Medicaid Transformation. 1115 waivers. Delivery System Reform Incentive Payment (DSRIP) programs. Expansion. Contraction. We’ve been at this for a long time. Why isn’t Medicaid transformed already?
Well… it turns out that this is really difficult work.
First off, there are complex political and ideological issues. Even if we all agree that we want the best healthcare for every American – a conceptually easy outcome to rally behind – we don’t all agree on what that looks like, how to get there, or how to pay for it.
Second, it takes a long time for policy levers to play out in the real world. That makes it exceedingly difficult to measure the success of our programs, which further exacerbates the first issue.
Add in a bunch of multi-billion-dollar entrenched institutions, technology hurdles, and social determinants of health, and you are still just scratching the surface of the many issues that need to be addressed and aligned to “succeed”.
But all is not lost. We’ve learned a lot over the past 30-40 years, and we’ve made progress in many areas. There are approaches and mental models that have led to certain levels of success. And today’s guest has been participating in and observing many of them over the past few decades.
Today we talk with Alan Weil, Editor-in-Chief of Health Affairs, the nation’s leading health policy journal.
Alan takes us through the history of Medicaid Transformation from the early 1980s on. We discuss the approaches taken, the thinking behind them, and the many factors that influenced their success. We explore the conflicts and hurdles, the friction and confounders, not to define a path forward, but to give the listener a more productive framing from which to build.
This is admittedly a bit more of a philosophical discussion than what we usually have on this show. However, I feel we’ve taken a practical approach to the philosophical exploration and yielded actionable advice on how to adjust your frame.
Please do let us know what you think!
Alan Weil is the Editor-in-Chief of Health Affairs, the nation’s leading health policy journal. He is an elected member of the National Academy of Medicine, and recently completed a term as an appointed member of the Medicaid and CHIP Payment and Access Commission (MACPAC). He is a trustee of the Consumer Health Foundation in Washington, DC and directs the Aspen Institute’s Health Strategy Group. He was the executive director of the National Academy for State Health Policy (NASHP); directed the Urban Institute’s Assessing the New Federalism project; held a cabinet position as executive director of the Colorado Department of Health Care Policy and Financing, the state’s Medicaid agency; and was assistant general counsel in the Massachusetts Department of Medical Security. Weil earned his bachelor’s degree from the University of California at Berkeley, a master’s degree from Harvard’s Kennedy School of Government, and a J.D. from Harvard Law School.
About Health Affairs
Health Affairs is the leading journal of health policy thought and research. The peer-reviewed journal was founded in 1981 under the aegis of Project HOPE, a nonprofit international health education organization. Health Affairs explores health policy issues of current concern in domestic and international spheres. Its mission is to serve as a high-level, nonpartisan forum to promote analysis and discussion on improving health and health care, and to address such issues as cost, quality, and access.
The journal reaches a broad audience that includes: government and health industry leaders; health care advocates; scholars of health, health care and health policy; and others concerned with health and health care issues in the United States and worldwide.
Health Affairs articles are cited by U.S. administration officials, U.S. lawmakers, and ministry of health leaders around the globe. Members of Congress from both sides of the aisle reference Health Affairs in drafting legislation. US Supreme Court Chief Justice John Roberts cited the journal in his decision regarding the Affordable Care Act. In addition, Health Affairs is frequently cited by national media, including the Washington Post, New York Times, Wall Street Journal, network television and radio, and NPR.
- Upcoming events at Health Affairs https://www.healthaffairs.org/upcoming-events
- Subscribe to Health Affairs Insider https://www.healthaffairs.org/subscribe/individual
- Health Affairs Council on Health Care Spending And Value report: https://www.healthaffairs.org/council-on-health-care-spending-and-value
- Twitter: https://twitter.com/Health_Affairs
- Facebook: https://www.facebook.com/HealthAffairs
- LinkedIn: https://www.linkedin.com/company/health-affairs
- Youtube: https://www.youtube.com/channel/UCwUsADInNLmtxNHd4Pw8ibw
You can also find this episode on your favorite podcast network such as:
Trying to drive change within your healthcare organization? Launching a new product? Having trouble getting decision-makers’ attention and buy-in?
We’ll help you understand the whole picture so that you can align your innovation with the things decision-makers care about. And then we’ll help you execute It’s not easy, but it’s possible and we’ll help you get there. Sign up here and we’ll keep you up to date on healthcare industry news with podcasts, blog posts, conference announcements and more. No fluff. No hype. Just the valuable (and often not-so-obvious) information you need to get things done.
Music by StudioEtar