH #Hygieia #HealthEquity #MakingCarePrimary #PrimaryCare  

I appreciate the hard look at 15 years of Medicaid and CHIP Quality Measurement in a recent Health Affairs Forefront article. The authors point out that in that time, despite massive investment in performance measurement, we’ve seen very little progress in improving the quality of care for adults and children enrolled in Medicaid. 5 of the 11 metrics they compared over time actually saw a decrease in quality, and the other half showed only modest quality gains. They also rightly point out that a big gap lies in what we’re measuring – too many quality measures miss what matters most to patients and their families. What the article misses is how to refocus measurement on what matters most to the people we ultimately seek to benefit. 𝗛𝗼𝘄 𝗱𝗼 𝘄𝗲 𝗸𝗻𝗼𝘄 𝘄𝗵𝗮𝘁 𝗺𝗮𝘁𝘁𝗲𝗿𝘀 𝘁𝗼 𝗽𝗮𝘁𝗶𝗲𝗻𝘁𝘀 𝗮𝗻𝗱 𝗰𝗮𝗿𝗲𝗴𝗶𝘃𝗲𝗿𝘀? 𝗪𝗲 𝗺𝘂𝘀𝘁 𝗮𝘀𝗸 – 𝘁𝗵𝗲𝗻 𝗮𝗰𝘁 𝗼𝗻 𝘄𝗵𝗮𝘁 𝘄𝗲 𝗵𝗲𝗮𝗿. Patients’ and caregivers’ lived experience is essential expertise for developing and implementing measures. It’s expertise we’ve mostly ignored and sidelined in measurement efforts to date. If the last 15 years of widescale measurement efforts aren’t achieving the kinds of transformational change we know we need, shouldn’t we do something different? Partnering with patients and caregivers to decide what to measure, what those measures mean, and how to make improvements, is essential for a patient-centered and equitable healthcare system. #communityengagement #measurewhatmatters #livedexperience #patientexperience https://lnkd.in/gR9em2T2

In her new Forefront article, Kate McEvoy from National Association of Medicaid Directors discusses how the Medicaid program continues to be both the bedrock means of providing comprehensive health services to low-income people as well as the central seat of innovation in our health care system around people’s co-occurring health-related social needs. But two issues, she argues, are getting in the way of this essential work. "The first of these is the serious and intractable bottleneck in federal capacity to timely review and approve the large and growing volume of 1115 research and demonstration waiver applications and renewals that are the central means of advancing reform and innovation in Medicaid. The tough reality is that the Center for Medicaid and CHIP Services (CMCS), which has taken many steps to streamline its administrative processes, simply does not have the staff resources to move forward all of the waivers in its pipeline, to say nothing of the many submissions that will likely yield this spring from legislative sessions all across the country." Read the full article here: https://bit.ly/3JkTKii

Community health worker (CHW) programs have faced significant funding challenges across the U.S. — despite numerous studies showing the positive impact they can have on health outcomes and costs for patients receiving Medicaid. In a new article published in the Journal of Community Health, we compared Medicaid payment rates for CHW programs to costs for implementing them across all 50 U.S states, Washington D.C. and Puerto Rico. Our study found that current payment rates are insufficient to achieve benefits of CHW programs on patient outcomes and costs identified in previous randomized trials. The results demonstrate the need for considerably higher payment for CHW services. This is our third peer-reviewed journal article of 2024 (❗). As a public benefit company, we’re committed to advancing the evidence base for models and approaches that work in Medicaid care delivery and we’ll continue publishing original research, data and commentary in the months ahead. Read the study here 👉 https://wymrk.co/3w85YaT Sanjay Basu Sadiq Y. P. Kiiera Robinson, Ed.D, MPH, MA Aaron Baum #medicaid #communityhealthworkers #communityhealth

In terms of recommendations, they said the Centers for Medicare and Medicaid Services' new Interoperability and Prior Authorization rule should ease the burden surrounding care approval, and that establishing greater visibility into Medicare Advantage claims data would provide a much-needed lens into how well Medicare beneficiaries are being served. #diversityandinclusion #healthequity #health #socialdeterminantsofhealth #sdoh #dataanalytics #populationhealthmanagement #valuebasedhealthcare #valuebasedcare #vbc #healthequityandaccess #integratedhealthcare #integratedhealthcaresystems #healthtech #Persivia #PersiviaAI https://lnkd.in/gcnDyadz

It's time to reimagine healthcare delivery for the 28% of Americans covered by Medicaid, accounting for $728 billion( ❗❗❗) in annual health expenses. At 7wireVentures, we delve into this in our latest piece "Empowering Underserved Americans: Revolutionizing Medicaid Care Through Digital Health Solutions" 🌐 We see an immense opportunity to employ #digitalhealth to dismantle systemic barriers faced by 92% of beneficiaries who find health plan information confusing, and the 75% burdened by financial worries. We've spotlighted innovative players making strides in this space, including MedArrive, Homeward, SameSky Health, Luma Health, Quartet Health, Babyscripts, and many more. Despite the challenges, with over $11 billion invested in Medicaid solutions in the last few years, the journey has just begun, and the potential of digital health to revolutionize Medicaid care is boundless. Check out our full thoughts below 👇 #MedicaidInnovation #HealthcareEquity