Play by Play

Playbook postings and exclusive perspectives from leaders in the field

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On Thursday, January 17, 2019 , the Playbook presented a webinar exploring how nurses can be integrated into complex care teams. This interactive online discussion provided opportunities to share ideas and ask questions. The panelists had expertise in both nursing and policy. 
Throughout 2018, we have featured several posts authored by the leadership of the Six Foundations Collaborative that supports the Playbook. In honor of the second anniversary of the Playbook’s launch, Jay Want, MD, Executive Director of the Peterson Center on Healthcare, reflects on the philosophy behind the Playbook and shares his vision for its use.
Aligning quality improvement is a key principle of the Special Needs Plan Alliance and its member health plans. One health plan that has been working toward such alignment in an innovative way for several years is Senior Whole Health, part of the Magellan system, located in Massachusetts. Recently, Deborah Paone sat down with Andrew McClure of Senior Whole Health, a Magellan company, to discuss his work around aligning quality measurement and improvement. Andrew also presented this information at the Special Needs Plan Alliance Executive Forum in October 2018. This blog post offers insight from Andrew on what they did and what drove the success of this partnership between medical group providers and this special needs health plan.
On February 9, 2018, Congress passed and the President signed into law the Bipartisan Budget Act of 2018. Title III of this legislation contained a series of landmark provisions for advancing the integration of Medicare and Medicaid and for improving care for persons with complex chronic conditions. In this post, Rich Bringewatt, President and CEO of the National Health Policy Group describes the implications of this new law.
This interactive online discussion, moderated by Kedar Mate, MD, Chief Innovation and Education Officer at the Institute for Healthcare Improvement, provided opportunities to share ideas and ask questions about how to make the finances work for complex care.
When individuals participate in both Medicare and Medicaid, it would be ideal for them to be enrolled in one plan that integrates both programs and coordinates the benefits. And in some cases, this is already happening. But too often, these individuals—who are already highly vulnerable—are enrolled in entirely different, uncoordinated plans for each program. This further complicates an already fragmented delivery system for this high-needs group.

We all know that the emergency department is the simplest, most relaxed place in a hospital. Given this, it should be easy to treat and refer patients with substance abuse disorder, right? Of course not!

In fact, it’s so complex that I have yet to find any U.S. hospital that allows patients to be identified, treated, and transferred with any degree of consistency and predictability. But it can be done.

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