This month’s newsletter features a conversation with University of Utah Health’s Dr. Amy Locke on innovative approaches to health care policy, new data from DHHS on health inequities related to COVID-19, and an update on the work of the One Utah Health Collaborative.
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State of Reform
1. Q&A: Dr. Amy Locke, Chief Wellness Officer at U of U Health
Amy Locke, MD, leads the University of Utah Health’s Wellness and Integrative Health program, which offers both on-site medical care and community outreach to improve the health of Utahns. In this Q&A, Locke—who serves as the Chief Wellness Officer at U of U Health—discusses her organization’s participation in the Osher Collaborative, the numerous initiatives U of U Health is pursuing to address SDOH, and her belief that the health care system needs to move away from fee-for-service models in order to better serve patients.
Some of her organization’s current work includes diabetes prevention efforts, a wellness bus program that visits surrounding communities to conduct health screenings, and identifying where it can help fill gaps in the community’s health needs. “There are many, many people working in this space and I think that one of the things that we need, especially as a newer center and as a group that is more recently on the scene, is to really think about how to knit together the pieces that are already existing within the health system and community and see where the opportunities are to break down silos.”
2. DHHS reports COVID-related equity gaps
A recent interim report from DHHS highlighted concerning health disparities among racial/ethnic minorities in Utah. Released as part of its COVID Community Partnership project, the report revealed that non-white Utahns have lower rates of COVID vaccination and higher rates of COVID-related hospitalization and death than white Utahns.
The partnership, which Utah created in 2020 to address inequitable COVID outcomes in the state, says it will continue connecting with community-based organizations and engaging community health workers to bridge these racial equity gaps. DHHS will also work to improve access to testing and vaccines and address social needs within the community.
3. What They’re Watching: Tracy Gruber, Utah Department of Health and Human Services
Tracy Gruber, the Director of the Utah Department of Health and Human Services, wants the state’s health care system to move to a place where it accepts the fact that COVID-19 will be around for a long time and to provide the needed support for Utahns to continue living their lives while the disease continues to be present in their lives. During our conversation with her at our Utah event earlier this year, Gruber also discussed the main focus areas of the now-complete health department merger.
“[We’re] moving to what the state is calling a ‘steady state,’ [which is] this idea that COVID is going to be with us, like other contagious diseases, and we are at a place with advancements in technology and vaccination and therapeutics [and] we can actually start integrating our COVID response into almost a typical contagious disease model,” Gruber said.
4. Update on the One Utah Health Collaborative
The One Utah Health Collaborative recently concluded its “‘organization” phase and is now working to draft a charter that will lay out the Collaborative’s governance plan and main focus areas for innovation. Ryan Morley, Partner at SpringTide Ventures and Co-Chair of the Collaborative, says the charter—which he anticipates will be finalized this fall—will serve as the consortium’s “raison d’etre.”
Created in March of this year, the Collaborative’s organizing committee surveyed almost 500 people throughout the state to gather input on how the group should be organized and identify the key problems it needs to address. The imminent charter will detail how the Collaborative will use APMs to lower the overall cost of care in the state, as well as how it will spend the funds it has received from the state and numerous community-based organizations.
5. Updating Medicare’s physician fees is a challenge again
In the wake of rapidly rising inflation following a complicated history of federal policy, physicians across the US are expressing disapproval over Medicare reimbursement rates. In his most recent piece, State of Reform columnist Jim Capretta overviews the history of Medicare reimbursement policy and evaluates Congress’s likely path for addressing the inadequate reimbursements provided to physicians as the cost of providing care increases.
With “notably low” reimbursement levels outlined by Congress in 2015, mandatory cuts to Medicare spending through the PAYGO and the BCA programs, and a record 8% inflation rate, Capretta says physicians face increasingly significant cuts to Medicare reimbursement. “Given the many challenges involved, the most likely path forward is the one that Congress has been on for some time: annual ad hoc adjustments to address immediate pressures without any clear plan for finding, much less implementing, a more enduring solution,” he writes.