Aneesh Chopra

"Last year, #Maryland established the Maryland Commission on Public Health to recommend improvements for delivering public health services, including how to reform how it uses technology and shares data." Without steady funding, public health agencies slow to upgrade old tech, report shows via StateScoop https://lnkd.in/eCJ5pZUY

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A recent report has unsurprising findings about the challenges in accessing and assessing Medicaid HCBS, and includes a necessary call for improving how Medicaid HCBS is delivered! "A maze of federal legal authorities has resulted in inconsistent and inequitable access to [long-term] care among [Medicaid] beneficiaries and across geographies. The many programs are difficult to understand, even for researchers and regulators trying to measure outcomes." #Medicaid #longtermcare #caregiving #HCBS

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MACPAC met last week and released new data showing HUGE increases in Medicaid state-directed payments. Make no mistake--it's SDPs for hospitals, funded w/provider taxes and IGTs, driving this growth. MACPAC noted that the link to better HOSPITAL access is tenuous at best for these payments. We'll have a new Congress and Administration in January, and this spending category is surely going to be a target--even if Florida and Texas hospitals are among the biggest beneficiaries of this spending. We've been here before (yeah, I'm old enough to remember). Those of us who care about #Medicaid need to call for hard caps on these payments, more accountability from those who receive them, and shifting them out of expensive hospital systems and into community-based care. And provider taxes must be reformed, too, so that they are more re-distributive and fund a range of high-value services. Rebecca Pifer MACPAC - Medicaid and CHIP Payment and Access Commission #Medicaid

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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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Epic Systems’ recent move to back the TEFCA medical records exchange is interesting. On the surface, it’s all about creating a seamless flow of patient data across hospitals, QHINs, and all relevant stakeholders. But let’s be real—data is the oil of the new economy, and interoperability is the pipeline that delivers this precious resource to all the right stakeholders. By aligning with TEFCA, Epic might just be positioning itself as the refinery. All in all, this is a welcoming move by Epic Systems—especially if it really is as straightforward as they make it sound. But given the lack of details, one has to wonder if there are any hidden catches. After all, when it comes to something as valuable as healthcare data, it’s wise to look out for the fine print. Let’s hope this is genuinely about improving patient care. https://lnkd.in/gDdDCcmj

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More evidence that #Medicaid state-directed payments (SDPs) to hospitals are out-of-control (see Table 1) and fueled by hospital provider taxes (see Figure 14). It's even worse than it appears because some states, like North Carolina (not included in table below), are adding new taxes to pull down additional SDPs for behavioral health facilities. This isn't just bad for the federal budget and for all the other health care needs that are shortchanged (like community mental health), but as behavioral health facilities raise their commercial prices, more families--at a time of terrible distress-- will incur medical debt. There are so many other unintended consequences like over-hospitalization likely to occur from this policy. In Delaware, they've enacted a hospital provider tax for the first time (not shown below) to draw down SDPs. Delaware only has 6-8 acute care hospitals (including 1 children's hospital) and 3-4 systems, depending on how you count them. One large system with 1,000+ beds by itself can drive the average commercial rate higher by raising its prices, thereby effectively setting its own Medicaid rates. All this federal Medicaid funding is going to pad hospital margins while in most states home care aides are making $10-$15/per hour and nursing facilities say they can't afford better staffing ratios. States can and some do use state-directed payments to increases long-term care wages, but hospitals resist using "their" provider tax revenue to fund non-hospital SDPs. LTC doesn't have the capacity to leverage provider taxes the way hospitals can and has to rely on state general fund dollars to finance services. Massachusetts and New York (see report) want to add provider taxes on health plans. This could cascade provider taxes on top of each other, further compounding the impact on the federal budget and the commercial market, including ACA marketplaces, undermining affordability for ACA consumers and working families. It's not going to be fun or easy to halt this enormous inequitable shift in health care resources, but halt it we must. KFF Shawn Gremminger Claire Brockbank Joshua Gordon https://lnkd.in/eDteMcJT

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Interesting perspective on #TechnologicalDebt in health care by Dave Lamar focused on the provider market, but we seem the same issues within state depts and payers. While good data governance practices are key, there must be a better way to solve this common - if not universal - challenge in health care, if only by offloading some of the administrative responsibilities that require the individual management and administration of no-value-add administrative functions. #healthdata

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NCPDP Foundation is presenting an excellent opportunity for innovative pharmacists in the following: 1. **Precision Medicine and/or Pharmacogenomics**: Pharmacists play a critical role in precision medicine by utilizing pharmacogenomic data to tailor medication therapies based on individual genetic profiles, optimizing treatment efficacy and minimizing adverse effects. 2. **Digital Therapeutics**: By integrating digital therapeutics into patient care, pharmacists can monitor adherence, provide education, and support patients in managing chronic conditions through technology-based interventions. 3. **Social Determinants of Health**: Pharmacists can address social determinants of health by assessing patients' socioeconomic factors, such as access to medications and healthcare services, to develop personalized care plans that improve health outcomes. 4. **Health Equity**: Pharmacists advocate for health equity by ensuring that all patients, regardless of their background, have access to medications and healthcare services, and by participating in community outreach programs to address health disparities. 5. **HL7 Accelerator Alignment**: Pharmacists can contribute to HL7 accelerator initiatives by collaborating on the development and implementation of health information standards that enhance communication and interoperability among healthcare providers. 6. **Industry Interoperability**: In promoting industry interoperability, pharmacists can help ensure that electronic health records (EHRs) and pharmacy management systems seamlessly share patient information, improving care coordination and medication management. 7. **Pharmacist Supported Clinical Services**: Pharmacists can enhance clinical services by providing medication therapy management, chronic disease management, and preventive care services, leveraging their expertise to improve patient outcomes and reduce healthcare costs. Thanks for sharing this Robert P. Nickell

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Check out this new Mathematica blog on improving postpartum care in Medicaid and CHIP. Very timely and actionable. #Medicaid, #CHIP, #maternalhealth, #Mathematica

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How are you using #AI in health communication?

