Aneesh Chopra

Seamless data is essential for communities to effectively address public health disparities. The past three years have shown us just how important data is to addressing needs in a timely manner, and the lack of data needed to respond to continuous public health threats has shown us why an updated data infrastructure is long overdue.    In their recently updated Public Health Data Strategy for 2024-2025 and a companion 2023 Lookback Report, @The CDC Foundation shares how they intend to continue improving data modernization across all levels of public health.   More here: https://lnkd.in/ehWsk2d9    #PublicHealthData #DataQuality

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I wrote a new piece, it's about how we can change the structure of time to get a better understanding of public health concepts. https://lnkd.in/e_tY8kec

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CMS’ newly finalized rules on #Medicaid access, managed care, and HCBS aim to modernize the framework for defining, measuring, and enforcing the standards for access to care in Medicaid and #CHIP. Sharing this helpful summary from my colleagues that outlines the key details of the rules and implications for enrollees, states, providers, and managed care organizations: 

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Check out the terrific new interview series by René Quashie a must-read for anyone passionate about digital health!

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"..data demonstrates that across rural and urban regions, when voting rates are high, health outcomes are better." This powerful insight comes from a new Forbes article spotlighting the work we do at Vot-ER and A Healthier Democracy that emphasizes the critical intersection of healthcare and politics. As healthcare providers, we witness firsthand how policies impact patient care. Now, more than ever, doctors are urging patients to exercise their right to vote—because healthier communities start with civic engagement. Read the full article written by incredible physician-author Adaira Landry, MD MEd here: https://lnkd.in/duS77Msx #VoteForHealth #CivicHealth

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Very thoughtful piece out from American Enterprise Institute James Capretta. His diagnosis seems spot on to me. I quibble on a few of the solutions. I think public option plans have a place in disciplining a market that lacks incentives to control costs (and high hospital prices with outliers at the very high end), but he identifies the key levers for lowering costs--more standardized plans and services, and incentives to use lower cost services and settings. This makes me hopeful for bipartisan solutions. https://lnkd.in/edgv7MJQ

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Check out this new Mathematica blog on improving postpartum care in Medicaid and CHIP. Very timely and actionable. #Medicaid, #CHIP, #maternalhealth, #Mathematica

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NCPDP Foundation is presenting an excellent opportunity for innovative pharmacists in the following: 1. **Precision Medicine and/or Pharmacogenomics**: Pharmacists play a critical role in precision medicine by utilizing pharmacogenomic data to tailor medication therapies based on individual genetic profiles, optimizing treatment efficacy and minimizing adverse effects. 2. **Digital Therapeutics**: By integrating digital therapeutics into patient care, pharmacists can monitor adherence, provide education, and support patients in managing chronic conditions through technology-based interventions. 3. **Social Determinants of Health**: Pharmacists can address social determinants of health by assessing patients' socioeconomic factors, such as access to medications and healthcare services, to develop personalized care plans that improve health outcomes. 4. **Health Equity**: Pharmacists advocate for health equity by ensuring that all patients, regardless of their background, have access to medications and healthcare services, and by participating in community outreach programs to address health disparities. 5. **HL7 Accelerator Alignment**: Pharmacists can contribute to HL7 accelerator initiatives by collaborating on the development and implementation of health information standards that enhance communication and interoperability among healthcare providers. 6. **Industry Interoperability**: In promoting industry interoperability, pharmacists can help ensure that electronic health records (EHRs) and pharmacy management systems seamlessly share patient information, improving care coordination and medication management. 7. **Pharmacist Supported Clinical Services**: Pharmacists can enhance clinical services by providing medication therapy management, chronic disease management, and preventive care services, leveraging their expertise to improve patient outcomes and reduce healthcare costs. Thanks for sharing this Robert P. Nickell

