Investing in Health: Seven Strategies for States Looking to Buy Health, Not Just Health Care

Prepared in partnership with The Health Initiative on behalf of the Blue Shield of California Foundation and The Commonwealth Fund

By Melinda J. Dutton, Partner, Manatt Health | Kyla M. Ellis, Manager, Manatt Health | Rocco Perla, Co-founder, The Health Initiative | Rebecca Onie, Co-founder, The Health Initiative

In the wake of a pandemic that has pummeled our public health and health care delivery systems, crippled the economy, and brought into stark relief long-standing racial inequities, states are faced with both the opportunity and the imperative to rethink their role in protecting and improving health. Over the past decade, policy makers and industry leaders have pursued significant changes in the way we deliver and pay for health care, moving away from incentivizing volume and high-cost interventions and linking payment more closely to “value.” Yet improvement in health care is not enough to improve health. An estimated 20 percent of health outcomes are linked to medical care; the remaining 80 percent stem from socioeconomic, environmental and behavioral factors collectively referred to as drivers of health (DOH).

Efforts to address DOH are growing—the Centers for Medicare & Medicaid Services (CMS) recently released new guidance to support state efforts to address DOH in Medicaid and the Children’s Health Insurance Program (CHIP), several states are offering food or housing supports to prevent the spread of COVID-19, and virtually all states in the nation include at least one requirement related to DOH in their Medicaid managed care contracts. Yet these and other efforts to address DOH remain diffuse, episodic and grossly underfunded, lacking clear expectations of the appropriate role of health care payors, providers and regulators.

In “Investing in Health: Seven Strategies for States Looking to Buy Health, Not Just Health Care,” a new white paper prepared in partnership with The Health Initiative with support from the Blue Shield of California Foundation and The Commonwealth Fund, Manatt Health proposes seven strategies to help states bring scalable, sustainable integration of DOH into their state health care systems—creating greater alignment of financial incentives, seeding shared assets and resources needed to identify and address DOH, and setting new expectations for health care providers and payors as anchor institutions in their communities and stewards of public funds.

To access the full white paper, click here. To access Manatt Health’s recently published federal action plan, click here.



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