August 14, 2024
HMA Conference Keynote Speaker Discusses Innovation in Medicaid, Medicare, and Marketplaces (Video)
1312 Results found.
Helping North Carolina create a sustainable public health workforce
THE CLIENT
North Carolina Association of Local Health Directors Region 7 comprises seven Local Health Departments (LHDs) in north/central North Carolina. Participating counties include Franklin, Granville, Johnston, Nash, Vance, Wake, Warren, and Wilson representing 1.78 million residents. T he Lead LHD for Region 7 is Granville Vance Public Health, a district health department which serves both Granville and Vance counties. Region 7 is representative of North Carolina in terms of county population, population density, and economic viability.
BACKGROUND
Beginning in March 2023, Health Management Associates (HMA), Evergreen Solutions, LLC, and Trailhead Strategies (collectively, the “HMA team”) partnered with Region 7 to assist with efforts to improve its public health workforce. These partnered projects included the (1) Workforce Investment and Modernization Study, which aimed to improve the competitiveness and retention of the public health workforce in Region 7; (2) the Cost Study to assess Region 7’s capacity to provide public health services and estimate total costs associated with delivering Foundational Public Health Services and Capabilities (FPHSCs); and (3) a supplementary Labor Market Analysis which collected data on the current state and projected needs of the public health workforce. These projects (shown in Figure 1) provide support for each county within Region 7 to create a scalable and flexible approach for implementing future changes in its public health workforce.
APPROACH
To complete the Workforce Investment and Modernization Study, the HMA team implemented a multi-phased approach to develop a set of workforce retention recommendations, including conducting a class and compensation assessment, market survey, qualitative interviews with regional staff to assess workforce perceptions, and a literature review of peer-reviewed best practices and cost methodologies to develop two reports. The effort required bringing together experts in public health workforce and services, as well as local staff who understand the unique nature of North Carolina’s individual counties. The strong partnership and rapport established throughout the project allowed everyone to effectively tailor recommendations and final products to ensure that they would be effective and actionable for Region 7 to both invest in and sustain a public health workforce.
For the Cost Study, HMA expanded on one such recommendation which advised that Region 7 counties develop a 5- to 10-year plan to promote public health workforce class and compensation competitiveness. To help accomplish this, HMA developed the Cost Study Tool to assess Region 7 LHDs’ current capacity for providing FPHSCs and support each county within the Region to create a scalable and flexible approach for implementing future changes in its public health workforce. To develop the Cost Study Tool, the HMA team conducted a literature review of various public health cost methodologies to determine the most applicable one for use in this work, resulting in the development and refinement of the Cost Study Tool to estimate the 5-year costs of providing FPHSCs.
Finally, the HMA team also conducted the Labor Market Analysis to enhance Region 7’s understanding of the current state and projected needs in the North Carolina public health system and, as a result, inform long-term decision-making and strategic planning (e.g., taking proactive measures to address potential shortages or shifts in skill requirements).
TESTIMONIAL
“HMA provided Region 7 with a carefully constructed evaluation of LHDs’ recruitment and retention practices, recommendations for modernization efforts, and the tools and data needed to quantify current and future costs and staffing to provide FPHSCs. HMA’s subject matter expertise and understanding of our individual health departments resulted in an integrated plan for modernizing our health departments as we advocate for and support an incredible public health workforce in North Carolina now and in the future.”
Lisa Macon Harrison, Health Director, Granville Vance Public Health
RESULTS
For each project, the HMA team developed a robust report of quantitative and qualitative findings associated with the project’s objectives.
For the Workforce Investment and Modernization Study, this included summaries of the class and compensation results for each county in Region 7 and qualitative interviews with public health staff. The report also included 15 recommendations related to: class and compensation; strategic planning, evaluation, and continuous quality improvement; recruitment and human resource practices; retention and workplace culture; local and regional partnerships and shared services; and technology, equipment, and physical location.
