Last week, I had the privilege of attending the United Hospital Fund’s 2016 Medicaid Conference in New York City. This year’s conference focused on ongoing efforts in New York’s Medicaid program to develop delivery and payment systems that reward value instead of volume. New York has an innovative waiver that enables the state to reinvest $8 billion in federal savings generated by Medicaid Redesign Team (MRT) reforms. The goal of the waiver is to address critical issues throughout the state’s Medicaid program and allow for comprehensive reform through a Delivery System Reform Incentive Payment (DSRIP) program. Under the DSRIP program, funds for providers are tied to meeting a set of specified performance metrics.
As consumer advocates, we often have to fight to get the consumer viewpoint integrated into programs like Medicaid. Throughout the conference, panelists challenged audience members to build programs that truly consider the unique needs of Medicaid consumers.
One of the most compelling panels focused on engaging and protecting Medicaid members. The three-member panel included Christina Jenkins (President and CEO of OneCity Health), Rebecca Novick (Director of the Health Law Unit, Legal Aid Society) and Harvey Rosenthal (Executive Director of the New York Association of Psychiatric Rehabilitation Services). The panelists focused on transforming provider/patient relationships by training providers on motivational interviewing, building trust between providers and consumers, and using community health workers and peer counseling.
All three panelists agreed that Medicaid programs must look beyond the physical aspects of health care and seek to address beneficiaries’ behavioral health and social service needs. Dr. Jenkins recommended establishing formal contracts with community-based organizations. Another theme of the panel was the need for trust and empathy between providers, frontline staff and patients. For example, Mr. Rosenthal discussed the need to train frontline workers on meaningfully engaging with their patients and not just focusing on hitting the required benchmarks. Ms. Novick emphasized the need to change the current adversarial relationship many providers and Medicaid patients have with one another through long-term relationship efforts and practices that reach beyond just treating health symptoms.
The DSRIP program enables states like New York an opportunity to build a more person-centered culture of care. The panel highlighted some strategies that can be employed to build a health system that focuses on the whole person, providing a range of coordinated services that can best match her or his goals, values and preferences. When a health system embraces this mindset, improved quality of life for consumers and lower overall costs will generally follow. And that’s what we call value.
Stephanie Cohen, State Advocacy Manager, Value Advocacy Project