The 2021 Medicaid Enterprises Systems Conference (MESC) ended last Thursday following a multitude of sessions urging attendees to think about how to improve Medicaid processes, innovate their technological solutions, and identify the unique challenges that COVID-19 poses to these topics.
The last day was considerably shorter than its predecessors, ending shortly after 11 am; however, the attendees that elected to stay joined some of the most engaging sessions of the conference.
Medicaid Leading the Charge in Health Equity
Verlon Johnson, Senior Vice President of CNSI, Cheryl Powell, MITRA representative, and Ryan Bosch, President of Socially Determined, did an exceptional job contextualizing the entire conference with larger societal issues. COVID exasperated long-standing health inequalities strew throughout our nation’s healthcare system. Recent legislation has attempted to combat these injustices, but there is still ample to be done.
Medicaid is the driving force behind much of today’s current reform. Other benefit programs are slowly following suite after the groundwork has been laid by individuals who attended MESC 2021. Renewed focus on advancing technology, health disparities exacerbated by COVID, and advancements in data-driven decisions result in right now being the time for radical change in how Medicaid addresses social determinants.
Issues With How We Addressed Health Inequities in the Past
The panel points to two main reasons why we have yet to fully address health inequity despite putting many resources towards this issue:
- Lack of prioritization regarding what people actual need
- The siloing of past efforts, so their scope is limited
Dr. Bosch simplified the issue of prioritizing social determinants with the saying “three hot meals and a cot.” He goes on to elaborate, once we address the essential needs of survival, we can begin to tackle the more nuanced issues regarding access to care. Transportation to treatment facilities and health literacy come second to concerns such as housing and food. The message of this sentiment being, that deeper rooted social issues must first be addressed before programs that deal with surface level access to care concerns can be effective.
Programs aimed to address social determinants have been few and too hyper specific. While food banks and programs to increased health literacy are great and have the potential to positively impact the communities they serve, scaling them to effect country wide change is impossible with the current mindset. Instead of over-arching systematic change, communities are serving personalized needs of care one individual at a time. This creates silos as different initiatives do not have the resources needed to share their findings and expand their impact to a wider scope.
Utilizing Collaboration and Optimism to Move the Needle Towards Equity
The experts urged Medicaid personal to view their approach to rectifying health inequity as a traditional economic system and consider both the supply and the associated risk. Expansion of the person-centered perspective through innovative technologies would result in both an increase in the net benefits alongside an increase in fraud & abuse.
Small scale community have a high level of precision, but their impact is limited to the individual level. To move from isolated change to a larger scale movement, the panel agree that data silos must be broken down and a new age of collaboration must emerge. To achieve this, both collaboration and optimism is needed. Powell stresses that Medicaid officials must be willing to take some risks to facilitate large scale change and move the needle towards equity.
The Future of Data-Driven Innovations
The emerging focus on outcome-based technology to guide these high-level changes requires an extensive amount of data. Luckily, the community-based efforts that have been in hyperdrive since the onset of COVID has created a rich catalogue of data to draw from. The challenge will be accumulating this data from their respective silos and turning it into actionable insights. All three experts featured on this panel agreed that innovative technology will be needed to utilize these multiple data sources.
This sentiment was followed by a call to action that resonated throughout the room. The time for change is now. With COVID both exasperating and highlighting issues in our healthcare system, the public continues to express their desire to tackle these issues head on. Such a consensus and drive has never been seen before, and experts worry this motivation will not last forever. This concern was echoed by the audience as many of the questions centered around who the driving force would be to implement such wide-spread reforms based on pre-existing data. Issues in the past centered around a lack of measurable results; however, this stalemate has flipped on its head. Now, there is such much information, but a lack of direction, and individuals are concerned about spearheading such an important movement.
I implore you to take the existing data, this challenge, this drive, and remember the message of creativity and breaking the norm introduced by keynote speaker R. Michael Hendrix, Assistant Professor of Business Management at the Berklee College of Music. Advocating from breaking away from mainstream solutions, Hendrix emphasized that innovation and new voices can overcome any issues prevalent in the Medicaid space. Feature the minds of diverse racial and ethnic representatives to combat heath inequity, as it is an issue that disproportionately effects underrepresented communities. Think outside the box and don’t be afraid to take calculated risks. Above all, act today as the inequities that plague our healthcare system have been running rampant for far too long.