For the Cost Study, the report summarized HMA’s literature review of public health cost methodologies and described how the HMA team applied the selected methodology to develop and refine a prototype data-driven tool to estimate the costs of providing FPHSCs in each Region 7 county. Concurrent with the report, the HMA team also developed a user guide to accompany the Cost Study Tool, both of which are to be distributed for Region 7 LHDs’ use. Finally, the HMA team provided a report detailing the following Region 7 factors:
- Region Overview
- Occupation Selection
- Labor Market Growth and Occupation Trends
- Job Posting Data
- Major Employers
- Demographics (Race and Ethnicity, Gender, Age)
- Skill Analysis
- Occupation Forecasting
- 10-Year Analysis
- Educational Alignment
- Aging Population
HMA believes that, in partnership, these studies will provide each LHD of Region 7 with the tools necessary to develop a sustainable, actionable public health workforce that will be prepared to continuously serve and improve the health of all North Carolinians now and in the future.
FY 2025 Medicare hospital inpatient final rule to affect hospital margins and administrative procedures
This week, our In Focus section reviews the policy changes that the Centers for Medicare & Medicaid Services (CMS) finalized on August 1, 2024, in the fiscal year (FY) 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Final Rule (CMS-1808-F). This year’s IPPS final rule will impact hospital margins and administrative processes beginning October 1, 2024.
The remainder of our article delves into five of the key policy changes included in the final rule.
Key provisions in the FY 2025 Hospital IPPS and LTCH Final Rule
For FY 2025, CMS will modify several hospital inpatient payment policies. We highlight five of these policies because they will have the most significant impact on Medicare beneficiaries, hospitals and health systems, payors, and manufacturers:
- The annual inpatient market basket update and changes to the standardized payment amount
- New technology add-on payment (NTAP) policy changes
- Implementation of the Transforming Episode Accountability Model (TEAM) bundled payment model in 2026
- Hospital wage index changes and labor market adjustments
- Severity of illness increase for housing insecurity social determinants of health (SDOH) codes
Several of these and other policy changes for FY 2025 will become effective October 1, 2024.
Market basket update
Final rule: Overall CMS’s Medicare 2025 Hospital IPPS Rule will increase hospital inpatient payments to acute care hospitals by 2.9 percent from 2024 to 2025, an estimated increase of approximately $2.9 billion after other policy changes are included.
Health Management Associates (HMA) analysis: CMS’s 2.9 percent increase is largely based on an estimate of the rate of increase in the cost of a standard basket of hospital goods—the hospital market basket. For beneficiaries, this payment rate increase will lead to a higher standard Medicare inpatient deductible and increase out-of-pocket costs. The finalized payment increase (2.9 percent) is larger than the increase included in CMS’s IPPS Proposed Rule (2.6 percent) but continues to fall below economy-wide inflation over the past year (3.5 percent).1,2 Importantly, after accounting for the various policy changes made within the final rule (e.g., wage index reclassifications) we anticipate individual cases will experience an average payment increase of 1.7 percent.
Transforming Episode Accountability Model
Final rule: CMS finalized the creation of a new mandatory episode-based CMS Innovation Center methodology—TEAM. Under TEAM, selected acute care hospitals will coordinate care for people with traditional Medicare who undergo one of the following surgical procedures:
- Lower extremity joint replacement
- Surgical hip femur fracture treatment
- Spinal fusion
- Coronary artery bypass graft
- Major bowel procedure
Hospitals in the model will assume responsibility for the cost and quality of surgical care through the first 30 days after a Medicare beneficiary leaves the hospital. Hospitals also must refer patients to primary care services to support optimal long-term health outcomes. Hospitals will be assigned to different risk tracks to allow a graduated path to ease in to full-risk participation.
HMA analysis: The mandatory nature of this model requires hospitals in the selected geographic areas to begin to prepare for implementation of the model requirements in 2026. TEAM builds on and combines previous models such as the bundled payment for care improvement (BPCI) and the comprehensive care for joint replacement (CJR) models. Hospitals in roughly 23 percent (188 of 925) of the nation’s core-based statistical areas (CBSAs) are required to participate in this advanced payment model, with some exceptions, such as hospitals in Maryland and Sole Community Hospitals. Participating hospitals will be required to report various quality measures, and payment will be based on spending targets and include retroactive reconciliation. Reimbursement under the model will follow four different tracks, which vary by the level of upside and downside risk that the hospital accepts and with a specific track for safety net hospitals.
