Ki Siadatan’s Post

Medicaid covers nearly one-fifth of our population—yet it has long been overshadowed when it comes to healthcare innovation. That’s changing fast. By giving states greater flexibility and focusing on social factors that shape health, Medicaid is becoming a trailblazer for more holistic, technology-driven models of care. Here’s how diapers, data, and digital tools are redefining what it means to deliver value. https://lnkd.in/edTsdSEC

Better integration between Medicare and Medicaid supports better outcomes for dually eligible individuals. Hear more on how ACAP D-SNPs are improving health: https://bit.ly/3Reixci    #Medicare #Medicaid #DualEligible 

Research in JAMA Health Forum underscores the benefits of better integration between Medicare and Medicaid for people who are dually eligible.     People whose Medicare and Medicaid plans were more highly integrated reported higher levels of satisfaction with their health plans, were more likely to report being treated respectfully by customer service, were more likely to know how to obtain information related to their health and healthcare, and reported less out-of-pocket spending.    These findings add to the growing body of knowledge on improving health for dually eligible individuals and are yet another reason I am proud to be working with the Association for Community Affiliated Plans (ACAP) and Medicare-Medicaid Integration Alliance to advance policy solutions.    More on the research findings in McKnight's Home Care: https://bit.ly/3zmVyG7     #Medicare #Medicaid #DualEligible  

The future of U.S. health care is evolving. With a record-low uninsured rate and Medicaid expansion across many states, progress is evident. But what's next?   Bill Pierce and Matt Eyles explore the potential for value-based care to transform the system. From reshaping how care is delivered and paid for to who will lead the next wave of reform, they highlight and discuss critical questions and opportunities.   Read the the full article here: https://lnkd.in/eT87Qwaz   #healthcare #healthreform #uncommonground

This is my first write-up based on one of my panels at VALUE 2024. Two quick takeaways... First, spoken word is a very effective medium of communicating a volume and depth of information that is difficult to replicate and/or match in a written format. Really folks, you have to be here to get the maximum value (pun not intended, but hopefully welcomed) from the insights that #behavioralhealth leaders share with us. Second, there is much more optimism for reimbursement innovation and steps toward value-based care in #Medicaid than in commercial health plans. Still, myths and misconceptions persist. #addictiontreatment #mentalhealth #managedcare #healthinsurance https://lnkd.in/e3jYPmA6

Another day, another juicy health policy tid bit. 🥤 The headlines in the National Health Expenditures report are about drug pricing and Medicaid redeterminations, but this caught my 👀. "During 2025–26, Medicaid spending is projected to grow 5.7 percent, on average, with average Medicaid enrollment growth near zero (−0.2 percent) (exhibit 2). Among services and goods, average spending growth is strongest for other health, residential, and personal care because of states’ continued expansions and use of home and community-based services." These Medicaid services are critical for supporting independent living and aging in place, and it's KEY that where possible, there's connectivity between the HCBS and the rest of the continuum of medical services. Integrated Medicare-Medicaid models aim to do that, and well-designed, they can create a more balanced value proposition between the federal gov't and the states! https://lnkd.in/ddzc88-T?

