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3 posts from April 2014


ACA and Innovation: Mary's Center's Efforts to Improve Population Health: A Conversation with Gina Pistulka (April 28th)

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The 2010 Affordable Care Act created the Center for Medicare and Medicaid Innovation at CMS with $10 billion in funding to test innovation and service delivery models to improve health care delivery and outcomes and reduce costs.   To date the CMS Innovation Center has funded one round of innovation awards throughout the US (a second round of awards are expected to be announced this summer).  In DC, Mary's Center was awarded in 2012 a three-year $15 million grant to create the "Capital Clinical Integration Network" (CCIN).  The CCIN promises to save $17 million over three years by implementing and testing an integrated clinical network to improve care for chronically ill DC residents whom typically rely on emergency room visits for health care.  To do this Mary's Center will, in part, train and hire 44 health care workers to serve as care managers and community-based care coordinators.  

During this 18 minute discussion Dr. Pistulka discusses Mary's Center's work generally, how the CCIN is organized, the clinical care and social service support work CCIN is doing via care coordinators and others and results they've been able to achieve now two years into the three year CMMI award.   

Gina Pistulka joined Mary’s Center in 2006.  During her 17 years in nursing, she has also worked as Photo (5) - Copya rural public health nurse and as an urban health nurse educator in Minnesota.  She has also done nursing work overseas in Central America.  Her research background includes having done cross-cultural intervention research.   She has also served on boards to further nurse training through Catholic University of America and via the nonprofit organization Truth About Nursing.   Gina was graduaged from Johns Hopkins with a duel Master’s in Public Health and Community Health Nursing and in 2007 received her Ph.D. in Nursing also from Johns Hopkins. 

To learn more regarding CMMI's innivation awards see: http://innovation.cms.gov/initiatives/map/index.html.



The Work Community Health Centers Have Been Doing With ACA Funding: A Conversation with Michelle Proser (April 10th)

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Since the 1960s Community Health Centers (CHCs) have been providing health care services to moreover minority populations, the poor and the uninsured.  Today there are approximately 1,200 health centers providing health care to over 20 million Americans in all fifty states.  They our the nation's true safety net.  The Affordable Care Act created the CHC Fund that provided $11 billion over five years for the expansion of health centers and services throughout the country.   

During this 20 minute discussion Michelle Proser discusses the work of the National Association of Community Health Centers, how CHCs work to reduce health care disparities, what work CHCs have been doing with ACA's $11 billion in  funding and the potential effect should CHC Fund moneys not be renewed when they expire later next year. 

Michelle Proser is the Director of Research at the National Association of Community M-Proser Hi-res0228 headshotHealth Centers where she conducts research and policy analysis on a variety of topics used to empower health centers and educate policymakers and the public.  Michelle also directs NACHCs’ efforts to build health center capacity for community-directed translational research.   Previously, Michelle served as a research analyst at the Center for Health Services Research and Policy at The George Washington University.   Michelle received her MPP from George Washington and is presently a Ph.D. candidate at GWU.



All "RUC'ed" Up or The Problems With How Physician Reimbursement is Determined: A Conversation with Kavita Patel (April 7th)

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Since 1992 use of the RBRVS (Resource Based Relative Value Scale) has been the prevailing method by which physician procedure prices are determined.  The method or formula for determining prices is managed by the AMA's RUC (or the Relative Value Update Committee).  In recent years the RUC has come under increasing criticism largely because their work perversely incents the use or overuse of higher priced medical procedures. The RUC has been a topic of Congressional hearings over the past few years and just this past week the Congress included a provision in the so called "doc fix" bill to have the DHHS Secretary begin to collect information on physician services to better determine relative values in setting physician fees.  

During this 23 minute conversation Kavita discusses how the RUC determines prices, the AMA's defense of the RUC process, what effect price skewing has on the practice of primary care and how the RBRVS might be reformed.   

Dr. Kavita Patelis a Fellow in the Economic Studies program and Managing Director for clinical transformation and delivery at the Engelberg Center for Health Care Reform at the Brookings Institution.  She is also a practicing primary care internist at Johns Hopkins Medicine.  She served previously in the Obama Administration as Director of Policy for the Office of Intergovernmental Affairs and Public Engagement in the White House.  Dr. Patel also served as Deputy Staff Director Echr238_16x9[1] for the late Senator Edward Kennedy.  She too has an extensive research and clinical background having worked as a researcher at the RAND Corporation and as a practicing physician in both California and Oregon.  She earned her medical degree from the University of Texas and her masters in public health from the UCLA.