Hospital Wage Index Adjustments and Labor Market Changes
Final rule: CMS finalized two wage index policies for FY 2025. First, CMS extended the temporary policy finalized in the FY 2020 IPPS/LTCH PPS final rule for three additional years to address wage index disparities affecting low wage index hospitals, which includes many rural hospitals. Second, as required by law, CMS revised the labor market areas used for the wage index based on the most recent CBSA delineations issued by the OMB based on 2020 Census data.
HMA analysis: The two wage index policy changes for FY 2025 will have important positive and potentially negative consequences on hospital payment. The policy to extend the low wage index policy for three more years will allow many hospitals with low wage indexes to increase their wage index and their payment rates across all Medicare severity diagnosis-related groups (MS-DRGs).
Specifically, the roughly 800 hospitals with wage indexes below 0.9007 (the 25th percentile across all hospitals) will automatically receive an increase in their wage index and payment rates for all inpatient cases. This policy will bring additional millions of dollars to individual rural hospitals in FY 2025. The second policy is a statutorily required update to the labor markets used to establish CMS’s hospital wage indexes. To implement this policy, CMS will use US Census Bureau data to redefine urban and rural markets. As a result, CMS will redefine 53 urban counties as rural and will newly redefine 42 rural counties containing a hospital as urban. These changes will disrupt various hospital payment policies for hospitals in these counties. The overall impact of both geographic policy changes for FY 2025 will be to increase inpatient payment rates to rural hospitals.
Revision to Social Determinants of Health Housing Insecurity Diagnosis Coding
Final rule: CMS finalized a change in the severity designation of the seven ICD-10-CM diagnosis codes that describe inadequate housing and housing instability. Under the final rule, these codes are changing from non-complication or comorbidity (non-CC) to complication or comorbidity (CC) based on the higher average resource costs of cases compared with similar cases without these codes.
HMA analysis: This new policy will enable hospitals to receive higher inpatient payment rates when they provide care for patients with inadequate housing or housing instability are served. Specifically, this policy change will result in assigning cases involving patients with one of these codes to a higher-level MS-DRG. Hospital staff will want to ask patients about their housing upon admission and discharge to accurately document this critical SDOH characteristic.
New technology add-on payments
Final rule: CMS finalized three changes to the NTAP program and approved several products for NTAPs in FY 2025.
HMA analysis: CMS seems willing to increase NTAP payments in certain limited situations to boost selected policy goals but rejects comments seeking to increase the percentage for sickle cell products or expand the higher payments to other medical conditions. In addition, portions of the final rule indicate that CMS is applying some of the criteria for NTAPs more strictly than in recent years. If this trend continues, it may be more difficult for future new technologies to be approved for NTAPs.
Connect with Us
HMA’s Medicare Practice Group works to monitor legislative and regulatory developments in the inpatient hospital space and assess the impact of inpatient payment, quality, and policy changes on the hospital sector. We will continue to follow these and other changes happening to hospitals and are available to provide additional detail on these or other policies in the final rule. If you have any questions, please contact our featured experts below.
August 7, 2024
FY 2025 Medicare Hospital Inpatient Final Rule Will Alter Hospital Margins and Change Administrative Procedures
Enabling County Governments to Plan for Use of Opioid Settlement Funds
THE CLIENT
Cabarrus County, NC, located in the south-central part of the state, is the ninth most populous county in North Carolina with a population around 226,000 people as of the 2020 census. It stands to receive approximately $22 million in opioid settlement funds over the next 18 years.
BACKGROUND
Cabarrus County engaged HMA to support the development of a strategic plan that will guide the use of the County’s opioid settlement funds. In partnership with applicable cities and municipalities, the collaborative planning process provided opportunities to engage the community—both professionals working in and around the opioid space as well as those with lived experience—to hear the needs of residents, understand current services offered and existing strengths, and explore barriers to accessing care.
APPROACH
HMA supported all aspects of this project – from process design to research to stakeholder engagement. Below is a brief summary of the key areas of HMA’s support:
Process Design
HMA met with Cabarrus County’s Assistant County Manager, Dr. Aalece Pugh, early in the process to finalize the strategic planning approach, establish protocols for project management and oversight, and identify stakeholders to engage.
