Inside Angle

The COVID-19 pandemic has put extraordinary stress on state Medicaid budgets. Enrollment is increasing, along with direct and indirect costs, at a time of declining state revenues. What can be done to mitigate these issues? CareMore Health, an integrated health plan and care delivery system for Medicare and Medicaid patients, is moving away from fee-for-service incentives to provide comprehensive care to its high needs/high cost patients. In this episode, Dr. Theresa Brown and Dr. Vibin Roy discuss the success of the CareMore Health clinical model, where clinicians and community resources are aligned and coordinated as a team.

During this time of COVID-19, we've seen a striking increase in the use of telemedicine services. The Inside Angle podcast revisits an episode featuring telemedicine pioneer Barb Johnston, co-founder and CEO of HealthLinkNow, a network of clinicians providing mental health services to patients online. With nearly two decades of experience in implementing telemedicine programs, including the creation of the California Telemedicine Network (CTN), she brings her veteran perspective to the table in discussing the regulations, payment policies and technology needed to achieve the well-documented benefits of virtual health care.

There are thousands of wellness apps, devices, wearables and telehealth tools that can be used for chronic disease management and patient health monitoring at home. Although new technologies can lead to early identification of health concerns, they may also lead to unnecessary interventions that result in unintended complications and worse outcomes. In this episode, we reconnect with Juggy Jagannathan, PhD, AI evangelist for 3M, to consider which people are most likely to benefit from new care tools and strategies.

Immigrant communities and underserved populations experience disparities in care due to high poverty, limited access, cultural or linguistic differences, and other concerns. In this episode, Dr. Gordon Moore talks with Iliana Gilman, the former chief executive officer of El Buen Samaritano, an organization serving the Latino immigrant community in Austin, Tex. With a team dedicated to breaking down barriers to care, El Buen Samaritano is improving outcomes by tackling social determinants of health.

As a palliative care physician, Dr. Beth Wolf experienced the complexity of communication. As she helped patients and families navigate issues related to pain or end-of-life care, she saw that the way clinicians communicate with each other was rich with opportunity for misunderstanding. So, how do we help physicians accurately document a patient's true burden of illness without disrupting the delivery of efficient and compassionate care? Now, as a documentation champion at Roper St. Francis Healthcare (and an advisor to 3M), Dr. Wolf trains physicians on how to incorporate accurate and concise clinical documentation into their work with patients.

When public health initiatives account for 90 percent of improvements in population health, what is the role of the care delivery system in addressing non-medical or social factors that drive outcomes? For Nico Pronk, PhD, President of the HealthPartners Institute and Chief Science Officer at HealthPartners, it means finding the right balance between caring for the urgent needs of a community and enhancing the vital conditions of a community, such as affordable housing, healthy food accessibility, and early childhood education. Based on the success of HealthPartners' Power Up 4 Kids program and other intiatives, Dr. Pronk discusses an approach that pays careful attention to the needs of a community and engages local stakeholders to improve the chances of good outcomes.

As the largest health insurance program in the country, providing the majority of mental health care and long-term services and support, Medicaid is an indispensable component of the U.S. healthcare system. Matt Salo, Executive Director of the National Association of Medicaid Directors, works with state Medicaid agencies around the nation to improve quality, cost and the experience of care for patient populations that are most vulnerable. Our host, Dr. Gordon Moore sat down with Matt Salo to discuss the state of Medicaid in 2020 and beyond.