April 2021 | Volume 2
MOVING INTELLIGENT CHANGE FORWARD
INNOVATION DIGEST
Momentous change is emerging as the theme of 2021. In so many ways, that is both an energizing and a daunting opportunity. The conversation about health equity (as just one aspect of the historic dialogue happening now) is evolving to prioritize actions and outcomes that must become our new yardstick for quality, effectiveness and value. Transparency to the purchaser and the patient is on the rise, and this trend is exposing the sober realities of disjoint and even discriminatory pricing across the healthcare system. If we mean to have a patient-driven system that prioritizes and achieves health, these two areas are top of my list for hard conversations about how policy can better align incentives and drive market action. First, we must consider the unmet needs and lived experience of people that differ by age, gender, geography, socio-economic reality and community (race, ethnicity, culture, identity). Such inputs must drive innovation, research, delivery design and access to care. Second, such work must be inclusive of those communities from the beginning, with transparency of both processes and shared learning, in order to build trust and accelerate change. 
It’s time to get health care value assessment right
Trying to gauge the value of new drugs and devices is becoming increasingly important in the U.S. health care system, something that other countries have done explicitly for years.
Pressure to get value assessment right is accelerating. The Biden administration is reportedly considering creating a health technology assessment board to evaluate drug and other health care pricing.
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Epic, Humana ramp up partnership to focus on streamlining prior authorizations
Two years after teaming up to boost data sharing and ease administrative headaches, Epic and Humana are ramping up their partnership to streamline prior authorizations for providers.
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Reinventing the Center for Medicare and Medicaid Innovation
The Patient Protection and Affordable Care Act (ACA) is now more than 10 years old, and so is one of the law’s most important creations: the Center for Medicare and Medicaid Innovation (CMMI).
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A Next Frontier In Health Care Transparency: Health Plan Drug Coverage Policy
Health plans frequently impose utilization management tools, such as prior authorization and step edits, in their prescription drug coverage policies. Their goal is to curtail inappropriate use and contain costs, but the policies can create barriers to appropriate care.
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Ethics Consult: Stop Treatment for Costly Patient? MD/JD Weighs In
In 2014, 1% of the U.S. population accounted for 22.7% of healthcare costs, while the top 5% of users consumed 50% of all care, according to the Agency for Healthcare Research and Quality. Some individuals require even more expensive treatment: a retired prison guard named Slim Watson, suffering from a blood disorder similar to Edith's, spent 34 days in a North Carolina hospital in 2000 -- at a cost of $5.2 million.
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Where hybrid work can't work
In the COVID-19 era, it's easy to think of work as a fluid experience that roams between virtual and physical spaces. But some functionalities aren't well suited for a seamless connection between remote and on-site workers.
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Is the concept of ‘social determinants of health’ inhibiting progress toward equity?
The time has come to refer to social determinants with more realistic, less euphemistic, nomenclature. Make no mistake: Social determinants are real but they also get cast aside by those thinking the problems are too large and difficult to solve or that there’s little health care leaders can do to adequately address them.
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Passion + Quality = Change That Matters
  
I embrace the powerful opportunities in our evolving health care landscape. I founded Momentum Health Strategies to be a catalyst for change through continuous learning, diverse engagement and thoughtful policy and practice initiatives. I deliver innovative, strategic thinking and a passion for improving the patient experience. My personal drive and dedication to high-quality results will help you navigate the competitive terrain you face and convert your vision to action.

Momentum Health Strategies

Jennifer L Bright, MPA
(703) 628 - 0534
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