With ongoing health care workforce shortages, the rise of telehealth, and an increasingly diverse population now on Medicaid as a result of the pandemic, COVID continues to impact our communities in ways yet to be seen.
Four experts, including newly-appointed House Health and Government Operations Committee Chair Del. Joseline Peña-Melnyk, came together during last month’s 2022 Maryland State of Reform Health Policy Conference to discuss a unified, long-term approach to improving health in the post-COVID world.
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Eric Bush, MD, Chief Medical Officer at Hospice of the Chesapeake, highlighted three areas where Maryland should strengthen care coordination: prenatal care, behavioral health, and aging in place. With many instances of the pandemic placing restrictions on visiting loved ones in nursing homes and other long-term care facilities, Bush said there should be more options for people to receive home and community-based care.
“What I’ve seen is a shift away from skilled nursing facilities … really a desire for people to maintain their independence in their home, or wherever they call their home for as long as possible.”
Utilizing data in the primary care space and increasing medical literacy are key to improving Marylanders’ health, he continued.
Nicole Stallings, Chief External Affairs Officer and Senior Vice President of Government Affairs and Policy at the Maryland Hospital Association, moderated and spoke on the panel. She highlighted data’s key role in helping health settings adapt to the pandemic, especially with an ongoing health workforce shortage.
“[Data tools] are gifts that we have here in the state,” she said. “To be able to not just track positivity rates and hospitalizations—those were important—but to also know where our patients were, to know what the capacity was in our ICU so that we could move patients within systems, across hospitals, to other settings of care.”
Stallings also urged health settings to take action on system weaknesses that were revealed during the pandemic. During the height of the Omicron variant surge, she said 15 hospitals had to declare crisis standards of care.
“We have a responsibility to also evaluate what did not go well, where we were not ready, and [where] we need to put the plans in place.”
Peña-Melnyk discussed a number of bills her committee passed this last legislative session, many aiming to increase access to care for underserved communities. This included HB 1080, which provides Medicaid coverage for undocumented pregnant women and their child for up to one year, and HB 97, which establishes a workgroup on Black, Latino, Asian American Pacific Islander, and other underrepresented behavioral health professionals.
She described her priorities for the next legislative session, which include reducing Maryland’s uninsured rate.
“As we think about health care in Maryland, we have done an amazing job in reducing the number of uninsured with the [Maryland Health Benefit Exchange], with the expansion of Medicaid, with the reinsurance program,” she said. “But the fact is that there are still 350,000 people uninsured, and 275,000 of them are undocumented. As we move forward, think about a path where we cover everyone, because Maryland is a rich state and it is simply the right thing to do as well.”
Barbara Brookmyer, MD, Health Officer of the Frederick County Health Department, rounded out the discussion with comments about her concerns on the long-term impacts of COVID. She applauded Maryland’s efforts to lower barriers to care, such as using funds from the American Rescue Plan Act (ARPA) to support child care, food, or rent assistance programs. She urged stakeholders to continue investing in services that address the social determinants of health for vulnerable Marylanders.
“When we look at the investments, we have seen that the investments through ARPA, through the General Assembly, [they] have made a difference. It would be a shame for us to go backwards and to not continue with the investments that have made a difference in people’s lives. It’s more than just what occurs in an exam room that contributes to the overall health and wellness of our community.”