Stakeholder Engagement
HMA coordinated and facilitated a series of stakeholder engagement efforts to solicit feedback from key constituencies. HMA facilitated a series of interviews and 14 focus groups – including four focus groups with individuals with lived and living experience. HMA also designed, administered, and analyzed a community survey that received 250+ responses.
Decision-Making
Overseeing the planning process was a team of county leaders – called the Community Response Team – that included representatives from the board of commissioners, county administration, behavioral health, emergency medical services, and the county jail. HMA facilitated four meetings of this group to review data, discuss stakeholder engagement findings, and prioritize strategies to fund.
Deliverable Development and Presentation
Based on the input from the Community Response Team, HMA developed a robust strategic plan deliverable. In addition to developing the document, HMA also supported a presentation to the Board of Commissioners seeking approval of the plan. SUBJECT MATTER EXPERTISE HMA assembled a team that was uniquely qualified to support this work. The team included individuals with the functional strategic planning and stakeholder engagement expertise required to complete this work, as well as subject matter experts in medications for addiction treatment and harm reduction which proved valuable. HMA’s team also included individuals with a depth of county government experience in North Carolina. They were responsive and worked together seamlessly to provide high-quality support throughout the engagement. HMA provided a clear plan and direction to successfully accomplish Cabarrus County’s intended goals, while also demonstrating an ability to adapt as needs and circumstances changed.
TESTIMONIAL
“Nine months ago, and through a rigorous and competitive selection process, HMA was selected to lead our opioid settlement strategic planning efforts. I am very pleased with the final product and the work of HMA’s team of professionals to help Cabarrus develop a strategic roadmap. HMA’s levels of professionalism, expertise, and engagement were above reproach.”
Dr. Aalece Pugh, Assistant County Manager, Cabarrus County Government
RESULTS
The final deliverable was a five-year Opioid Settlement Collaborative Strategic Plan. Cabarrus County wanted to assure that the voice of the community, persons with lived experience, providers, and key stakeholders were elevated to inform the final priorities. T he document provides an overview of the crisis and settlement funds, highlights the strategic planning process and input received, and describes the prioritized strategies and implementation plan. The strategic plan will serve as a guide for the use of opioid settlement funds for years to come, providing a clear roadmap while offering enough flexibility to make adjustments as the crisis continues to evolve. The plan was presented and approved by the Board of Commissioners in June 2024. The plan document can be viewed at cabarrus-county-strategic-plan-opioidsettlements.pdf (cabarruscounty.us)
Don’t just grab the shiny new thing: integrating IT and business strategies to optimize technology ROI
The emergence of generative artificial intelligence (Gen AI) and large language models, like OpenAI’s ChatGPT or Google Gemini, has spurred a renewed focus on the use of cutting-edge technology in healthcare. Healthcare payers, providers, and state Medicaid agencies are racing to deploy Gen AI and other technologies to improve patient outcomes, reduce costs, improve patient engagement, streamline administrative operations, and simplify compliance. While Gen AI holds tremendous potential to improve healthcare, we should heed the lessons learned by recent waves of technology: deploying technology—including Gen AI—in isolation of a broader business strategy is a recipe for underperformance. Optimizing the return on technology investment requires taking a structured approach to integrate technology strategy with business strategy.
Investing in health IT is essential to meet innovation challenges. Technology can enable the scale, reach, speed, and the consistency needed to thrive in today’s fast-changing landscape. Moreover, as workforce shortages persist, technology must become a “force multiplier,” allowing healthcare practitioners and other healthcare staff to focus on what they do best. In today’s changing business and social environment, there is no choice but to embrace health IT.
Investments in health technology, however, have often fallen short of expectations. For years, CEOs and chief information officers (CIOs) have lamented the poor return on substantial investments in health IT. For example, in a recent EY study, 70% of hospital executives report they have not seen an ROI from investments in digital health. A few years ago, only 10% of health professionals surveyed by Health Catalyst assessed the ROI on Electronic Health Records (EHR) investments as positive or better. Mis-investing in technology has long-term implications for any organization. Over-investment in technology reduces ROI and diverts resources from more productive uses. Under-investment in technology can undermine effectiveness, reduce productivity, and weaken patient engagement. So, optimizing technology ROI is essential to driving effective outcomes.