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In my experience in healthcare, urgency can compromise quality of care. Let me explain. Healthcare providers who offer services in areas that are unstocked, understaffed, or remote, often face difficulties getting the resources they need to respond to urgent situations. They provide the best care possible, but the supplies they need are not always easily available. This is where medical logistics comes in. This article from Modern Healthcare states that supply chain spending accounts for 40% of healthcare costs. Despite these high costs, in a recent survey, 60% of healthcare workers reported a shortage of single use supplies, durable medical equipment, or at least one of twenty drugs in the six months prior to the survey. The approach towards this problem is increasingly a more strategic one, with 67% of C-suite executives reporting to a 2022 survey by McKinsey that "they now view the supply chain function as more strategic and less transactional." Recent medical logistics trends include e-commerce and partnering with pre-existing distribution networks to increase reach and speed. What do these trends mean for the future? In short, they are promising. Effective medical logistics management is essential for providing healthcare workers the resources they need. Whether hospitals are investing in these trends or others, taking a strategic approach towards medical logistics is important. Without it, the patient populations who suffer disproportionally include those with systemic barriers to care or those in geographic isolation. Key questions: 1. How can we be a part of driving trends for medical logistics? 2. What trends do you believe need to be driven in this area? #healthcare #MedicalLogistics #HealthcareSupplyChain

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Do you have a plan? Environmental Public Health is uniquely able to provide the first and best proof of value for AI use in public health. The permits, inspections, and related documents are public records, making them great training data for an LLM. Add in all the regulations, research, and training materials every local EH operation has and the ability to keep the public informed is unparalleled in any other field of public health. If we work with the industry, like adding IOT devices to see real time temperatures and hand washing practices, the AI systems could be a food manager alert system between inspections and support a food safety culture. Alternately, building a machine learning tool with image recognition could make onsite sewage system inspections faster and more reliable. This is just scratching the surface. make a plan to participate as this technology evolves. It will be ubiquitous within this decade.

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"Despite the stakes, physicians vote at rates nearly 20% lower than the general population, which is concerning given our unique role in influencing health policy." Grateful to Forbes for highlighting the importance of civic health on the precipice of this critical election night. What I'm most proud of is the impact our team at Vot-ER made in the 2024 election cycle so far. With time still left on the clock, our team has helped over 168,000 clinicians, patients, and their families make their voices heard through voter registration, mail-in ballots, and other readiness actions. But its more than the impact in numbers. Amid declining trust and disillusionment, one thing remains clear: healthcare professionals have the opportunity to embrace their role not only as healers but as champions of civic engagement. We don't merely treat symptoms; we combat the roots of inequity when we help our patients vote. And Vot-ER is doing its small part helping to change the culture of medicine so it can embrace this opportunity. This is the heart of creating A Healthier Democracy. Read more: https://lnkd.in/gK5jXdN8

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I'm excited to join the Board and be associated with Health Bank One. I've been wondering what to do next, and this feels really good for patients, clinicians, and researchers. Health Bank One integrates disparate medical records into a single app, controlled by us-- patients and our families-- then summarizes those records with AI into patient-understandable and actionable terms. It does all the technical and administrative work for patients. All you have to do is signup and tell it where your records are. For me, my records were spread over six different healthcare systems in Salt Lake City, Chicago, and Asheville. My current primary care doc loves it, too, because now he sees my complete health history in one place. The founder, Bo Holland, is not your stereotype opportunistic tech founder, looking for a big money exit in healthcare. He's a hands-on technology product leader, a successful veteran entrepreneur, with my kind of values. His son, Ford, was diagnosed with a rare brain tumor in 2013. The family was tossed into the mess of navigating Ford's medical records, which planted the seed for doing something about it. My dear friend, teammate, and colleague, Timothy R. Zoph, is also on the Board and introduced me to Bo, about two years ago. It's inevitable that patients possess and control a complete view of our clinical records. Now is the time for this solution in the market, given the laws which require healthcare systems to share your medical records; the adoption of FHIR technology; and the emergence of AI. Keeping fingers crossed that we can make a difference...! https://lnkd.in/gcxVcXzE

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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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National Association of Medicaid Directors #13November2023 #IssueBrief : #Why #did #they #do #it #that #way? "Check out NAMD’s latest issue brief to learn more about #Medicaid #eligibility #policy."

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"It Is Time to Consider More Price Regulation in Health Care." My favorite excerpt below: Research on hospital productivity in Medicare finds that hospitals often misallocate their resources, and the hospitals that spend less may have outcomes that are as good as the hospitals that spend more. In the commercial market, hospitals paid higher prices do have better mortality outcomes, but that is only true in less concentrated markets. In markets with little competition, hospital prices are high but quality is lower than in competitive markets. Amitabh Chandra Sherry Glied JAMA and The JAMA Network #hospitalconsolidation https://lnkd.in/eZ2mqGje

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More evidence that it pays for #hospitals to merge and dominate local markets. To be clear, they are not merging to succeed at "value-based care"; they are merging to succeed at extracting more--significantly more--value from us.

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