CHICAGO – Seven new health systems have joined the Medicaid Transformation Project, a national effort to transform healthcare and related social needs for the nearly 75 million Americans who rely on Medicaid. In total, the project now includes 24 health systems that comprise 342 hospitals, more than 65,000 beds, in 25 states with over $121 billion in combined annual revenue.
The Medicaid Transformation Project was formed with the vision that healthcare organizations can work collaboratively to enable better health and outcomes for vulnerable populations, while also reducing costs, through the adoption of digitally-enabled care models.
New members, shared commitment
The seven new health systems joining the Medicaid Transformation Project span distinct geographic and socioeconomic markets: BayCare Health System in Clearwater, Fla.; Boston Medical Center in Boston; Cedars-Sinai in Los Angeles; Carilion Clinic in Roanoke, Va.; Children’s Hospital Colorado in Aurora, CO; Jefferson Health in Philadelphia; and University Hospitals, in Cleveland. These systems join 17 additional health systems across the nation who are united by a commitment to action that improves health for their diverse communities.
Underpinning this action is an acknowledgement of the current health disparities seen in communities across the country. A leading indicator of such disparity is life expectancy, which is highly correlated with ZIP code, income, and race because care delivery varies greatly based on those factors. Insufficient healthcare access, patient engagement, and social determinants create variations in life expectancy that can be as great as 16 years between communities that are just a mile or two apart. The Medicaid Transformation Project’s commitment is to close the gap in care and outcomes in communities in need through a renewed focus on innovation and investment.
“The current healthcare delivery system needs to be disrupted to dismantle health inequities. At Jefferson Health, we believe that collaboration and creativity will drive this necessary transformation,” says Stephen Klasko, President and CEO of Jefferson Health. ”We’re joining the Medicaid Transformation Project to learn from others across the country and to find the best innovations that improve care and outcomes for the most vulnerable among us.”
Launched this summer by AVIA, the nation’s leading network of healthcare organizations committed to digital transformation, and Andy Slavitt, former Acting Administrator of CMS, the Medicaid Transformation Project worked with health systems to target four critical challenges over the next two years to better meet the needs of vulnerable, low-income populations: behavioral health, women and infant care, substance use disorder, and coordinating community care to reduce avoidable emergency department (ED) visits.
First challenge area: Enhancing community care, transforming the ED
The Medicaid Transformation Project convened its first Action Forum in Chicago in October, drawing more than 125 people from 24 health systems to begin engagement on how they might reposition the role and the function of the ED in a sustainable way. To do this, Project participants are seeking to improve linkages from the ED to other critical parts of the delivery system, namely primary care, behavioral health, specialty care, and social services and supports. The underlying goals are reducing unnecessary ED visits, reducing avoidable ED visits, and improving patient disposition and sustainable transitions at the moment of discharge.
“By bringing together the nation’s leading health systems, we have a unique opportunity to improve the health of underserved populations in a way that hasn’t been done before. We’re committed to sustainable, durable solutions that improve care and outcomes for people. We must consider the best existing and new ideas and invest in the right ones,” says Andy Slavitt, Medicaid Transformation Project Chair.
At the Action Forum, Medicaid Transformation Project participants discussed care models that had shown success—but had been previously limited by barriers in labor, cost, or technology. They viewed 10 on-site demonstrations of scalable solutions and engaged directly with company founders to explore relevant care models, ranging from community health worker (CHW) programs to virtual triage. They gathered insights from one other and from leading Medicaid experts, including Dr. Molly Coye, former Commissioner of Health for the State of New Jersey and Director of the California Department of Health Services, and Vikki Wachino, former Director of the Center for Medicaid and CHIP Services.
The Action Forum concluded by prioritizing opportunity areas and evaluating projected system and community impact. The event created common framing and orientation around challenges and identified a path forward for the collaborative work.
“The collaborative model of the Medicaid Transformation Project is providing us with a new and necessary lens to view a long-standing challenge, which is improving access and coordination to community care,” says Thomas M. Priselac, president and CEO of Cedars-Sinai. “Our team is excited to share what we’ve learned working with our community partners, and to scale new digital solutions that lower long-standing barriers to care.”
24 health systems taking action together and upcoming work
The health systems in the Medicaid Transformation Project will next select scalable solutions to extend care models and begin early implementation. “These 24 health systems have put a stake in the ground around transforming the function of the Emergency Department in communities with heightened vulnerability. By acting locally and collaborating nationally, we can create a force-multiplier effect that will inspire ripples across the country. We’re honored to help lead this work,” says AVIA President Linda Finkel.
The Medicaid Transformation Project will launch its next body of work on behavioral health in January 2019.
About the Medicaid Transformation Project
The Medicaid Transformation Project is a national effort to transform healthcare and address related social needs for the most vulnerable. Health systems will implement innovative solutions that address challenges like behavioral health and substance use disorder. This will create long-term systemic impact with the goal of improving the health of 75 million Americans.
AVIA leads a network of health systems working together to innovate and transform. AVIA Innovator Network members solve pressing challenges with digital solutions that deliver financial and clinical results. AVIA provides strategic focus and a collaborative approach to accelerate innovation. Learn more at aviahealthinnovation.com. Follow us on LinkedIn and Twitter.
Jarrard Phillips Cate & Hancock