Since 2014
THE TRIPLE AIM AND POPULATION HEALTH MANAGEMENT: FUTURE DIRECTIONS FOR MEDICAID OVERSIGHT
The Journal of Health Care Finance
View Archive Info| Field | Value | |
| Title |
THE TRIPLE AIM AND POPULATION HEALTH MANAGEMENT: FUTURE DIRECTIONS FOR MEDICAID OVERSIGHT
|
|
| Creator |
Paul, Amy; Amy Paul, MJ, BSN, RN, CCM
|
|
| Description |
The Centers for Medicare and Medicaid Services (CMS) has expressed a commitment to improvement of population health, identifying population health as a goal in its 2013-2017 strategy roadmap.[i] The means by which the CMS will encourage population health management by states is not yet evident; in September, 2015, only two of 63 documents supporting state applications for Section 1115 Medicaid waivers mentioned population health or the Triple Aim.[ii] The Medicaid program’s design as a reimbursement mechanism for health care services does not allow for payment for services that address social determinants of health (SDOH).[iii] Nonetheless, according to a CMS Chief Medical Officer, the CMS could extend its impact on population health management by “aligning our incentives with those of private-sector payers, supporting infrastructure building, and collaborating with public health and social programs.”[iv] This paper will argue that the CMS should issue stronger guidance to state Medicaid programs in the creation of population health initiatives, and that the CMS can influence reduction of health disparity and costs by rewarding collaboration with communities, public health entities, and social services agencies. The paper will begin by describing the history of Medicaid, the role of Medicaid as a payment source for health care services rendered to the indigent, and the ongoing health policy debates about the purpose and scope of Medicaid. Next, population health and SDOH will be defined. Additionally, the critical role of population health management to improve Medicaid beneficiaries’ health and decrease health care expenses will be explained. Public health law’s impact on integrating population health management programs into Medicaid will be described. Finally, a framework for evaluating results of population health management in Medicaid will be advanced.
|
|
| Publisher |
Worldwebtalk.com, Inc.
|
|
| Contributor |
—
|
|
| Date |
2016-03-17
|
|
| Type |
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion Peer-reviewed Article |
|
| Format |
application/pdf
|
|
| Identifier |
http://healthfinancejournal.com/index.php/johcf/article/view/54
|
|
| Source |
Journal of Health Care Finance; Vol 42, No 4, Spring 2016
|
|
| Language |
eng
|
|
| Relation |
http://healthfinancejournal.com/index.php/johcf/article/view/54/56
|
|
| Rights |
Copyright (c) 2016 Journal of Health Care Finance
|
|