One challenge with IT investment is that measuring ROI in healthcare is an inherently difficult calculation. In addition to financial returns, the hoped-for return on technology investments is an improvement in patient outcomes, which may not translate into immediate financial benefits. Another challenge is that fragmented healthcare systems make it difficult for any single organization to gain system-wide efficiencies that drive a positive ROI.
However, an often-overlooked challenge to optimizing IT investment is thinking of IT strategy as something separate from, rather than integrated with, the business strategy. In healthcare, executing nearly every business strategy requires leveraging IT. To optimize the ROI in health tech investments, organizations must align and integrate their health IT strategy with their business strategy.
Organizations often take one of two different approaches to technology. In some cases, they cede responsibility for the IT strategy to the CIO, perhaps because technology can seem imposing, and the CIO speaks the language of IT. In these cases, the IT strategy may reflect imperatives important to the IT shop—for example, consolidating on a common tech stack or replacing a software component—that do not support or advance the business strategy.
In other cases, organizations develop a business strategy in isolation of a technology strategy—they define their business strategy, then look for technology to support it. This approach leads to a business strategy that either cannot be realistically supported by available technology or does not exploit technology effectively. Under either approach the result is the same: Failing to integrate and align your tech strategy with your business strategy will undermine the value of your technology investments.
To optimize the return on their technology investments, healthcare organizations should take a structured approach to aligning their technology strategy with their business strategy. HMA works with health care organizations to:
- develop or refine their business strategy,
- develop an integrated technology strategy fully aligned with that business strategy,
- assess their existing technology,
- develop a strategic roadmap to modernize technology,
- support technology procurements, and
- support technology implementations.
HMA will be at MESC 2024 August 12-15, and if interested in learning more about this approach, come see us at Booth 450. Or for more hands-on exploring of how this can work for an organization, join us at these two pre-conference sessions at HMA’s Fall Conference on Unlocking Solutions in Medicaid, Medicare, and Marketplace, October 7-9 in Chicago. The session on Navigating the Medicaid 1115 Demonstration Processes will give nuanced understanding of CMS’ criteria concerning budgeting, implementation, evaluation frameworks and administrative supports, along with strategies to effectively navigate through the approval process. Another session on A Framework for Thinking About – and Using – AI Effectively will share real-world examples of successful AI implementation, their impact on business outcomes, and lessons learned. Both will examine how HMA works with clients to integrate their technology strategy into the overall company strategy.
For more information, contact our IT experts below.
Webinar Replay: Integrating Behavioral Health into Whole-Person Care
This webinar was held on August 21, 2024.
Whether you insource or outsource your behavioral health benefits, the integration of behavioral health and medical care continues to emerge as a critical strategy to improve health and reduce healthcare costs. This webinar is designed to help organizations begin to navigate this important shift in expectations and ultimately be a part of successful change in this area. By focusing on the value of a whole-person care approach to behavioral health, HMA experts described the different models for integrating behavioral health and provided a training framework to support the behavioral health aspects of whole-person care.
Learning Objectives:
- Articulate the benefits of incorporating a strong Behavioral Health approach into Whole-Person Care Models
- Learn the different models for integrating Behavioral Health care into Health Plan Functional Areas and Operations
- Able to develop a training framework for all Health Plan staff to increase their competencies for addressing Behavioral Health conditions
Webinar Replay: The New Administrative State: Implications of Recent Landmark Supreme Court Rulings for Federal Regulations, Agency Deference, and State Implementation
This webinar was held on August 14, 2024.
While legal experts assess the recent U.S. Supreme Court rulings, federal and state agency leaders face significant questions about how their agencies and their responsibilities will be impacted. This webinar featured insightful discussions with former federal and state agency leaders exploring the known and yet-to-be determined impacts of recent rulings on federal regulations, rulemaking and actions, and agency deference, and also explored the impact on state agencies implementing federal rules. The webinar addressed the impact of the pivotal Loper Bright Enterprises v. Raimondo and West Virginia v. EPA decisions. Together these decisions overturned the longstanding Chevron deference doctrine, are pushing Congress to craft more specific legislation, and are directing courts to interpret ambiguous statutes. The discussion also explored the most appropriate responses of agency leaders, anticipated the ways that these decisions impact federal and state agency decision-making, and identified areas of growing uncertainty.
