Monday, February 12, 2024
Saturday, April 8, 2017
My Community and Professional Accomplishments
1) Past and Founding Chair of Safe Silver Spring, 2009-2016. See http://tinyurl.com/sssaccompl for a list of our accomplishments. 2) American Association of Individual Investors: Chair, Chapter Leaders Executive Committee; Program Co-chair and Past President, DC Metro Chapter. 3) Spent 40 years as a community activist and 35 years professionally in human services, mainly with the US Centers for Medicare and Medicaid Services (CMS). Here is a summary of my community and professional activities during this time period: http://tinyurl.com/thc mtyprofaccompl
CBPP: House ACA Repeal Bill Would Be Largest Robin-Hood-in-Reverse Transfer in Modern U.S. History
House ACA Repeal Bill Would Be Largest Robin-Hood-in-Reverse Transfer in Modern U.S. History http://www.cbpp.org/blog/house -aca-repeal-bill-would-be- largest-robin-hood-in-reverse- transfer-in-modern-us-history
I highly respect Bob Greenstein. He is a top analyst in the field. I suggest this be shared widely. I did not realize the magnitude of this policy change. This is a big deal in my opinion.
Thursday, January 5, 2017
Accomplishments for Safe Silver Spring 2009-2016
In 2016, we successfully supported increases in County resources to address gangs, and
revisions in county deportation policies.
We also successfully supported legislation on body cameras, and criminal
justice reforms.
•
In 2015, we
supported successful passage in the Maryland Assembly of police body camera
legislation, a domestic violence bill dealing with dating relations, and the Second
Chance Act which passed the legislature but the Governor vetoed.
•
In 2014, we
supported successful passage of several domestic violence bills, marijuana
decriminalization, a county ban the box bill, and restoration to a full
complement of School Resource Officers.
•
In 2013, we
helped Gov. Martin O’Malley pass the most sweeping gun safety bill in the
country while continuing our efforts in Montgomery County to expand the police
force and provide youths with alternatives to crime.
• Councilmember Ervin
initiated several truancy efforts, including a Truancy Court Pilot Program now expanded
to 8 middle schools in this county.
• The Commonweal Foundation
funded a summer program for low income youth in Long Branch that included
academic and sports programs
• The Police Department
initiated the “Safe City” program in
Downtown Silver Spring which includes greater communications between police and
businesses and as well as greater use of information from videocameras.
• In previous years, the
Maryland assembly enacted several bills that Safe Silver Spring had supported,
including domestic violence, nuisance abatement, and Safe Schools Act.
• The County Executive
reformulated the Youth Advisory Councils to have more of a voice in youth
programs.
• Established a partnership
with 3rd District Police Division and working relations with many
organizations.
Wednesday, August 31, 2016
High Need, High Cost Patients
Been awhile since I have posted on this blog. I have cut back on my health reform agenda as I have focused on other projects, especially on investment education in my leadership roles with AAII and with criminal justice projects, as Chair/President of Safe Silver Spring. Also, active in politics and promotion of a preview showing of Denial" a film about a famous Holocaust denial trial.
I do post articles quite often on the following facebook page
https://www.facebook.com/NationalHealthReformTeamForObama/ as well as my facebook page at Tony Hausner.
Recently, I noticed that the Alliance for Health Reform was sponsoring a program on: High Need, High Cost Patients. Karen Davis, now at Hopkins was one of the key speakers. I am a longtime fan of Karen. Here is what I shared on facebook afterwards.
I do post articles quite often on the following facebook page
https://www.facebook.com/NationalHealthReformTeamForObama/ as well as my facebook page at Tony Hausner.
Recently, I noticed that the Alliance for Health Reform was sponsoring a program on: High Need, High Cost Patients. Karen Davis, now at Hopkins was one of the key speakers. I am a longtime fan of Karen. Here is what I shared on facebook afterwards.
http://www.commonwealthfund. org/publications/issue-briefs/ 2016/aug/high-need-high-cost- patients-meps2 Alliance for Health Reform and Commonwealth Fund hosted a C-span forum on High Need, High Cost Patients: Challenges and Promising Models. The paper here was part of the package and lays out some of the key issues. The forum presenters discussed the needs and potential solutions. An excellent discussion. Very glad that I attended.
These patients cost $21,000 per person per year which is 3 times adults with multiple chronic diseases but no ADL limits and 4 times the average adult.
Here are a few thoughts that I wrote up afterwards on addressing these and related issues. Many of these are consistent with what others including the panel members have said.