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More evidence that #Medicaid state-directed payments (SDPs) to hospitals are out-of-control (see Table 1) and fueled by hospital provider taxes (see Figure 14). It's even worse than it appears because some states, like North Carolina (not included in table below), are adding new taxes to pull down additional SDPs for behavioral health facilities. This isn't just bad for the federal budget and for all the other health care needs that are shortchanged (like community mental health), but as behavioral health facilities raise their commercial prices, more families--at a time of terrible distress-- will incur medical debt. There are so many other unintended consequences like over-hospitalization likely to occur from this policy. In Delaware, they've enacted a hospital provider tax for the first time (not shown below) to draw down SDPs. Delaware only has 6-8 acute care hospitals (including 1 children's hospital) and 3-4 systems, depending on how you count them. One large system with 1,000+ beds by itself can drive the average commercial rate higher by raising its prices, thereby effectively setting its own Medicaid rates. All this federal Medicaid funding is going to pad hospital margins while in most states home care aides are making $10-$15/per hour and nursing facilities say they can't afford better staffing ratios. States can and some do use state-directed payments to increases long-term care wages, but hospitals resist using "their" provider tax revenue to fund non-hospital SDPs. LTC doesn't have the capacity to leverage provider taxes the way hospitals can and has to rely on state general fund dollars to finance services. Massachusetts and New York (see report) want to add provider taxes on health plans. This could cascade provider taxes on top of each other, further compounding the impact on the federal budget and the commercial market, including ACA marketplaces, undermining affordability for ACA consumers and working families. It's not going to be fun or easy to halt this enormous inequitable shift in health care resources, but halt it we must. KFF Shawn Gremminger Claire Brockbank Joshua Gordon https://lnkd.in/eDteMcJT

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Wall Street analysts now are more bullish on for-profit #hospitals thanks to the huge grow in #Medicaid state-directed payments to hospitals, with big states like Florida, Texas and California soon expected to get federal approvals for rates approaching commercial levels (TX is already at commercial levels). This is a disaster for the federal budget and for workers who will continue to face higher premiums and higher medical debt as hospitals keep raising commercial rates to also increase their Medicaid rates. I remain utterly perplexed by this CMS policy. It's clear that the cost estimates for this policy from CMS and even CBO are much too low and will endanger the health of the #Medicaid program overall as its per capita growth rates and levels outpace Medicare and other important benchmarks. It keeps Texas and Florida from expanding Medicaid--why expand when you can overpay hospitals so they make a margin on "uncompensated care"? It's also raising the cost of ACA marketplace premiums. Medicaid continues to underpay primary care and behavioral health services while overpaying for hospital services, fueling hospital consolidation and forcing independent physician practices who want to remain independent to turn to private equity. MACPAC - Medicaid and CHIP Payment and Access Commission Susanna Vogel Shawn Gremminger Joshua Gordon Chris Deacon Ge Bai KFF https://lnkd.in/eyNkai9G

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A very sincere congratulations to Kirsten Beronio for getting this guidance out. Medicaid is articulating support for the states in developing behavioral health technology for Medicaid providers and Medicaid beneficiaries. Brent Weaver, MS, PMP, SPC and Edward Dolly worked to ensure that the 90% match for these technologies is described thoughtfully, addressing frequent state questions on various cost allocation approaches (allocations for provider facing technologies, etc.). And, my favorite, specific guidance on if/how/when to *weight* cost allocation by patient, as Medicaid beneficiaries with multiple conditions, BH concerns, SDOH concerns, etc., certainly take more provider time than college well-visits! Some behavioral health projects included in this guidance eligible for support (not an exhaustive list)! ·      Opportunities for: telehealth modalities for BH/SUD interventions; ·      Recent CMS Mental Health parity work which allows for improved compensation; ·      Care coordination connections between hospitals, community based BH/SUD providers, schools, primary care, criminal justice settings ·      BH/SUD screening tools ·      Smartphone applications ·      Creation of a public-facing website that links enrollees to social networks, peer support groups, resource sharing, and other functions ·      Implementation and maintenance of an information exchange platform connecting Medicaid beneficiaries on a Medicaid provider network of peer support specialists and addiction clinical staff who share resources ·      Establishment of an eConsent Management System that could support exchange of MH and SUD treatment information using common health information exchange standards and application programming interfaces (APIs) to connect and support data exchange ·      Development of a platform to facilitate patient consent to exchange of information regarding MH and SUD treatment , e.g., Consent2Share, an opensource software application developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) that allows patients to determine which health information they would like to share with their primary care and specialty health care providers (potentially coupled with a web-based health information exchange tool and clinical document repository that enable providers to access continuity of care documents and view key clinical data ·      Creation of an email or other electronic alert system ensuring MH and SUD treatment providers receive information on admissions, discharge, or transfer (ADT) so that when an enrollee with serious mental illness or serious emotional disturbance is being discharged from a hospital, that enrollee’s records regarding treatment could more easily be transferred to a community-based treatment provider. And thorough discussion of all the ways Medicaid can align with state 988 efforts. Congrats again team! https://lnkd.in/eifTf7a4

