Transcript New HCR Slides

Elena Rios, MD, MSPH
National Hispanic Medical Association
May 24, 2011
Access to Affordable Health Care
• The Pre-Existing Condition Insurance Plan provides
coverage to Americans who have been uninsured
because of a pre-existing condition.
• The Early Retiree Reinsurance Program makes it easier
for businesses to provide coverage to retirees who are
not eligible for Medicare.
• Distribution of important information that will help
small businesses claim the law’s small business tax
credit (>25 employees, 50% of ave. salaries <$50K)
• COMING: State Health Insurance Exchanges
Constitutionality May 10, 2011
• In the first case – Liberty University v. Geithner – a
district judge previously found that the law was
constitutional. In the second case – Commonwealth of
Virginia v. Kathleen Sebelius – a different district judge
issued a very narrow ruling on the constitutionality of
the health reform law’s “individual responsibility”
provision but upheld the rest of the law. Both cases
were argued on appeal. (US Court of Appeals, 4th
Circuit) – 45 days till decision.
Community Transformation Grants
 tobacco-free living;
 active living and healthy eating;
 evidence-based quality clinical and other preventive
services, HTN and high cholesterol;
 social and emotional wellness, especially for people
with chronic conditions; and
 healthy and safe physical environments.
 $100M for 75 grants - announced May 13th
Community Transformation Grants
 adolescent health;
 injury and violence
 arthritis and osteoporosis;
 cancer;
 diabetes;
 disabilities and secondary
conditions;
 educational and
community-based services;
environmental health;
 HIV;
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prevention;
maternal, infant, and child
health;
mental health and mental
disorders;
health of older adults; oral
health; and
sexually transmitted
diseases.
National Quality Strategy
 To focus on quality outcomes rather than services ordered.
 Better Care: Improve the overall quality, by making health
care more patient-centered, reliable, accessible, and safe.
 Healthy People/Healthy Communities: Improve the health
of the U.S. population by supporting proven interventions
to address behavioral, social and, environmental
determinants of health in addition to delivering higherquality care.
 Affordable Care: Reduce the cost of quality health care for
individuals, families, employers, and government.
National Quality Priorities
 Making care safer by reducing harm caused in the delivery of care.
 Ensuring that each person and family are engaged as partners in their
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care.
Promoting effective communication and coordination of care.
Promoting the most effective prevention and treatment practices for
the leading causes of mortality, starting with cardiovascular disease.
Working with communities to promote wide use of best practices to
enable healthy living.
Making quality care more affordable for individuals, families,
employers, and governments by developing and spreading new health
care delivery models.
Public Comment requested. NHMA working thru NQF.
Partnership for Patients
 Brings together hospitals, doctors, nurses,
pharmacists, employers, unions, and State and Federal
government to keep patients from getting injured or
sicker in the health care system and to improve
transitions between care settings.
 $1 billion investment planned.
 500 hospital partners have signed-up.
Partnership for Patients
• Hospital Acquired Conditions and Patient Safety in
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Hospitals
Care Transitions
Adverse Drug Events (ADE)
Catheter-Associated Urinary Tract Infections (CAUTI)
Injuries from Falls and Immobility
Obstetrical Adverse Events
Pressure Ulcers
Surgical Site Infections (SSI)
Ventilator-Associated Pneumonia (VAP)
Venous Thromboembolism (VTE)
Allignment Initiative
• An effort to more effectively integrate benefits under
Medicare and Medicaid for 9M dual eligibles
• Federal Coordinated Health Care Office – at CMS to
coordinate care, decrease costs
• Public comment for ideas on care coordination, feefor-service benefits, prescription drugs, cost sharing,
enrollment, and appeals – July 11th
Medicare ACO
 ACO = Providers who will collaborate to increase
quality and decrease costs.
 Pioneer ACO – advanced organizations ready to
participate in Medicare shared savings, private payers
– RFA this week
 Advance Payment ACO Model – public comment
requested till June 17
 Learning Sessions for provider groups
Value Based Purchasing
 In 2013, for the first time, the Hospital Value-Based
Purchasing program authorized by the Affordable Care
Act will pay hospitals’ inpatient acute care services
based partially on care quality, not just the quantity of
the services they provide.
CMS Innovation Center
• $500 million to test models of safer care delivery and
promote implementation of best practices in patient
safety.
• $500 million for a Community-based Care Transition
Program to support hospitals and community based
organizations in helping Medicare beneficiaries at
high risk for readmission to the hospital safely
transition from the hospital to other care settings.
New Minority Health Activities
• 2010: OMH, NIMHD, Offices – all agencies planned.
• 2011: strategic and cross‐cutting planning to drive
targeted and collaborative efforts; improving
integration of disparity elimination efforts across
agencies; expanding partnerships within HHS and
with external partners; increased information sharing
with community groups; improving data collection;
and promoting evidence‐based health equity policies.
• HHS Strategic Action Plan to Reduce Racial and
Ethnic Disparities in Health
– immunizations, tobacco, lupus
OMH National Partnership for
Action
 National Partnership for Action to End Health
Disparities mission is to increase the effectiveness of
programs that target the elimination of health
disparities through the coordination of partners.
 Three components: (1) National Stakeholder Strategy;
(2) Blueprints for Action; and (3) collaborative
initiatives and campaigns.
 Leadership ----Cultural Competence ----Hispanic
Health and Health Equity
NPA Goals
 Awareness of health disparities
 Leadership to address health disparities at all levels
 Health System and Experience
 Cultural Competence & Diversity of Workforce
 Data, Research and Evaluation
 Federal Interagency Team - NEW
Workforce
 Workforce Commission – Kathy Flores, MD, NHMA
Chairwoman of the Board appointed
 CDC lead agency for public health pipeline for
minority undergraduate students
 HRSA – integrative training, primary care
 NHMA working with CDC and HRSA to increase
public health leaders of the future: see information on
registration tables for CDC programs.
 NHMA Leadership Fellowship, NHMA Resident
Leadership Program supported by HRSA.
HHS Promotores de Salud Initiative
 Announced May 18th, 2011
 to recognize the work of promotores
 develop a database of promotores networks, including
training and where they work
 to foster cooperation among various networks
 English-Spanish web site with information and
resources to assist community workers
 State Health Exchanges to include community health
workers
E-health Technology
 Need for physicians, clinics, hospitals to be connected
for better data collection, coordinated care,
information for patients and physicians
 RECs will provide training and support services to
assist doctors and other providers in adopting EHRs
 Provider incentive program now in place.
 Health Information Technology Extension Program,
please email [email protected].
Contact NHMA & NHHF
 www.nhmamd.org
 www.nhmafoundation.org
 www.hispanichealth.info
 National Hispanic Health Foundation
Scholarship Dinners:
 Nov. 10th, 2011 – Santa Monica, CA
 Dec. 4th - NYC