Rey Faustino’s Post

We at One Degree have observed firsthand some of the issues raised in this article regarding the CalAIM roll-out. The core problem: Top-down implementations of well-meaning health and social care policies often perpetuate and amplify power imbalances. Large healthcare organizations and for-profit companies drive policy, while community-based organizations and frontline providers—underpaid and understaffed—are left to do the work. This should also serve as a call to action for all of us in the social services sector. We need to advocate for more inclusion and equitable participation in policy discussions to ensure that the voices of frontline staff and the communities they serve are not only heard but become central to shaping solutions. It’s time for policymakers, funders, community-based providers and community voices to be at the decision-making table together. Will you join us in bringing attention to this issue and pushing for change? Please share your thoughts in the comments, send a message, or share this post to show your support! You can also read more about our perspective here: https://lnkd.in/d5YxDFuH #calaim #medicaid #carecoordination #sdoh #digitalhealth #nonprofit

It's simple. The middle people - from the Advantage plan CEO to authorization staff (who deny most of the needed care) get paid. And it's either taken from the providers (low rates or non payments) or the patients (by denying care). There is only so much money available, and if you pay the middle people, there is less for the providers and patients. The administrative burden in the USA is huge compared to other countries, and that's one of the reasons. #ImproveHealthcare #ReduceAdminCost #AccesstoCare

CarePoint Health System is a beacon of hope for Hudson County's underserved population, providing essential community health care services at its safety net hospitals for a population that has few other options. Charitable, empathetic, compassionate and quality-driven care is essential to our mission, but economic conditions mandate additional state funding to support this approach. Hudson County is home to nearly 70,000 residents who lack health insurance, as well as approximately 80,000 undocumented immigrants. When these residents need health care, they come to CarePoint’s safety net hospitals and they are never turned away — but that spirit of altruistic health care access cannot be sustained without state funding support. We urge our state leadership to recognize this need and allocate appropriate funding from the state budget and any available discretionary funds towards CarePoint’s community health initiatives. By signing this petition, you are not only supporting a noble cause but also advocating for better healthcare services in Hudson County. Please sign this petition today and help support CarePoint’s mission to continue providing care to our underserved communities. CarePoint Health System was ranked as the 4th best safety net hospital in the United States based on performance in: patient outcomes, civic leadership (treating lower-income and minority patients), and value of care (avoiding overtreatment). CarePoint Health System was also ranked as the #1 most Equitable Healthcare System in the United States in 2021 by the Lown institute, which is a non-partisan healthcare think tank. #compassionatecare #healthequity #hudsoncounty Link to Sign Petition: https://chng.it/P8sHNgtPLz

#NonProfit #MedicareAdvantage #HealthPlan #SCANHealth squeezes $250M more #Obamacare #PayForPerformance cash from #CMS by requiring it to follow its own rules. Several other MA plans who thought they had fallen off the 5% PMPM 4-STAR (HUGE for #healthplans) cliff are rescued too. What will next year bring? The all-out competition to improve the experience of care, to improve #PopulationHealth, to gain more membership and all the while limiting the per capita cost of care remains intense. 32 million Americans (more than half of all #Medicare recipients) have voted with their feet for MA. #HealthcareReform #HealthcareTransformation #HealthcareCosts #HealthcareQuality #SDoH #HealthEquity #PrimaryCare #PublicPrivatePartnership #PublicPrivatePartnerships #DSNP #BehavioralHealth #MentalHealth #DualEligible #TripleAim #QuadrupleAim

