The State Innovation Model (SIM) grant program gives states funding and technical assistance to design and test new ways to provide and pay for health care. This brief examines the six states that received Round 1 SIM Testing grants to identify best practices for consumer advocate engagement.
States are leading the way in improving how health care is paid for and delivered. Consumer advocates are integral to these reform efforts. Their participation can help ensure that reforms protect and improve consumers' access to high-quality care. While advocates often find it difficult to get involved in these discussions, the State Innovation Model (SIM) grant program gives consumer advocates an opportunity to weigh in on reforms in their states.
Across the country, states are experimenting with new health delivery models aimed at strengthening primary care and addressing social service needs that can affect a patient’s overall health. Both community health workers and enrollment assisters can serve an important role in this work by connecting clients with services that enable them to access care and manage their health.
If the Supreme Court sides with the plaintiffs who brought the case, an estimated 6.4 million moderate-income people would lose premium tax credits. Without these subsidies, many people will simply be unable to afford to purchase health insurance.
Dr. Mary Williard, a mother and a dentist working in Alaska Native communities, describes how our broken dental care system brought her adopted daughter into her life for the first time. And, how an innovation she has made her life's work could change the way we provide dental care to the millions in the United States, like her daughter, who have suffered without it.
In just 10 years, dental therapists in Alaska have been able to expand dental care to 40,000 people here who couldn’t get that care before. They are so effective because they work with dentists as part of a team to bring dental care to communities that dentists can’t get to very often.
The activity around payment and system reform creates an opportunity to develop interventions that directly address racial and ethnic health disparities. However, some reforms could inadvertently make disparities worse. For example, they could discourage providers from treating sicker, more complex patients, or undermine the financial viability of struggling safety net providers.
Fortunately, some communities are implementing delivery system reforms that reduce health disparities and bend the cost curve. The effective models we describe in this blog series share several features in common.
Across the country, there is tremendous momentum to change how health care is delivered and paid for in order to improve quality and to curb costs. These initiatives to transform the health system have the potential to improve care for everyone, and could directly address health disparities. Advocates must actively engage in these reform efforts—both to protect communities of color from harm and to take maximum advantage of opportunities to transform health care delivery to better serve people of color.
Yesterday, President Obama and Department of Health and Human Services Secretary Burwell kicked off the Health Care Payment Learning and Action Network (Network), a network of cross-sector stakeholders focused on quality and costs in the health care system. The network aims to transform our entire health care system—beyond Medicare and Medicaid—from a system that pays for volume to one that pays for quality and value and that actively engages consumers in their own care. More than 2,800 payers, providers, employers, and consumer groups (including Families USA) have registered to participate in the Network.
Over the past two decades, state-based consumer advocates and health care practitioners have worked together to help low-income people—including those living in communities of color or with chronic medical conditions—gain access to health coverage. As more people gained insurance coverage, consumer advocates and health care providers focused their attention on improving the patient’s experience with the health care system.
One of the most significant and popular features of the Affordable Care Act (ACA) is the new protection that puts an end to insurance company discrimination against people with pre-existing health conditions. This important ACA protection depends on two other provisions that keep coverage affordable: premium subsidies and the coverage mandate.