Just saying...Over the past four years, value-based care (VBC) has been the driving force behind our Community Health Center’s transformation. We've made big improvements in: 📊 Data infrastructure ⚙️ Operational efficiencies 🤝 Care coordination 🏥 Population health management By reinvesting VBC savings into critical infrastructure, we've enhanced our ability to serve our community more effectively. But now, we’re facing a new challenge. As more patients transition from Medicaid to ACA marketplace plans, we face a widening gap in payment models. While Medicaid contracts include value-based care options, ACA plans remain fee-for-service. This shift complicates our ability to optimize care delivery and infrastructure investment. On top of that, ACA plans are often paying higher rates to hospitals and emergency departments, incentivizing more expensive care over primary care. This disparity makes it harder to consistently deliver the high-quality care our patients deserve, no matter their insurance. 💬 Really? I've seen this before, and it always ends the same way. We need to keep forcing others in the system to adapt, but we keep reinforcing bad habits! Healthcare delivery is a cost play, not a revenue play. 💬 Considering that a large portion of healthcare is federally funded, shouldn't we aim for consistency in how we incentivize and pay for care across programs? To policymakers: Help us help your economic peers by supporting #VBC across all insurance plans. Consistent payment models will empower health centers like ours to continue providing the most efficient, high-quality care to the communities that need it most. #HelpUsHelpYou 📢 #VBC #PrimaryCare #ValueBasedCare #HealthcareInnovation #HealthcareReform #HealthPolicy #CommunityHealth #CHC's #NACHC https://lnkd.in/eD22msyJ

Sentara Healthcare's recent decision to cut 200 positions as a case study. As states review Medicaid eligibility, many individuals are losing coverage, leading to financial strain on healthcare providers. Hospitals are facing challenges as they provide care for uninsured patients and struggle with reduced Medicaid reimbursements. This situation highlights the unfair burden placed on hospitals and health systems, which are essential for community health but are now coping with increased financial pressure and workforce reductions. In today's challenging healthcare environment, Medicaid redeterminations are creating additional strain on hospitals and health systems. Many individuals are losing coverage, directly affecting financial stability and leading to difficult decisions, such as Sentara Healthcare's reduction of 200 positions. This adjustment places an unfair burden on essential healthcare providers who are pivotal to community health. As they navigate reduced reimbursements and rising uninsured care costs, it's imperative to address these systemic challenges to ensure the sustainability and effectiveness of our healthcare institutions. #HealthcareFinance #Medicaid #HospitalChallenges #HealthcareSustainability #CommunityHealth https://lnkd.in/e2t7bhRv

📈 "Value-based care models have already seen a 25% increase in health care provider participation from 2023 to 2024, based on data from the Centers for Medicare & Medicaid Services. However, these models can be challenging for health care practices, and success (i.e., operating at a profit while providing quality care to patients) requires an understanding of the reimbursement model, significant investment in infrastructure and expertise, and possible changes in the way medicine is practiced." I'm proud to be at Stellar Health, where we simplify, enable, and reward the delivery of value-based care to all Americans, making it not just easier but even enjoyable for care teams. 👇 Comment below or DM me to learn more about how we partner with health plans and systems. I'll send you a recent KLAS Research study titled: "Improving Patient Outcomes and Coding Accuracy by Incentivizing Non-Provider Staff." #valuebasedcare #vbc #stellarhealth #qualityimprovement #healthcare #healthcaretechnology #healthplan #primarycare #medicare #medicaid #populationhealth

In their new Forefront article, Leighton Ku and Sara Rosenbaum from The George Washington University discuss how, in its February 2024 cost estimate for the Bipartisan Primary Care and Health Workforce Act, the Congressional Budget Office for the first time drew on a body of research that has consistently demonstrated that high-quality primary and preventive care delivered by community health centers lowers Medicaid spending and Medicare costs for high-cost care. "The CBO estimates that the bill’s increase in mandatory community health center funding generates $20.4 billion in higher federal outlays over a 10-year period. It estimates that improvements in primary and preventive care facilitated by increased health center funding would lower federal spending on Medicare and Medicaid by $11.4 billion by reducing costs for emergency, inpatient, and other care (this does not include additional state savings), when compared to costs without enhanced health center funding. Enrollment assistance provided by health centers would increase estimated federal costs by $8 billion. Thus, $11.4 billion in savings minus $8 billion in higher costs leads to $3.4 billion in net federal savings over 10 years. In addition to these potential savings, enhancing health center funding could be particularly important given reductions in Medicaid enrollment due to “unwinding,” which is also threatening these safety-net clinics." Read the full article here: https://bit.ly/3INTFU1