Highlights from Day 2 of the Annual Research Meeting (ARM) included a plenary on the role of resiliency in communities and health care systems and diverse sessions on critical topics from anticipated changes in the health care workforce to innovations in payment and delivery system reform.
Lunch Plenary: Responding to Crises: The Role of Resiliency in Communities and Health Care Systems
Chair: Karen DeSalvo, U.S. Department of Health and Human Services; Speakers: Anita Chandra, RAND Corporation; Nicole Lurie, Indian Health Service; Herminia Palacio, City Hall - New York City
The speakers in this plenary examined the lessons we have learned about the role of resiliency and preparedness in helping communities and local health systems effectively respond to crises, particularly in the context of increases in catastrophic weather and terrorism events. Equity and social determinants became a focus of the discussion as speakers addressed the disproportionate impact crises have on impoverished communities. The panel acknowledged that disasters are not equal opportunity events, and they often amplify the existing health care problems facing certain communities.
During the Q&A, conversations turned to the importance of capturing data on disaster response to identify opportunities for how the systems can become more resilient.
This session aligns with AcademyHealth’s work in building healthy communities by producing the evidence on the factors that affect, and support the health of communities. Learn More.
Disability and Civil Rights: Protest, Litigation, and Research
Chair: Craig Thornton, Mathematica Policy Research; Panelists: Alan Coulter, LSU Health Sciences Center; Marsha Katz, Social Security Advisory Board; Susan Meyers, Advocacy Center of Louisiana
Over 40 years have passed since regulations were implemented for the landmark civil rights Section 504 of the Rehabilitation Act of 1973, providing a moment of reflection on the protests, litigation and research that have improved the lives of people with disabilities. Panelists in this session explored both challenges and advances created by this legislation since its enactment as well as future opportunities for change and improvements.
Session Chair, Dr. Craig Thornton, opened the session with an explanation of the Rehabilitation Act of 1973 followed by an introduction of each panelist. Panelists then shared their experiences promoting civil rights from perspectives including personal protestor, litigator, special education advocate and overall civil rights advocate.
This session highlighted AcademyHealth’s mission to move knowledge into action through synthesis, translation, dissemination, and technical assistance. Learn more.
Getting the Price Right: Approaches to Pay for Comprehensive Care
Chair: Grant Martsolf, RAND; Panelists: Christiane LaBonte, Centers for Medicare & Medicaid Services; Robert Berenson, Urban Institute; Gary Bevill and Pete Atkinson, SAMA
Many payers, both public and private, are experimenting with new primary care payment models. In this session highlighted innovative primary care payment models, presenters discussed how models were designed to improve quality, reduce costs, improve population health, and to minimize the risk of negative policy externalities.
Discussion from the audience focused on the challenges around the speed of innovation and the reproducibility of strategies that work.
This session highlighted AcademyHealth’s work to address cost growth, encourage efficiency and quality, and provide for care via insurance, Medicare and Medicaid so that people receive the best care at the best value. Learn more.
Solving Disparities through Payment and Delivery System Reform
Chair: Marshall Chin, University of Chicago; Panelists: Andrea Ducas, Robert Wood Johnson Foundation; Peter Milgrom, University of Washington; Elizabeth Howell, Mount Sinai Medical Center; Len Nichols, George Mason University.
Payment systems generally do not directly encourage reduction of health disparities. The Robert Wood Johnson Foundation Finding Answers: Solving Disparities through Payment and Delivery System Reform program sought to understand how alternative payment models might intentionally promote health equity. Presenters shared lessons learned, such as the need for payment reform efforts to understand non-financial motivations to be effective in reducing disparities.
Audience discussion focused on the challenges around measuring social risk factors versus unmet need.
The session highlighted AcademyHealth’s commitment to evidence on the factors that affect, and support, the health of communities. Learn more.
Chair: Edward Salsberg, The George Washington University; Panelists: Joanne Spetz, Philip R. Lee Institute for Health Policy Studies at UCSF; Leighton Ku, The George Washington University; Bianca Frogner, University of Washington.
The panelists discussed the workforce implications of repealing the ACA. Presenting three microsimulation models of how ACA repeal impacts the number of jobs lost within healthcare and across the country, panelists also discussed the policy mechanisms by which job loss may occur.
Discussion focused on how the simulations might play out in attendees’ specific states as well as trends attendees have seen in specific sectors of health care workforce, particularly long-term care.
The session highlighted AcademyHealth’s work to improve both the supply and quality of health services research is by assessing the skills and composition of the HSR workforce, and building programs that respond to emerging needs. Learn more.
Rebuilding the Health Care Delivery System from the Ground Up
Chair: Mark Diana, Tulane University School of Public Health & Tropical Medicine; Speakers: Rebekah Gee, Louisiana Department of Health; Michael Griffin, Daughters of Charity Services of New Orleans; Fernando Rivera, Southeast Louisiana Veterans Health Care System
During this special session, speakers discussed the challenges, issues, and experiences of key stakeholders involved in rebuilding the health care delivery system in the Greater New Orleans area post-Katrina, including efforts to develop a resilient community and a learning health system. While the continued efforts of physical and logistical rebuilding were discussed, presenters focused on the need to build the foundations of health care in New Orleans through improved quality, standards development, and outcomes reporting.
During the audience discussion, conversations turned to how multiple stakeholders, who have an interest in improving the health systems in New Orleans, can help foster and create a collaborative environment.
This session aligns with AcademyHealth’s continued efforts to improve care delivery through research that includes assessing and improving the quality of care itself, expanding access to care, and understanding the many ways to organize and improve care in hospitals, health systems and other care settings. Learn More.
The State of Nursing Home Care 30 years After the Federal Nursing Home Reform Act
Chair: Vincent Mor, Brown University School of Public Health; Discussants: David Gifford, American Health Care Association; Bruce Vladeck, Greater New York Hospital Association; Speakers: David Stevenson, Vanderbilt University School of Medicine; R Tamara Konetzka, University of Chicago; Kali Thomas, Providence VA Medical Center
Another special session offered three unique perspectives on U.S. nursing homes, including (1) a review of care quality and residual challenges; (2) the transformation of nursing homes to providers of post-acute care; and (3) the emergence of assisted living as the future nursing home. The session provided historical perspective of the Nursing Home Reform Act, from the regulatory stringency to the more resident-centered focus, and how facilities were transformed by changes in Medicare payment policies and the availability of nursing home alternatives.
Audience discussion centered on the impact of continued industry regulations on quality and care improvement.
This session aligns with AcademyHealth’s continued efforts to improve care delivery through research that includes assessing and improving the quality of care itself, expanding access to care, and understanding the many ways to organize and improve care in hospitals, health systems and other care settings. Learn More.