1. HEALTH POLICY In 2018: Emerging Challenges and Opportunities
January 23, 2018
Greater Kansas City Chapter of HIMSS

2. I aM KARI BRUFFETT Director of Policy
You can connect with me at:

3. One of these things is not like the otherS

4. ABOUT KHI
Nonprofit, nonpartisan educational organization focusing on health policy and research.
Established in 1995 with a multi-year grant by the Kansas Health Foundation and located directly across from Kansas Statehouse in downtown Topeka.
Committed to convening meaningful conversations around tough topics related to health.

5. Key THEMES
Policymakers want to understand how data and technology can:
Help them understand and address factors that influence health.
Allow partners along the continuum of care to understand each other and the populations they serve.
Better integrate medical and behavioral health care.

6. “Population Health”
The health outcomes of a group of individuals, including the distribution of such outcomes within the group.
Kindig, Stoddart 2003

7. WHOSE Population? Employer Health system Insurer Community State
Nation

8. Determinants of health
Social
Environmental
Behavioral
Medical Care
Genetic

9. 1. HEALTH Access to food Poor physical environment Smoking Stress
Poor housing
Air Pollution

10. Opportunities
Policymakers are interested in new models that link medical care and the factors that influence health.
Examples:
More than 20 states require managed care organizations to screen Medicaid beneficiaries for social needs
In Kansas, KanCare 2.0 proposes coordination of “social determinants of health and independence”
Accountable Health Communities
Managed Service Networks

11. Challenges Incomplete information
Disconnect between social service and health care systems
Includes disparities in size and sophistication of providers
Requires process and culture change
Billing complexity
Example: Medicare chronic care management codes when initially rolled out

12. Integrating medical and behavioral health care
Source: SAMHSA-HRSA Center for Integrated Health Solutions

13. Co-Occurring Conditions
Source: SAMHSA-HRSA Center for Integrated Health Solutions

14. Opportunities
Heightened interest from policymakers in behavioral health system reform
Integrating medical and behavioral health care
Models in Missouri and Kansas
Interventions can work
Example: Per SAMHSA, community-based addiction treatment can reduce ER costs 39 percent, inpatient costs 35 percent, and total medical costs 26 percent.

15. challenges Inpatient capacity Funding for community systems
Billing restrictions (codes, provider types)
Workforce
Impact of opioid addiction
Regulation limiting access to information related to substance use (42 C.F.R. Part 2)
Rule revised in 2017

16. You can connect with me at: kbruffett@khi.org