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3 posts from August 2021


Matt Salo Discusses Potential Medicaid Program Reforms Under Proposed Reconciliation Legislation (August 11th)

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This past Tuesday Senate Democrats passed a $3.5 trillion budget resolution what would allow Congressional Democrats to fund significant health care reforms along with education, immigration, climate crisis and other termed “care economy” policies.  Among other healthcare policies Congressional Democrats are working to fund are expansions to Medicare coverage, boost by $400 billion Medicaid Home and Community Based Service (HCBS ) waiver funding and address health equity issues.  Dedicated listeners may recall I interviewed Matt in March 2017.  

During this 40 minute interview, Matt Salo discusses, in sum, the merits of Medicaid reform policies Democrats have already outlined beginning with improvements in long term care, again, expanding HCBS waiver funding.  He discusses several related Medicaid reform policies NAMD has already identified, discusses Medicaid-related social determinants funding, the merits of expanding value based purchasing arrangements in the Medicaid program and issues concerning Medicaid access and provider participation in the Medicaid program.  

Mr. Matt Salo has served as Executive Director of the National Association of Medicaid Directors (NAMD) for the past Salo-headshot-1-150x150 decade.  NAMD represents all 56 of the nation’s state and territorial Medicaid Directors, and provides them with a strong unified voice in national discussions as well as a locus for technical assistance and best practices.  Mr. Salo formerly worked for 12 years at the National Governors Association where he forwarded the Governors’ health care and human services reform agendas.  He worked previously for five years as a health policy analyst for state Medicaid Directors at the American Public Human Services Association.  He also spent two years as a substitute teacher in the public school system in Alexandria, VA.  Mr. Salo holds a BA in Eastern Religious Studies from the University of Virginia.

Information on NAMD is at: https://medicaiddirectors.org/about/.


TFAH's Adam Lustig Discusses Social Determinants of Health Policy Opportunities (August 9th)

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As listeners are likely aware the Biden administration has given priority to addressing health equity, meaning distributing health-related resources based on recipients’ needs.   This is not surprising since, in part, research published in JAMA in June 2019 by Zimmerman and Anderson concluded, "there has been a clear lack of progress in health equity during the past 25 years in the US."  (Think: the failure of neoliberalism.)  When discussing health equity, the issue of social determinants of  health (SDOH) are immediately begged since one’s social or lived environment is substantially more responsible than medical care in explaining one's health status and because the poor and/or minority population’s social and economic circumstances are comparatively far worse.  This explains why, as Trust for America's Health (TFAH) recent report titled, "Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity," notes, race and ethnicity-based health disparities total over $90b annually in excess medical costs.  Listeners of this podcast are aware I’ve discussed the social determinants of health on several occasions over the past nine years.  For example, this past March I discussed the topic with UCSF’s Drs. Braveman and Gottlieb.  

During this 32 minute interview Mr. Lustig moreover discusses several of the policies outlined in TFAH's "Leveraging Evidenced-Based Policies" under five categories identified in the report:  access to high-quality health services; economic mobility; access to affordable housing; improving learning environments; and, health-promoting taxes.   

Mr. Adam Lustig is Senior Policy Development Manager at TFAH. H is responsibilities include leading TFAH’s Promoting Health and Cost Control in States (PHACCS) project.  The Download PHACCS project seeks to promote the adoption and implementation of effective, evidence-based state public health policies outside the healthcare sector that will have a positive impact on residents’ well-being.  Prior to joining TFAH, Mr. Lustig was the Senior Manager of Health Systems Transformation at the National Network of Public Health Institutes, where he developed strategies related to improving healthcare systems, alternative payment models, and supporting people-centered health systems.  Mr. Lustig has also held positions at the Advisory Board Company, the National Pharmaceutical Council and the University of Pennsylvania.  He received his MS in Health Policy from the Thomas Jefferson University College of Population Health and a BA in Public Policy from the State University of New York at Albany.

TFAH's report is at: https://www.tfah.org/report-details/leveraging-evidence-based-policies/.

Regarding economic mobility, listeners are encouraged to read the recent July 22 NEJM Perspective essay by Lucy Marcil, et al., titled, "Medical-Financial Partnerships - Beyond Traditional Boundaries."


IPCC Report's Sixth Climate Assessment Report Published Today (August 9th)

Listeners of this podcast are well aware I've spent considerable time discussing the climate crisis, i.e., have posted over 20 climate crisis-related podcast interviews.  Therefore, it is important to note the United Nation's Intergovernmental Panel on Climate Change's (IPCC's) sixth climate assessment report was published today. 

Needless to say the report's findings are dire.  For example, about the report the UN Secretary General, Antonio Guterres, stated the report "is a code red for humanity," "the alarm bells are deafening . . . the evidence is irrefutable . . . greenhouse gas emissions . . . are choking our planet and putting billions of people at immediate risk."  

All report info is at: https://www.ipcc.ch/report/ar6/wg1/#SPM.   Please note this page identifies a 42-page "summary for policymakers."   I also recommend reading today's coverage in The Guardian.