Last week, 5 governors took advantage of being in Washington, DC for the National Governors Association (NGA) winter meeting to release a bipartisan proposal to improve health care in the United States. These governors are: John Hickenlooper of Colorado (D), John Kasich of Ohio (R), Bill Walker of Alaska (R), Tom Wolf of Pennsylvania (D) and Brian Sandoval of Nevada (R). They released the plan in the hopes of breaking the political stalemate over health care. The 7-page document can be accessed here.
Key highlights for IDD providers are:
The plan does not advocate for Medicare or Medicaid reform. While it acknowledges that both those programs could use improvements, the plan states that they are “well understood and much more stable than is often believed. These mechanisms should be the foundation of efforts to expand affordable health care coverage.”
It does, however, identify proven state Medicaid innovations and calls for them to be replicated. Specifically, the report asks that “Federal and state governments should recognize and replicate the successful track record of select states to increase quality and lower costs in state Medicaid programs.” This content can be found on page 5 of the report, though for your convenience we have copied that segment of the report below:
- Define and scale value-based care and payment models (e.g., integration of physical and behavioral health, comprehensive primary care, episodes of care).
- Invest in state-based transitions to new value-based models of care that have the potential to reduce per capita Medicaid spending over time.
- Incorporate social determinants of health into Medicaid.
- Measure and incent health and critical social outcomes (e.g., reducing poverty, increasing employment, reducing criminal recidivism).
- Manage Medicaid risk-adjusted cost per person, over time, below national medical inflation.
- Use best practice vendor management to extract meaningful value from third parties (e.g., managed care companies, IT vendors).
- Provide a smooth transition from Medicaid to the individual market (back and forth) while reducing churn between the two.
Overall, the plan calls for re-centering health care delivery away from volume and towards values. The plan states “With the support of the federal government, states are resetting the basic rules of health care competition to pay providers based on the quality, not the quantity of care they give patients.” The plan outlines 5 key components necessary to do so successfully: 1) measuring value fairly; 2) using information and incentives to promote system evolution; 3) using information and incentives to empower and hold health care providers accountable; 4) using Medicaid and state employee benefits as catalysts for change; and 5) aligning federal priorities for value-based purchasing across all federal agencies. You can read more about these components on page 3 of the report.
Currently most of the media and policy discourse is centering on gun control following the tragedy in Florida so this report has not generated discussion in Congress, which is also preoccupied with the appropriations process. However, ANCOR will let members know if this proposal receives more national traction.