“Medicaid Innovation” – A Contradiction in Terms?

InnovationEach September marks the end of summer vacation and the start of a new school year. For me, September also marks the unofficial start of the health care conference season. My colleagues and I attend several Medicaid-focused conferences each year, representing Ideomed and Abriiz.

Each year, a prevailing theme seems to emerge and get carried from one meeting to the next. The Medicaid professional community is relatively small, so there is some inevitable overlap of speakers, attendees, and subject matter from one meeting to the next. Last year, the dominant themes as I perceived them focused on Medicaid innovation and improving patient engagement.

Those two phrases – “Medicaid Innovation” and “Patient Engagement” are practically screaming for a snarky retort. One could easily write them off as oxymorons –  the “Jumbo Shrimp” of healthcare euphemisms. However, any thoughts of generic stereotypes were quickly forgotten once I began to hear presentations from Medicaid payers and providers.

Over the course of 5 or 6 conferences, I sat in on no fewer than 30 separate sessions, all of which touched on these same themes in one way or another. In my observation, these presentations emphasized some common characteristics. Here is a sampling:

High Tech – The rapid expansion of the Medicaid population that anticipated as a result of the Affordable Care Act (ACA) requires sophisticated technological support to be successful. Advancements in Big Data, Mobile Health, Personal Health Tracking, and Cloud-based computing hold tremendous promise for transforming healthcare delivery, outcomes, and costs.

High Touch – There’s no question that “Patient Engagement” has become the battle cry throughout the continuum of care. Ever increasing requirements in the ACA will keep this goal front and center for the foreseeable future.

Technology alone cannot deliver engaged patients. Several presentations focused on expanding care management programs, with an emphasis on making personal connections with patients.

Same As It Ever Was –  While most reports focused on practical initiatives already underway, some attention was given to speculating on what Medicaid might look like in the years to come. These prognostications stood out in stark contrast to the optimism and fresh thinking I had experienced elsewhere.

It would seem that many in the field see little difference for public health care in the future from what we are accustomed to today – unless you consider worse “different”:

– Federal and State bureaucracy at least as dysfunctional as it is today;
– Continued downward pressure on Medicaid at both Federal and State levels;
– Ever-increasing demand for scarce and diminishing resources;
– Payers, providers, and patients still caught in the middle.

In spite of this bleak picture, I enter into another conference season buoyed by a sense of optimism. Positive change after all, is rarely initiated by politicians in Washington DC or our state capitals. Genuine innovation and engagement comes from those with “boots on the ground”, who are committed to making positive changes in the communities they serve.

If those who I met last year are any indication, I can confidently look toward a bright future – so bright, I gotta wear shades!


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