Learning Objectives:
- Understand what we know about the impact of these decisions on agency rulemaking and decision making, consider the impact on federal agency discretion, and understand the shift in power towards Congress and judicial interpretation
- Analyze the likely impact on agency rulemaking processes
- Explore state governance issues, both as a partner to federal agencies and as an implementer of federal policy and funds
- Identify the most important questions yet to be answered
HMA celebrates 59th anniversary of Medicaid and Medicare
This week, Health Management Associates (HMA) shifts In Focus from a newsworthy development to commemorate a seminal event in the expansion and strengthening of healthcare access in the United States. On July 30, 1965, Medicaid and Medicare were signed into law under Title XVIII and Title XIX of the Social Security Act. Today we celebrate the 59th anniversary of this pivotal moment in America’s healthcare journey.
Medicaid: A Critical Safety Net that Remains Strong
All states, the District of Columbia, and the U.S. territories have Medicaid programs designed to provide health insurance coverage for low-income individuals. As of March 20241, 82,751,338 people, including eligible low-income adults, children, pregnant women, older adults, and people with disabilities are covered under their state’s Medicaid program in accordance with federal requirements. The COVID-19 pandemic underscored just how important this safety net program is for American families, as it continued to deliver vital services during unprecedented times.
Beyond its traditional role, Medicaid also drives significant innovations in care for people with complex conditions and challenges. States have implemented various programs and initiatives to improve healthcare quality and outcomes. These include:
- Managed Care Expansion: Many states have expanded Medicaid managed care programs to enhance care coordination and improve health outcomes.
- Value-Based Care Models: Innovations in value-based care are being tested, aiming to link reimbursement to quality of care and patient outcomes rather than volume of services.
- Integration of Behavioral Health: Several states are integrating behavioral health services into Medicaid to address mental health and substance use disorders more effectively.
- Telehealth: The pandemic accelerated the adoption of telehealth services in Medicaid, expanding access to care and reducing barriers for patients.
Medicare: Leading in Innovation and Coverage
Medicare provides coverage to more than 60 million seniors and people with disabilities. In addition to being a lifeline for so many Americans, Medicare is a force for innovation in health policy, piloting changes to payment and care delivery through the Innovation Center and through Medicare Advantage plan design. Key innovations include:
- Alternative Payment Models: The Innovation Center has been at the center of piloting various alternative payment models to improve quality and reduce costs.
- Medicare Advantage Enhancements: Medicare Advantage plans continue to evolve, offering more comprehensive benefits that include mental health and substance use disorder services and integrating additional services such as dental, vision, and wellness programs.
- Chronic Care Management: Medicare is expanding its focus on chronic care management, providing additional resources and support for individuals with chronic conditions.
HMA’s Commitment to Medicaid and Medicare
Since HMA’s founding, our experts have helped states, plans, providers, and other stakeholders deliver the full spectrum of Medicaid and Children’s Health Insurance Program (CHIP) services. As HMA has evolved, we have built a leading-edge Medicare team that includes former agency officials, plan leaders, policy and data analysts, and actuaries. Healthcare plans, providers, and innovators call upon our colleagues to anticipate policy and regulatory change, develop and support Medicare Advantage business, transform fee-for-service programs, and support access to new technologies and treatments that can both improve quality patient outcomes and reduce costs of care.
Our growing team of includes 10 former state Medicaid directors and many more former state agency leaders, hospital and health plan executives, senior officials from the Centers for Medicare & Medicaid Services (CMS), and public health leaders.
HMA Colleagues Who Are Former Medicaid Directors Looking Ahead
HMA’s Top Medicare Experts
Looking Ahead
As Medicaid and Medicare near their seventh decade, the programs will continue to evolve and change to better support covered individuals and meet the demands of policymakers and taxpayers. HMA experts are committed in service of this important mission, and we are excited about building their future together with our clients to create more innovative, high-quality care that improves health outcomes for all.
