In Blog: Factually Speaking

Two days spent in warm, sunny Chicago. Not a bad way to start the week. And even better than the weather and location—which admittedly I didn’t have much spare time to enjoy—was the opportunity to hear from a variety of health industry leaders on their latest priorities and their advice to those committed to the work of improving healthcare in the U.S.

Earlier in September I had the opportunity to attend the 2019 Health Management Associates Conference.

I most enjoyed the opening keynote speaker Alan Weil, Editor-In-Chief of Health Affairs. He delivered (without slides!) a thoughtful and positive presentation about some of the lessons Medicaid can teach us and some of the lessons Medicaid can learn.

Mr. Weil did not shy away from commending the 54-year-old program and shared the ways Medicaid has been doing the work so many of its commercial counterparts are only now beginning to prioritize. For example, the topic of social determinants of health was recurrent throughout the conference and mentioned by several panelists from large health plans and hospital systems as one of their growing areas of interest. But, as Mr. Weil highlighted, Medicaid has been doing the work of social determinants for years. (Dare I say long before it was cool?) And historically speaking, Medicaid’s origins are inseparable from those of many of our nation’s other social welfare and social insurance programs.

Among the other lessons about what Medicaid can teach us was: requiring limited or no cost-sharing in combination with offering comprehensive benefits are program strengths. (Resilience and nimbleness are certainly strengths of Medicaid, too.)

For me, the most notable takeaway from Mr. Weil’s discussion about what Medicaid can learn was: health insurance makes a lousy carrot and an even worse stick. It’s vital for Medicaid programs across the country to recognize that leveraging health insurance as a bargaining chip to get individuals to behave as we’d have them behave is ineffective, wrong policy.

For all of the acronyms and industry jargon, “MCO,” “MLR,” “integrated delivery systems,” “capitated payments,” shared throughout the two-day conference, there were still moments punctuated with words like “people,” “equity,” and “wellbeing.” And that’s really why all of us were there. Attendees, myself included, sought clarity from the chaos of our healthcare system.

We sought strategies to better articulate the value of Medicaid not just for enrollees but for our states and economies. And we sought connection with others who work to establish systems and policies that make living well in community available to all of us.


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