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More adventures with Novant Health! The FTC is suing to block Novant's acquisition of Lake Norman Regional in Mooresville, NC. Lake Norman's hospital prices (IP & OP) were 234% of Medicare in 2020--on the lower side for NC. Novant's systemwide prices are almost 300% of Medicare (2020), but its prices are higher where it has dominant market share in Winston-Salem. What do you think will happen at Lake Norman if Novant buys it? The famous RAND study, Hospital Price Transparency Study Round 4, which includes data from 2018-2020, is a treasure trove. It breaks out commercial pricing data shared by employers and a few other sources by hospital, hospital system, state, IP, OP, professional services, etc. New data is coming out on May 13! Novant ranks 3rd behind Mission/HCA and Atrium for highest prices in NC. The statewide average price (IP & OP) was 266% of Medicare in 2020, and Novant's prices are almost 300% of Medicare. Novant Forsyth Hospital in Winston-Salem, where Novant has a market share of 52%, has prices at 306% of Medicare--putting in the 9th highest price decile nationally. In 2020, when Novant bought county-owned New Hanover RMC, NH's prices were only 226% of Medicare-a benevolent public hospital monopoly! I can't wait to see NH's prices in the next round of data under Novant's ownership. I also want to see what happens in Winston-Salem since Atrium acquired Wake Forest's academic medical center in 2020 (hope the same sizes are big enough). Will prices across both systems be even higher? Thanks to all the employers sharing their data! https://lnkd.in/eXzhmsu5 #NorthCarolina Christopher Whaley Jon Rankin Brian Briscombe Rose Kerber, MPP Brenna O'Neill Aaron Kofner Gloria Sachdev Shawn Gremminger Claire Brockbank James Gelfand Julie Havlak North Carolina Department of State Treasurer Ann Lewandowski Ge Bai

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I couldn't wait to share this recent data the CaringBridge team pulled together about the IMPACT delivered on our non-profit health tech platform. While healthcare is trying to figure out how to meet underserved and access needs, CaringBridge has quietly been delivering support across emotional, social, and functional needs for over 27 years. We won't be quiet anymore. Healthcare needs us. And more importantly caregivers and patients need us. 💰 Almost $1M a MONTH, over $10M a YEAR raised to support the financial needs of family caregivers and their loved ones on a health journey through our Go Fund Me partnership alone. That's over 7,000 individual contributions of financial support A MONTH through the caregiver's or patient's community of choice activated on CaringBridge pages. 🥘 🛒 Over 1,900 meals A MONTH, almost 23,000 meals a YEAR, delivered in support of food needs which will grow as CaringBridge just launched gift cards with InComm Payments and soon with Instacart for grocery delivery. 💬 💗 650,000 comments and reactions a MONTH, 7.8M a YEAR that lead to better emotional health. In fact, a 4x improvement of feeling less alone after using CaringBridge for more than 6 months. More to come as the CaringBridge team continues to measure the impact of helping to alleviate some of the #overwhelm caregivers feel on a daily basis. btw... did I tell you we're not just a communication platform?

