The expansion includes raised payments and payments for currently unreimbursed services such as creating patient care plans. They also unveiled a shared-savings program, up to 30% and plans to invest in staffing and data sharing in exchange for measures such as participating in monitoring programs and offering 24 hour access. Wellpoint plans to invest $1 billion. They hope to achieve savings of up to 20% from improved health and reduced use of costlier services (ER visits).
Wellpoint companies include Anthem Blue Cross & Blue Shield in Virginia. Wellpoint is taking a business risk by pursuing this investment. Since providers tend to contract with several insurers competitors may take advantage of the program without making a similar investment or taking on similar risk of loss. This free rider problem may have discouraged insurance companies from aggressively pursuing cost-savings—at least until now.
See this article in the Virginia-Pilot for an overview of the bills: http://hamptonroads.com/2012/01/virginia-needs-health-exchange
“America’s Health Threat: Poor Urban Design
by Scott Carlson
Researchers can have revelatory moments in remarkable places—the African savannah, an ancient library, or the ruins of a lost civilization. But Richard J. Jackson’s epiphany occurred in 1999 in a banal American landscape: a dismal stretch of the car-choked Buford Highway, near the Centers for Disease Control and Prevention in Atlanta.
Dr. Jackson, who was then the head of the National Center for Environmental Health at the CDC, was rushing to a meeting where leading epidemiologists would discuss the major health threats of the 21st century. On the side of the road he saw an elderly woman walking, bent with a load of shopping bags. It was a blisteringly hot day, and there was little hope that she would find public transportation.
At that moment, Dr. Jackson says, “I realized that the major threat was how we had built America.” His center had already been dealing with problems that he suspected had origins in the built environment—asthma caused by particulates from cars and trucks, water contamination from excessive runoff, lead poisoning from contaminated houses and soil, and obesity, heart conditions, and depression exacerbated by stressful living conditions, long commutes, lack of access to fresh food, and isolating, car-oriented communities.
Treatments could come in the form of pills, inhalers, and insulin shots, but real solutions had bigger implications. “More and more, I came to the conclusion that this is about how we build the world that we live in,” he recalls, speaking over the phone from San Francisco.
Dr. Jackson, who is now a professor and chair of environmental health sciences at the University of California at Los Angeles’s School of Public Health, has become one of the leading voices calling for better urban design for the sake of good health. Georges C. Benjamin, executive director of the American Public Health Association, says that Dr. Jackson’s work has been highly influential in public health and public policy. Dr. Benjamin first started talking with Dr. Jackson about the links between urban design and public health in the 1990s.
“It was an eye-opening moment for me,” Dr. Benjamin says, adding that those links have since become widely accepted among public-health specialists. Dr. Jackson’s work, he says, “gets people who do not view themselves as health providers or health practitioners to begin thinking about their role in public health.”
Via: The Chronicle of Higher Education
Image: Richard Jackson waits for a bus outside Los Angeles International Airport. The UCLA scientist is a leading voice in the call for better urban design for the sake of public health. (David Zentz for the Chronicle)
Much of the policy research related to ACO’s and population based financing focuses on continuity of care. However, ACO’s may shine by making these types of basic safety investments profitable.
The settlement closes four Virginia’s five training centers and creates over 4,000 Medicaid waivers for community-based care of the intellectually and developmentally disabled. The cost is projected at $2.1 billion over 10 years, split between the general fund ($1.1 billion) & Federal sources.
Sidebar: Weldon Cooper Center’s 2008 Report on Virginia’s veteran population:
http://www.coopercenter.org/demographics/publications/serving-our-nations-veterans