- Greater integration of post acute services
- Greater integration of Medicare/Medicaid programs for duals
- A more comprehensive long term care services system that is affordable
- Greater integration of health and other human service programs, etc.
- More comprehensive quality outcome measures. And greater integration of measures across services. Each service has unique measures right now, e.g., home health and nursing homes are very different sets
- I particularly like Atul Gawande's paper on "The Hot Spotters"
- Electronic data systems need much greater integration. A great deal of work needed to develop compatible systems between health care services and even within a given service. Partly tied to quality measures above but need for more consistency even within a given service, e.g., many different hospital systems.
- More rigorous evaluation research strategies. CMS has gotten away from the model that we used in the first 35 years of the program.
Thursday, January 7, 2016
Tuesday, June 9, 2015
My Medicare/Medicaid Story; Blog Status
As indicated, I am doing very little blogging these days as I have cut back on my involvement in health reform in favor of other activities. I have been posting articles of significance on a facebook page: National Health Reform Team for Obama as well as on my facebook page.
My Medicare/Medicaid Story
For Medicare and Medicaid's 50th anniversary which is this year, CMS has requested CMS employees and alumni to submit stories concerning our contributions to the program. Here is what I submiited.
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My Medicare/Medicaid Story
For Medicare and Medicaid's 50th anniversary which is this year, CMS has requested CMS employees and alumni to submit stories concerning our contributions to the program. Here is what I submiited.
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I worked at CMS from
1979-2006. Where I had the privilege to work on many important projects. For 13
years, I was in the Office of Research and Demonstrations (ORD) and the
remaining 13 years in the Managed Care Policy Division. I want to single
out 4 stories which have particular significance for me.
1) The Evaluation of the Obstetrical Access
Project.
I served as the
evaluation project officer for this grant.
This project was
written up in the Health Care Financing Review in 1987. This project expanded
the women eligible to participate in the Medicaid and included an expanded set
of prenatal care services of psychosocial, health education and nutrition
services. The project achieved a 33% reduction in low-birth-weight babies vs. a
matched control group. This was cited as an incredibly successful
project. The study was cited as a key finding when Congress twice expanded the Medicaid
prenatal care program in 1985 and 1987. This has resulted in a tremendous
increase in the number of healthy infants being born and savings both short
term and long term in costs to the U.S.
2) Home Health Prospective Payment Demonstration
From 1985-1993, I
served as the evaluation project officer for this demonstration. During
this time period, I worked with the evaluation contractor, Mathematica Policy
Research, to develop the case-mix system to be used in the demonstration. The
system that we developed was incorporated for the most part into the Outcome and Assessment Information Set
(OASIS) which CMS (then called HCFA) implemented as written into
legislation in the 1998 Budget bill. This prospective payment system has
resulted in tremendous savings to the Medicare program and is still used today.
3) Home Health Quality of Care Demonstration
In 1985, I proposed that
CMS (HCFA) develop an outcome based approach to the quality of care for home
health services. This approach focused on the following outcome
measures: re-hospitalizations and activities of daily living (ADLs)
such as eating, bathing,
dressing, toileting, and transferring. These ADLs are considered key to
successful rehabilitation of home health patients. CMS and the Robert
Wood Johnson Foundation combined to award a contract to the University of
Colorado to develop such a measurement system. I served as project
officer for the first 5 years of that contract. After successful completion of
that contract, which occurred after I left ORD, another contract was awarded to
test these outcome measures in a demonstration. That demonstration
resulted in a 25% reduction in re-hospitalizations, which represents a dramatic
savings to the Medicare program. Those measures were incorporated into
the OASIS system mentioned above to ensure that not only was payment optimal
but also to maximize the quality of care outcomes.
4) Medicare + Choice regulations
In the 1997 Budget
bill, Congress authorized the Medicare+Choice program. This program
significantly expanded the Medicare HMO program with many new policy features
such as case mix payment, bidding, rate setting, marketing plans, access and
quality of care provisions, etc. Congress mandated that CMS (HCFA) issue
interim final rules within 9 months of enactment, an incredibly short period of
time for such rule development. I was tasked with coordinating the efforts of
23 workgroups which were assigned the different provisions of these
rules. Five months after enactment, we held a public meeting to layout
some of our preliminary thoughts and questions and receive the public's input
on these issues. In developing the rules, we had to brief
CMS officials, Department officials and OMB staff. We published the
interim final rules exactly on our deadline which was considered an incredible
accomplishment. Many of these provisions were incorporated into the current
Medicare Advantage program.
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