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The Health Misinformation and Trust Initiative at KFF is dedicated to identifying and addressing misinformation while building public trust—and we’re expanding our team! In case you missed it, here's some of our most recent features in the Health Misinformation Monitor: -- AI Chatbots & Health Misinformation: A look at how AI tools like ChatGPT, Google Gemini, and Microsoft CoPilot handled health claims, showing both opportunities and challenges in their accuracy. -- Vaccine Misinformation: As children headed back to school, misinformation about COVID-19 boosters resurfaced. -- Fentanyl & Political Rhetoric: Highlighting how political rhetoric spreads misinformation about fentanyl. If these topics resonate with you, we’re hiring a Health Misinformation Analyst. This role involves extensive writing, analysis, and collaboration with cross-functional teams to further our work. Obviously I'm bias here, but KFF is a also remarkable place to work. More details in the comments.

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💡Part 2 of Steve Gravely and Gravely Group's ongoing #HTI2ProposedRule series delving into the Proposed Rule for Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability. _______________________________________________________________ See Part 1 here: https://lnkd.in/esuG2yVV vi. New exception- #ProtectingCareAccess. This new exception is specific to EHI related to “reproductive health” as defined under #HIPAA. The exception would protect practices to withhold EHI about reproductive health services based on the Actor’s good faith belief that sharing the EHI could expose the patient to legal risk. This exception is specifically targeting situations in which a woman obtains reproductive health services in a state where such services are legal but their information is requested by someone else. In order to assert this exception, an Actor must demonstrate its good faith belief that the practice is no broader than necessary to protect the patient from legal risk. In addition to this threshold requirement, the Actor must show that the practice satisfies either the patient protection condition or the access to care condition: 1. Patient protection condition requires that EHI being withheld shows that patient obtained reproductive health services or inquired about them or EHI has specific demographic information that implicates reproductive health.   2. Access to care condition are practices that actor takes to limit exposure of providers to legal liability. vii. New exception- #RequestorPreferences. ONC notes that sometimes, a requestor of EHI will state specific preferences that limit the EHI it wants. This could be a date range, a specific type of care or anything else. ONC states that a requestor often does not want all of the EHI that an Actor has in its system. 🎙️Steve Gravely says, "Apparently, ONC has heard concerns that honoring these limitations could be an information blocking violation. I am skeptical, since information blocking is about fulfilling a request and if the requestor limits the scope of the request, I do not see how complying with this could be information blocking. Creating a new exception seems way over the top and makes me wonder if something else is going on." viii. #TEFCAMannerException - ONC is seeking input in HTI-2 about the new TEFCA Manner Exception that it created in HTI-1. Specifically, ONC wants feedback about the “carve-out” related to FHIR APIs. The TEFCA Manner Exception, as adopted in HTI-1, did not apply if the request for EHI was made using the standards adopted in 45 CFR 170.215 which include the FHIR API standards. ONC is seeking comments on whether specifically referring to the standards at 45 CFR 170.215 is too limited. Stay tuned for more insights!

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Can't wait to connect at MESC and dive into the latest insights from Google's HHS and public sector leaders! Join us for: - 1:1 meetings: Chat with our experts onsite about your unique challenges. - Speaking session: "Navigating the New Era of Medicaid using AI" with DOH leaders from NY and LA. DM me to schedule a meeting or learn more! #GoogleforGov #MESC2024

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Can't wait to connect at MESC and dive into the latest insights from Google's HHS and public sector leaders! Join us for: - 1:1 meetings: Chat with our experts onsite about your unique challenges. - Speaking session: "Navigating the New Era of Medicaid using AI" with DOH leaders from NY and LA. DM me to schedule a meeting or learn more! #GoogleforGov #MESC2024

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Can't wait to connect at MESC and dive into the latest insights from Google's HHS and public sector leaders! Join us for: - 1:1 meetings: Chat with our experts onsite about your unique challenges. - Speaking session: "Navigating the New Era of Medicaid using AI" with DOH leaders from NY and LA. DM me to schedule a meeting or learn more! #GoogleforGov #MESC2024

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Can't wait to connect at MESC and dive into the latest insights from Google's HHS and public sector leaders! Join us for: - 1:1 meetings: Chat with our experts onsite about your unique challenges. - Speaking session: "Navigating the New Era of Medicaid using AI" with DOH leaders from NY and LA. DM me to schedule a meeting or learn more! #GoogleforGov #MESC2024

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