CMMI and Population Health Science: Evidence for
Action on Determinants of Health
June, 25th - June 28th, 2016
The June 27, 2016 session was held as a breakfast meeting at the 2016 AcademyHealth Research Meeting held in Boston. Jo Boufford served as moderator. The lead presentation was by Dawn Alley, Deputy Director of the Center for Medicare and Medicaid Innovation (CMMI) for Prevention and Population Health. She discussed the recent CMMI Call for Applications for the “Accountable Care Communities” program which proposes to extend Medicaid coverage to a variety of personal social services integrated with health services for case management of the most complex patients. Also, she discussed the issue of the “level of evidence” needed by CMMI to include funding for broader determinants of population health, and the challenges the agency faces.
The three responders Sarah Gollust, Associate Professor at University of Minnesota, Brendan Saloner, Assistant Professor at Johns Hopkins, and José Pagán, Director of the Center for Health Innovation at The New York Academy of Medicine each discussed a different areas of the ACA driven health care reform that, in their view, provided important additional considerations for future CMMI initiatives. Sarah Gollust discussed the importance of the messaging from CMMI on its consideration of social determinants of health for financial support. Though the population health described may not be the broader, place based population health that population health scientists are exploring, it opens the door to health care audiences and the public to greater awareness of the importance of these determinants to achieving the Triple Aim. Brendan Saloner discussed his work on substance abuse and harm reduction and the well-integrated care models that already exist in these programs that could be mainstreamed in primary and secondary care for this extremely vulnerable and costly population, if the stigma and separateness of drug related pathology was lessened. Finally, José Pagán discussed the importance of research that links the impact of broader determinants (poverty, education levels, race and ethnicity for ex.) not only on the health of certain populations, but also on the costs and quality of health care –the major concern of most health policymakers right now--by modelling methods that take these factors into account. (PowerPoints Available Below). A lively discussion followed with the audience, and all agreed that while health care financing cannot cover models that address the full range of population based determinants of health, the system can and must go farther that the current individual care management models, and all were encouraged to provide evidence to that end.
|Dawn Alley (Bio) CMS Innovation Center and Delivery System Reform: the Accountable Health Communities model|
|Sarah Gollust (Bio) Impact of the Accountable Health Communities Model on the Public Agenda|
|Brendan Saloner (Bio) Paying for the social needs of individuals with substance use disorders: How can we build the evidence base?|
|José Pagán (Bio) Building and Aligning Evidence for Action on Social Determinants of Health|