Raising the bar: Improving health equity through actionable frameworks
This week, our In Focus section highlights an initiative, Raising the Bar: Healthcare’s Transforming Role (RTB), which is designed to strategically address inequities in the healthcare system. Leading this effort is the National Alliance to Impact the Social Determinants of Health (NASDOH), an alliance convened by Leavitt Partners, a Health Management Associates (HMA) Company, with support from the Robert Wood Johnson Foundation (RWJF).
Overview
There is significant and increasing demand across health and human services to address health inequities and eliminate disparities in service delivery and positive health outcomes. Organizations are asked to provide healthcare in holistic ways that recognize both individual and population-level needs.
Raising the Bar is a framework and a call to action for the healthcare sector to embrace all levers, resources, and opportunities available to advance equity and excellence. Raising the Bar seeks to accelerate the healthcare sector’s efforts to achieve equity and to improve the healthcare experience and well-being of individuals, families, and communities.
The Framework for Driving Action
The RTB project worked with healthcare leaders and people who have experienced inequities in the system to develop an actionable framework for the entire healthcare sector, which would embed equity and excellence throughout its work. The NASDOH convened extensive discussions with providers, hospitals, payers, and community leaders to develop foundational principles, essential roles, and concrete actions for the sector to achieve equity goals, big and small.
Raising the Bar Principles. The project generated five principles that put the priorities of individuals, families, and communities at the center of healthcare. They were informed by discussion with organizations and people who give, get, and pay for care.
Raising the Bar also identified four essential roles for individual contributors to the healthcare system and provide concrete actions they can take to transform how care is delivered.
Embedding Approaches to Address Health Inequities
Now in the next phase of this work, HMA consultants are working one-on-one with five organizations committed to embedding approaches to address health inequities by implementing the framework within their own systems of care. Participating organizations include a multi-site, multi-state Catholic health system, an academic medical center, an independent health system, one certified community behavioral health clinic, and one county public health department. The entities vary by geography, demographics, population size, and rural and urban location.
Each of the following sites is using the Raising the Bar framework and individualized coaching to meet their equity goals:
- Charles County Department of Health, White Plains, MD
Charles County is working to develop and strengthen trusting partnerships with local community organizations representing diverse populations to address health inequities in the county. - CHRISTUS Health, Texas, Arkansas, and Louisiana
CHRISTUS is developing an enterprise-wide six-year health equity road map that includes a strategy to build a community health worker sustainability. - Gaudenzia, Baltimore, MD
Gaudenzia is working to develop and implement a road map for establishing a Consumer Advisory Committee (a Substance Abuse and Mental Health Services Administration requirement for certified community behavioral health centers) that other Gaudenzia sites can use and spread nationwide. - Jefferson Health, Philadelphia, PA
Jefferson is conducting an enterprise-wide assessment and creating a governance structure for its health equity initiatives across multiple healthcare and medical education sites throughout their catchment area, which crosses state lines. - Sturdy Health, Attleboro, MA
Sturdy is creating an enterprise-wide health equity dashboard with measures that align with organizational goals and strategies and developing staff training to improve service delivery for populations who experience inequities in care.
The five entities are receiving individualized coaching from HMA health equity experts over a one-year period using the Raising the Bar framework and each organization’s self-identified goals and objectives. At the project’s completion, findings from the project will be published in the Raising the Bar implementation guidance, developed in partnership with the Health Care Transformation Taskforce.
Continue the Conversation
Raising the Bar will be featured in discussions during the HMA Fall conference in Chicago, October 7-9. In the opening plenary session on social determinants of health, Leticia Reyes-Nash and Sara Singleton will describe some of the work, and during a breakout session, speakers from some the organizations participating in this project will share their experiences.
For more information about Raising the Bar or the types of technical assistance that HMA can provide to organizations seeking to further develop equity in their practices and communities, contact our featured experts below.
Learn more at rtbhealthcare.org.
For details about HMA’s work in health equity, visit:
- Health Equity and Equity-Centered Strategic Approaches
- Rural Health and Challenges with Health Equity
Continue the Conversation
Raising the Bar will be featured in discussions at Unlocking Solutions in Medicaid, Medicare, and Marketplace, a conference powered by HMA taking place in Chicago, October 7-9.