Tricia Keith

The Centers for Medicare & Medicaid Services' final Access and Managed Care rules reflect the biggest regulatory changes to Medicaid and CHIP in nearly a decade. Here's how states should respond.

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Hello Linked-in! May brings us American Asian and Pacific Islander Heritage month + the continuation of the previous month's celebrations. (links below). This post is an invitation to share a survey in your communities/networks, and some related musings on elephants and ecosystems. Recently I was discussing a project we are trying to co-design + fund focused on Community Referral Networks and Arielle Mir rightly named it as a “big elephant" that many of us have our hand on. She asked, how can we narrate the whole elephant or the system and understand the important parts each of us has our hand on? This describes so much of Health Leads work + that of our partners. One thing about “ecosystem” or “system change” work is there is often little incentive to collaborate or even see the whole. In fact, the non-profit, social enterprise and many sectors in the United States put primacy on tidy stories and “solutions” to solve big intractable problems. Revenue often flows towards that and to the story of the single hero or organization that is going to “change the system.” And how is that going for us? Really? To be honest, in our earlier days stepping into “system change,” Health Leads used that kind of narrative in places, and we have seen the harm it can do and worked hard to change it - because none of us can do it alone. #Healthequity, #racialjustice, #economicmobility and other aims we aspire to is the work of many over generations. Yet, many of us see (and even feel) the gravitational pull to the exceptionalism story of the organization or person or product that will solve the big issue. It is almost like a societal addiction. Reframing not only the narrative but the approach around how to solve our biggest challenges is the work I am committed to as a person, as a leader and as part of my various communities. That commitment takes vigilance (including managing my own biases). Working on these intractable challenges as a collective is at the core of Health Leads’ work, and I would argue many of us who are working towards changes in policies, practices and institutions focused on #HealthEquity. It brings me a lot of joy when we get to partner with other organizations and people who are similarly committed. One of those we want to share about is a project focused on Medicaid (and talk about an elephant!). In our work with the State Health Access Data Assistance Center (SHADAC) + RWJF we want to invite you to: 1) Share and help us learn via a survey (below); 2) let us know about your related work + how we might work together (chat, comment or dm). Thank you to all involved across the partners and at Health Leads - LeAndra Padgett, MSW, Meredith Autry, MBA, Alexxis C., Susan McCarron, Susan Furtney, MPH, FACHE, Danielle D., Dominique Morgan In the meantime, appreciation for all of you doing your critically important part at every level + working towards the collective, especially in this moment in our country and globally. 🙏🏻

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The Ohio Department of Medicaid is advancing care with the Next Generation MyCare Program, focusing on fully integrated dual eligible special needs plans (FIDE SNPs). This initiative aims to enhance care coordination, improve quality measures and boost member satisfaction. We dive into what this means for Medicaid delivery in Ohio. #HealthcareInnovation #Medicaid #CareCoordination #ProspHireInsights

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Summary of new article in the Journal of Public Health Practice & Management, "Leveraging AI for Public Health Communication: Opportunities and Risks." Graphic by Karen Donohue. Read the article at https://lnkd.in/gJpJ3quH.

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Seamless data is essential for communities to effectively address public health disparities. The past three years have shown us just how important data is to addressing needs in a timely manner, and the lack of data needed to respond to continuous public health threats has shown us why an updated data infrastructure is long overdue.    In their recently updated Public Health Data Strategy for 2024-2025 and a companion 2023 Lookback Report, @The CDC Foundation shares how they intend to continue improving data modernization across all levels of public health.   More here: https://lnkd.in/ehWsk2d9    #PublicHealthData #DataQuality

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Within the new #hti2 rule are some critical signals: 1. It is a joint effort between Office of the National Coordinator for Health Information Technology (ONC) and Centers for Disease Control and Prevention —and also heavily influenced by recent rules from Centers for Medicare & Medicaid Services 2. #mfa (multi-factor authentication) is called out as required in some use cases 3. #ai algorithms for #caremanagement will need to be more transparent. 4. It attempts to harmonize #tefca from the The Sequoia Project 4. It sets specific versions of USCDI, and #fhir. https://lnkd.in/edb7NpaZ

