Archive for January, 2017


Defining “Success” in Addressing Social Determinants

With a growing number of programs designed to address the social determinants of individuals’ health care challenges, the question arises as to how to define “success” in those approaches.

A recent article on the Health Affairs Blog addresses this question by illustrating the many variables that go into determining what constitutes “success” and suggesting that success be viewed from a number of perspectives, including:

  • success for entire communities
  • success from the perspective of individual patients
  • success based on the effectiveness of addressing specific social needs (such as housing, transportation, or food security)

The article also describes the different ways that success can be defined and measured.

Learn more by reading the article “Defining Success In Resolving Health-Related Social Needs,” which can be found here.…

Participation in Alternative Payment Models Rises

In 2017 nearly 360,000 clinicians will participate in Medicare and Medicaid Alternative Payment Model programs sponsored by the Centers for Medicare & Medicaid Services.

CMS also reports that this year 570 accountable care organizations, including 131 that bear risk, will serve more than 12.3 million Medicare and Medicaid beneficiaries.

In addition, nearly 3000 primary care practices will participate in advanced primary care medical home models

Find more about the growth of participation in CMS’s alternative payment models, including descriptions of the different models and breakdowns in the numbers of participants, in this CMS news release.…

Medicaid Block Grants 101

Amid a great deal of speculation about the possibility of Congress and the new Trump administration turning Medicaid into a block grant program, Kaiser Health News has taken a step back to ask the question “What does this even mean?”

Among the issues the new article addresses are:

  • how a Medicaid block program might work
  • how block grants differ from per capita caps
  • why block grants are so interesting and so appealing to some public officials
  • the chances of Medicaid becoming a block grant program

See the Kaiser Health News article about Medicaid block grants here.…

Medicaid Directors Comment on Home and Community-Based Services

The National Association of Medicaid Directors has responded to a request for information published by the Department of Human Services seeking comment on the future of Medicaid-covered home and community-based services.

See the association’s comments and recommendations here.…

ACA Replacement?

While both the Trump administration and Congress insist that they will repeal and replace the Affordable Care Act, neither has yet provided information about what that replacement might look like.

But one place worth looking for a possible glimpse into the future is the Affordable Care Act replacement plan proposed by Rep. Tom Price (R-GA), President Trump’s nominee to serve as Secretary of the Department of Health and Human Services.

In 2015, Rep. Price proposed the Empowering Patients First Act as a vehicle for replacing the Affordable Care Act. While the bill was not adopted by Congress at the time, Dr. Price should soon be in a position to exert meaningful influence over the manner in which the Trump administration and Congress go about replacing the Affordable Care Act.

The Kaiser Family Foundation has prepared a summary of Dr. Price’s 2015 proposal. Go here to see that summary and to find a link to the legislation itself.