I attended the 2012 NAEH conference. The very last session on the very last day … (the one you can barely hear the panel speakers as the hotel staff is stacking up the chairs and moving the walls back to their “not currently in use” home) …. was a “brief look” at how the ACA may impact ending homelessness… There were less than a dozen individuals in the room… not including the panel… The take away: Housing IS healthcare … and The ACA is the first drip, drip, drip … with time … that will carve the path to ending homlessness! Friends and Colleagues, you have listened to me “lecture”, rant, babble, and advocate for over a decade regarding the value and necessity of infiltrating private health insurers and Medicaid to PAY FOR RENT AS A HEALTH CARE BENEFIT! You’ve listened to me yap about the small (but quiet) pilot programs being conducted across the country …. You’ve heard me whisper: “counties and jurisdictions are moving homeless services funding from their departments of human services into their departments of Public Health …. and addressing homelessness as the public health epidemic it is… because (let’s all say it together … and loudly for the cheap seats in the back) … Housing IS healthcare!” And, you’ve heard me say: “Mark my words … you’ll see … it’s about 20+ years give or take from policy to practice— policy passes … 10 or so years to pilot program outcomes … and, then 10 or so years for advocacy, development of best practices, and program implementation.” Well, My Friends, policy has passed … 10 or so years and we’re getting our research…. and, now IT’S TIME TO ADVOCATE AND IMPLEMENT!!! … just sayin …

Access to health care is a human right. Because the raising cost of living, people are pushed everyday to choose between paying for a roof on their head or getting access to healthcare. More than ever the FQHC services are needed to provide healthcare to the most in need. It should be an easy decision for Congress to secure sustainable funds for community health centers around the country. If we have money in the budget to bail out banks, support a war, or other countries needs, we certainly have the money to cover our own country fellows basic human rights needs.

𝐀𝐫𝐞 𝐲𝐨𝐮 𝐨𝐫 𝐲𝐨𝐮𝐫 𝐚𝐠𝐢𝐧𝐠 𝐩𝐚𝐫𝐞𝐧𝐭 𝐬𝐩𝐞𝐧𝐝𝐢𝐧𝐠 𝐦𝐨𝐧𝐞𝐲 𝐰𝐡𝐞𝐫𝐞 𝐲𝐨𝐮 𝐜𝐨𝐮𝐥𝐝 𝐛𝐞 𝐬𝐚𝐯𝐢𝐧𝐠? Often, it’s about knowing what questions to ask and who to ask. Here are a few key areas to consider: 1. 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞 𝐂𝐨𝐯𝐞𝐫𝐚𝐠𝐞: Understand what the insurance company pays for and how to advocate for it. Examples include: *Transportation: Some plans cover medical transportation services. *Pharmaceuticals: Check if cheaper generic alternatives are covered. *Care Coordination: Many plans include case management services to help organize care. 2. 𝐊𝐧𝐨𝐰 𝐘𝐨𝐮𝐫 𝐑𝐢𝐠𝐡𝐭𝐬 𝐚𝐧𝐝 𝐑𝐞𝐠𝐮𝐥𝐚𝐭𝐢𝐨𝐧𝐬: Be aware of your rights at the hospital, in the emergency room, and with healthcare agencies. Examples include: *Hospital Stays: Know what costs are covered under inpatient care versus outpatient services. *Emergency Room Visits: Understand what emergency services your insurance covers and what you might need to pay out-of-pocket. *Healthcare Agencies: Be informed about services like home health care that insurance might cover, such as skilled nursing or physical therapy. 3. 𝐂𝐨𝐦𝐦𝐮𝐧𝐢𝐭𝐲 𝐑𝐞𝐬𝐨𝐮𝐫𝐜𝐞𝐬: Explore local resources and support groups that can provide assistance at little to no cost. Examples include: *Area Agencies on Aging: Offers various services for seniors. *Nonprofit Organizations: Many, like Meals on Wheels, provide free or low-cost services. *Local Senior Centers: Often have support groups, activities, and resources. *Faith-Based Organizations: Many provide volunteer services for seniors. By being informed and asking the right questions, you can save money and reduce financial stress. 𝐍𝐞𝐞𝐝 𝐦𝐨𝐫𝐞 𝐭𝐢𝐩𝐬 𝐨𝐧 𝐞𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞 𝐜𝐨𝐦𝐦𝐮𝐧𝐢𝐜𝐚𝐭𝐢𝐨𝐧 𝐚𝐧𝐝 𝐬𝐚𝐯𝐢𝐧𝐠 𝐦𝐨𝐧𝐞𝐲 𝐰𝐡𝐢𝐥𝐞 𝐣𝐮𝐠𝐠𝐥𝐢𝐧𝐠 𝐫𝐞𝐬𝐩𝐨𝐧𝐬𝐢𝐛𝐢𝐥𝐢𝐭𝐢𝐞𝐬? I'm hosting a workshop this week. Register with the link below! #ItTakesaVillage #AgingParents #FinancialSavings