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The Association for Community Affiliated Plans (ACAP) kicked off 2024 by celebrating the implementation of continuous eligibility for children enrolled in Medicaid and CHIP in all states. Now, a report from the Assistant Secretary for Planning and Evaluation - HHS shows more than 17 million children could have more consistent access to health coverage because of these protections.   It is hard to overstate just how big of a deal this is for kids and families. Consistent access to health care in childhood is linked to better outcomes later in life not just in health but in education, employment, and overall wellbeing. This is an encouraging step forward for the health care safety net, and ACAP looks forward to continuing to work with policymakers to ensure families have coverage they can count on.   Read the full report: https://bit.ly/3UjuEa6

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I agree wholeheartedly with Dr. Geeta Nayyar, MD, MBA! There's a lot of #hubris if you don't believe #communications within healthcare is critical to its success. IMHO, there are two primary barriers to individuals interacting with healthcare. 1) Healthcare is #riskaverse and prefers to use technical terms when providing information. Why? It prevents a grey area and leaves no room for interpretation. The problem is that not all of us are trained medical providers or work for insurance organizations! So, technical lingo is a great CYA measure, but does nothing to make a member feel seen or confident in managing their health. 2) Healthcare is only built for some of the people who interact with it. Despite the push for #valuebasedcare, there's minimal incentive to make healthcare more accessible from a communications lens. So why fix something if no one is focusing on it? This is why #healthcommunications matters! #clarity, #precision, #dignity, and #respect are the cornerstones of any health communication program I create. When you center the individual human and talk TO them, instead of DOWN to them, it makes a world of difference. #healthcommunications is foundational to transformative individual healthcare. If you have questions about my approach to #scalable health communications process, message me.

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Will AI and ambient listening replace keyboards in exam rooms? Reid Stephan, VP and CIO at St. Luke's Health System, interviews Dr. Ashis Barad MD, CDIO, and Joseph Seliski, Director of Operations and Strategy, from Allegheny Health Network as they discuss their future predictions within healthcare. Dive into their insights on clinical advancements and the evolving healthcare landscape in this #TownHall: https://loom.ly/IUX_c74 #TWH #HealthIT

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Managed long-term services and supports (MLTSS) are emerging as essential lifelines for transformation, having significant impact on the #Medicaid landscape nationwide. Sellers Dorsey Managing Director, Suzanne Bierman, shares her insights with MedCity News to explore the how innovations in #MLTSS can help improve health outcomes, reduce costs, and enhance quality of care for Medicaid beneficiaries. Click the link to explore Suzanne's article: https://hubs.li/Q02Hfrg30

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Really enjoyed being on the AI and Health Equity Panel today. Excited to be a Member of this Health Equity Compact #HETS2024 #HealthEquityNow, #HealthEquityCompact, #AnActToAdvanceHealthEquity, Some of my thoughts on… “Proactive Mitigation of Unintentional Bias in AI To address and mitigate these unintentional biases, AI development must incorporate several strategic approaches: Inclusive Data Sourcing: Ensure that the datasets used for training AI include diverse narratives and cultural contexts, particularly those that are underrepresented. Bias Awareness Training: Implement training programs for AI developers that raise awareness about cultural biases and their potential impacts on AI behavior. Algorithmic Transparency: Foster transparency in AI algorithms to identify and correct bias. This involves making the processes behind AI decisions accessible and understandable to a broad audience. Ethical AI Audits: Conduct ethical audits of AI systems regularly to assess their impact on different cultural groups and adjust algorithms accordingly to prevent discrimination. Community Engagement: Engage with diverse communities to get feedback on how AI systems affect them differently and to gather insights that could lead to more nuanced AI applications.”

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This is an excellent read on the data required to achieve #populationhealth in the context of rapid health care systems change and Innovation in California. Touches on challenges and urgency but perhaps paints a best-case scenario of the continuum. The reality is... Change at this scale is HARD (and $$$$). A lot of organizations across the board are struggling to adapt. I am sooo grateful to see Office of California Governor Gavin Newsom prioritizing these initiatives. It's going to be a big win for collective well-being when the dust settles. I feel lucky I get to help some folks navigate and thrive through the overwhelming change-fatigue. If you're working in this space I'd love to connect. #wholepersoncare #integratedcare #CalAIM #interoperability #digitaltransformation #behavioralhealth

