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3 posts from November 2014

11/23/2014

Housing IS Healthcare: A Conversation with Rebecca Morley (November 24th)

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Beyond the problem of an estimated 600,000 Americans being homeless each night (and 1.5 million in any given year), homelessness or unstable housing is strongly correlated with high rates of chronic illness, unmet healthcare needs and mortality. Inadequate housing impedes access to health care and  an ability to stay healthy such as caring for injuries or disease and taking medications. For the chronically homeless mortality is four to nine times higher than for the general population.   Though current federal Medicaid rules do not allow states to provide supportive housing, it appears the health care industry is nevertheless beginning to close the gap between health care and housing by recognizing and addressing the fact it is a key social determinate of health.

During this 20 minute interview Ms. Morely discusses the work of the National Center for Healthy Housing, the magnitude of the housing "famine," how housing serves as a health care "vaccine," why health care providers have been slow to recognize its importance as a key social determinate of health and opportunities to better intergrate supportive housing and health care.     

Rebecca Morley is the Executive Director of the National Center for Healthy Housing (NCHH), Rebecca photoa national non-profit dedicated to creating healthy and safe housing for children. Among other
things Rebecca spearheaded NCHH's recovery work in the Gulf Coast after hurricanes Katrina and Rita and she led the development of the National Health Homes Training Center. She is the author of numerous publications including the new book, "Healthy & Safe Homes: Research, Practice and Policy." Before joining NCHH, Ms. Morley worked with ICF Consulting on affordable housing and related issues, at HUD as a Presidential Management Fellow and as a Legislative Fellow for Senator Jack Reed.  She serves on numerous boards and commissions including Health Housing Solutions. Ms. Morley was graduated from Nazareth College (in Rochester, NY) with an undergraduate degree in environmental science and from the Georgia Institute of Technology with a master's in public policy.   

For more on the National Center for Healthy Housing go to: http://www.nchh.org/

11/13/2014

Navigating Healthcare via "The Health Care Handbook:" A Conversation with Co-Author Nathan Moore (November 19th)

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Despite signifcant press coverage over the past four and a half years many provisions of the Affordable Care Act remain largely unknown to the American public.  Polling data shows slightly less than half of Americans know the ACA is still law, over half said they've heard nothing about the state marketplaces and over a third do not know there's a penalty for not having health insurance.  More generally, researchers have found Americans have a low health insurance literacy rate.  Less than half of those polled were unable to describe an insurance deductable.   None of this is surprising when you realize how complicated health care financing and delivery is.  For example, the recently published final rule that describes changes to how Medicare will pay physicians in 2015 was well over 1,000 pages.  

During this 20 minute interview Dr. Moore discusses the reasons he and Dr. Askin wrote the book, some of their findings, what he was surprised to learn and how health care is delievered in the US, how research and writing the volume changed his practice, reaction to, and use of, the work and changes in the soon-to-be-released second edition.       

Nathan Moore is an resident physician in internal medicine at Barnes-Jewish Hospital in St. Nathan Moore 2Louis. When he and his colleague Elisabeth Askin were in medical school at Washington University, they wrote The Health Care Handbook, A Clear and Concise Guide to the United States Health Care System. To date, approximately 60 medical schools and hospital residency programs have incorporated this handbook into their core curriculum.  Dr. Moore has been a featured speaker at dozens of medical schools, universities and health professions conferences and is currently working on the 2nd edition of the Handbook.  The 2nd edition is anticipated to be released this month. 

To learn more about "The Health Care Handbook" go to: http://healthcarehandbook.wustl.edu/
 

11/04/2014

Factoring in Bio-Psycho-Social Factors to Improve Patient Care Outcomes: A Conversation with Gretchen Alkema (November 4th)

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While it appears obvious a person's health status is directly related to their life circumstances the health care industry has been slow to recognize an individual's bio-psycho-social factors or characteristics in planning and delivering an individual's care.  This critcism is typically phrased as clinicians being over attentive to the "patient" and under attentive to the "person".  For various reasons having in part to do with utilization/cost, reimbursement and population health concerns this is changing.  That is the health care industry is developing a greater appreciation and more sophisticated understanding of the non medical predictors of health care risk.  

During this 21 minute interview Dr. Alkema discusses why the health care industry has been slow to adopt socioeconomic factors in care planning and delivery, non-medical factors that correlate with higher care utilization, how these factors or characteristics can be used for predictive purposes and related related issues.  

Dr. Gretchen Alkema currently serves as Vice President of Policy and Communications for The Gretchen Headshot resized[1]SCAN Foundation.  Prior to joining SCAN Dr. Alkema was the 2008-09 John Heinz Health and Aging Policy Fellow serving in the office of Sen. Blanche Lincoln.  Dr. Alkema earned her PhD at the University of Southern California’s Davis School of Gerontology and and completed her post-doctoral training at the VA Greater Los Angeles Health Services Research and Development Center of Excellence.  Her academic research focused on evaluating innovative models of chronic care management and translating effective models into practice.  She is a Licensed Clinical Social Worker and has practiced in government and non-profit settings including community mental health, care management, adult day health care, residential care and post-acute rehabilitation.

Listeners will recall in August 2013 Dr. Alkema discussed the relationship between Medicare utilization and cost and beneficiary (declining) functional status.  

For more on predictive analytics related to high-risk Medicare beneficiaries see: http://www.thescanfoundation.org/sites/thescanfoundation.org/files/identifying_high_cost_benefits_fact_sheet_1_1.pdf