In view of my advocacy work around the NHS and the charities who support patients, I was interested to attend today’s seminar hosted by Ruth Thorlby of the The Health Foundation that reported on collaborative work with Ipsos UK and Healthwatch England looking at the future of the NHS. This is very timely in view of the General Election on 4 July. My key take-aways are below. The full report will be made available at health.org.uk/pub Thanks all involved for a major piece of work that I hope will prove influential with Ministers and policy makers in the months and years ahead. Kate Duxbury from IPOS spoke of the strong affinity that people feel to the NHS and its founding principles. Most participants of the study want to see the NHS improved, with greater investment through taxation, rather than a health model with additional charges applied to patients or a social health insurance model. People think change is necessary – with longer term, evidence-based planning – but don’t like the idea of radical reform. Most would like to see investment in community accessed healthcare, ‘access’ being a key issue. Participants value highly NHS ‘frontline’ staff and are concerned about work pressures they’re under and the impact on care. Tom Gardener from the Health Foundation shared the implication of the study’s findings for policy makers: 1.     Be more open about the problems the NHS is facing 2.     Prioritise primary care and community services 3.     Don’t under-estimate the support for investment (even if it means higher taxes) 4.     Have better conversations about waste (efficiency) 5.     Improve rapport with NHS staff 6.     Act urgently to restore public trust 7.     A better NHS, not a different health system Teapot Trust hopes that governments, at both Westminster and Holyrood, commit to short, medium, and longer term plans, with informed input from healthcare professionals, health charities and patient groups. We’ll be reading what each political party says about health in its manifesto and will prepare our own in collaboration with other charities in the paediatric chronic health sector. #generalelection #healthpolicy #policymakers #communityhealth #accesstohealth #paediatrichealth #patientgroups #publicopinion #NHSinvestment #chronicillness #arttherapy

Minneapolis-based UCare seeks to grow its reach and social impact by competing for a #Medicaid contract in Kansas. Key Points: - UCare, a non-profit health plan, prioritizes expanding its mission to new communities. - The organization recently saw growth due to the COVID-19 pandemic's impact on Medicaid enrollment. - UCare aims to start with Kansas Medicaid and potentially offer plans for seniors and individuals in the future. - Their bid highlights a long-term commitment to serving Kansas residents, unlike some competitors. - This move signifies UCare's strategic growth plan and dedication to serving low-income populations beyond Minnesota. Learn more: https://hubs.ly/Q02mWqqg0

Interesting intrigue around the 4-star to 3.5 star 5% PMPM (HUGE for #healthplans) quality bonus #Obamacare cliff. Proposed #CMS changes may help the perennial 3.5 star plans (the #Centene's and #Molina's of the world) and hurt the 4.0 and 4.5 star plans (the nonprofits #Kaiser's, #UPMC's, #Providence's, etc). $20B in bonuses is in play over 10 years. Looks to be best to attain and maintain 5-Stars whenever possible (consistently demonstrate the absolute best care for the population served, demonstrate the best taxpayer value and the Obamacare-granted power to market for new membership the year around). #Darwinianism rules! #SDOH #HealthEquity #HealthcareReform #HealthcareTransformation #PrimaryCare #PopulationHealth #PatientCenteredCare #PatientCenteredHealthcare #HealthcareQuality #ValueBasedCare #ValuebasedHealthcare