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The Third Virtual National Health Care Transparency and No Surprises Act Summit ✅ April 16-19, 2024 Part 2 of 2 Aneesh Chopra shared how important it is for consumers to have access to health data, prices, and the resources necessary to understand quality. He also advocated for the standardization of Good Faith Estimates (GFEs) so a hip replacement, for example, would have the same bundled set of billing codes. Ahmed Marmoush, Susan Dentzer and many others shared that you can’t have price transparency without quality as the two must be taken into account in order to understand value. Justin Leader shared a heavy lift taking place in healthcare literacy and expanded on this by saying that consumerism can’t work for people who are unable to make an informed decision. Comments on the Machine Readable Files (MRFs) unearthed several challenges… Christopher Whaley and others talked about the health system Machine Readable Files (MRFs) being less complete, reliable and accurate than the posted MRFs from insurance companies. David Muhlestein in discussion with Niall Brennan shared how the machine readable price transparency files (MRFs) are riddled with ghost codes and other unusable data points. The pair shared the sentiment that price and quality aren’t correlated in healthcare. Kristyn Ulrich of CommonSpirit Health shared that the MRF framework doesn’t appreciate the complexity that occurs on the claim level which is how hospitals are paid. She wasn’t alone in expressing the difficulties that come with evolving and misaligned federal and state requirements. Finally, several people noted that the story is still missing on how all of these developments can turn into actionable impact to help patients at scale.   Additional people who I heard from and hope to continue the conversation with... Joseph Fifer, Francois de Brantes, Niki Panich MD, FCFP, Robert Tennant, Brian Cotter, Joel Ario, Ge Bai, Patricia Kelmar, Katherine Hempstead, Phil LeFevre, Cheryl Matochik, Lauryssa Humm, Peter Schultz, ASA, MAAA, Traci McGinnis, Julie Selesnick, Vanessa Candelora, Alice O'Carroll, POPM, Hemi Tewarson, Katie Martin, Mara McDermott, Doug Jacobs, MD, MPH, Matthew C., Amy Assenmacher, Stephanie Bird, Scott Roth, Howard Kraft, Melissa Speck, Erin Richter Weber, Melanie Wilson, Jamie Cleverley, Vance Ginn, Jeff Wu, continued in comments below.

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📢 Important news! MNCM and DHS have released this year's report on Minnesota Health Care Disparities by Insurance Type, focused on care delivered in 2022. A key goal this year: Boosting awareness about the availability of these crucial data. State government, health plans, and health care providers leverage these reports to shape strategies for advancing health equity. Yet, we recognize that many others—especially those driving local community efforts to combat disparities—may not be fully aware of these resources. By widening the dissemination of these reports, we aim to spark fresh dialogues on how this data can empower community-based organizations and local public health agencies in their vital work. Your assistance in sharing this information within your local networks is invaluable. Special thanks to Kate Hust, Clarence Jones, and Mariam Mohamed for sharing your insights on community context and engagement strategies. Kudos to Jess Donovan, MPH, BSN, Ma Xiong, and Alyssa Ida Pintar Breen for your outstanding work on the analysis and production of the report! #HealthEquity #CommunityHealth #DataDriven #MinnesotaHealthcare #PublicHealth #HealthDisparities #LocalEngagement

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As a healthcare leader who lives in a state where it can get rural very quickly, I believe it's imperative to recognize the profound impact recent CMS regulations have had on our patients, particularly those in rural areas. The restrictions on the delivery of cancer medications from medically integrated pharmacies (MIPs) not only disrupt the convenience and accessibility of vital treatments but also exacerbate existing healthcare disparities. For patients already facing geographic and economic challenges, mandating in-person pickups poses a significant burden, hindering treatment adherence and potentially compromising outcomes. It's crucial for policymakers to acknowledge these implications and work with community physicians towards modifying these rulings to ensure equitable access to life-saving cancer medications for all patients, regardless of their geographical location. Let's advocate for change and stand together in our commitment to improving patient outcomes and addressing healthcare disparities in rural communities.  #EquitableHealthcare #PatientAccess #OncologyCare

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Over the past 2 years, the Urban Institute has completed an impressive body of work focused on the question: How can we make substantial progress toward eliminating racial disparities in health and ensuring equitable care for all patients?  Our products include a 2023 symposium, papers and guides, and virtual dialogues. Current efforts include research on using demographic data to advance health equity, developing new research strategies to bolster equity initiatives in the wake of recent Supreme Court rulings, and preparing for the 2030 Census. As Tony Iton and Damon Francis have written, "The fractures in the US health system—and in the country’s social contract—can be fixed. The growing diversity of the United States makes this an urgent opportunity." Here's what the Urban Institute is doing to advance change. https://lnkd.in/e9ppAVuy

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