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New Year, New Coverage for Millions

Jan 9, 2015, 2:51 PM, Posted by John R. Lumpkin

Health Care Dot Gov healthcare.gov

The beginning of a new year is a great time to reflect on progress toward longstanding goals. At RWJF, we’ve spent the better part of four decades advancing solutions to help everyone in our nation gain access to affordable, high quality health care—a goal we reaffirmed in 2014 when we announced our vision for a Culture of Health in America.

Happily, our country has made enormous progress toward this goal in 2014. Health coverage rates improved dramatically last year because of robust enrollment through the health insurance marketplaces, Medicaid, and CHIP. As we enter 2015, we continue to see strong coverage gains, with nearly 6.6 million consumers newly enrolled or renewing through HealthCare.gov.

But let’s not forget that more than 40 million people remain uninsured. There is still more work to be done to make sure all those who are eligible can get the coverage they need and deserve.

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The Patient—and Her Data—Will See You Now

Jan 7, 2015, 1:48 PM, Posted by Susan Dentzer

Smartphone Photo by Viktor Hanacek, Picjumbo.com

It’s 2015, the year that Marty McFly, the fictional character in the 1989 hit movie "Back to the Future II," visits by time traveling into the future in a souped-up DeLorean automobile. Predictably, most of the technologies the film foreshadowed haven’t been invented as of the real 2015—not the “hover board” that Marty glides along on, nor the self-lacing sneakers, nor (of course) the time travel.

But plenty else has been invented or discovered in the last 30 years, revolutionizing much of our lives, including our health and health care. If you want to feel as exhilarated, and maybe even as disoriented, as Marty did after fast-forwarding to 2015, read Dr. Eric Topol’s new book, The Patient Will See You Now: The Future of Medicine Is In Your Hands.

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The Best Defense is a Strong Offense: Strengthening Our Nation’s Outbreak Preparedness

Dec 22, 2014, 5:08 PM, Posted by Paul Kuehnert

Outbreaks 2014

In the shadow of this year’s Ebola outbreak, the Trust for America’s Health and the Robert Wood Johnson Foundation released a new report, Outbreaks: Protecting Americans from Infectious Diseases.

The report finds that while significant advances have been made in preparing for, responding to, and recovering from emergencies, gaps in preparedness remain and have been exacerbated as resources have been cut over time.

On the eve of the report’s release, I spoke with Jeffrey Levi, PhD, executive director of the Trust for America’s Health to get his thoughts on today’s preparedness landscape—think, Ebola—what to do about shrinking budgets and growing infectious disease threats, and where to go from here.

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Violence and the Media in 2014: Q&A with Lori Dorfman

Dec 18, 2014, 5:59 PM, Posted by Eric Antebi

Cease Fire A Chicago bumper sticker.

A culture of violence is the antithesis to a Culture of Health. As Risa Lavizzo-Mourey recently said in a speech to the American Public Health Association, “We will never be a healthy nation, if we continue to be a violent one.”

Violence is always in the news. But 2014 saw several high profile stories about violence dominating news cycles, including major stories about child abuse (Adrian Peterson), intimate partner violence (Ray Rice), sexual assault on college campus, and, of course, the deaths of Michael Brown and Eric Garner.

Because media coverage influences the social and political response to violence in America, I wanted to hear from Lori Dorfman, who directs the Berkeley Media Studies Group. She has spent decades monitoring how the media cover violence and other public health issues, helping public health advocates work with journalists, and helping journalists improve their coverage. The following is an excerpt of my interview with her.

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Top 10 Signs We are Building a Culture of Health

Dec 17, 2014, 7:18 PM, Posted by Catherine Arnst

Buncombe Children Playing

Last January the Robert Wood Johnson Foundation alerted the world to its new strategy: To build a Culture of Health for all, one that would allow every one of us to make healthy choices wherever we live, work, and play. A big reach, we know, but we are nothing if not optimistic. So, 12 months on, we asked ourselves—How’re we doing? Pretty good, as it turns out. Here are the top 10 signs that America is moving towards a Culture of Health (in no particular order).

10. The evidence is in—kids are beginning to slim down.

Research published in February shows continued signs of progress toward reversing the childhood obesity epidemic: Obesity prevalence among 2 to 5 year olds dropped by approximately 40 percent in eight years, a remarkable turnaround. There is still much work to do in this area, but at least our youngest kids can look forward to a healthier future.

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Home is My Facebook Page: mHealth’s Potential to Help the Vulnerable

Dec 16, 2014, 12:09 PM, Posted by Susan Dentzer

La Clinica del Pueblo LaClinica del Pueblo, a federally qualified health center in Washington, DC, serves many Latino patients — and relies increasingly on social media to communicate with vulnerable patients about sensitive topics, such as using condoms to help prevent HIV and sexually transmitted diseases.

Say the words “smartphone user” and “app,” and what comes most readily to mind is probably some hipster pulling out his iPhone to book a ride from Uber. But at last week’s mHealth Summit in Washington, D.C., those words were also linked to far different images—of highly vulnerable people seeking and obtaining health care.

Consider:

  • At La Clinica del Pueblo, a federally qualified health center (and previous RWJF grantee) based in Washington, D.C., smartphones and Facebook are key communications channels for reaching hundreds of young gay Latino men and transgender women at risk for HIV. The clinic’s executive director, Alicia Wilson, said on one panel at the mHealth conference that La Clinica’s Facebook page now has about 1,000 followers. “It allows us to spread prevention messages and bring people into care who have been marginalized,” alerting them to free counseling, testing and referral services available through the clinic, Wilson said.
  • A company called Healthvana has a Yelp-like feature that allows people to search for places to get tested for HIV or sexually transmitted diseases. They can also register and set up secure accounts to receive the results from partner testing centers quickly and discretely, along with advice about “actionable next steps” to take should the tests be positive, says CEO and founder Ramin Bastana.
  • Based in Britain, but with a growing presence in the United States, a website and social network called Big White Wall offers a “professionally curated community” for people with psychological issues or mental illness—a virtual space where they can stay anonymous and confide in others; take courses on managing depression and other illnesses; and even have secure consultations with therapists via Skype. Endorsed by England’s National Health Service, and now offered in a “soft launch” phase to enrollees of Kaiser Permanente Northwest, the site demonstrates that “the depth of the need for alternative person-centered health care across the globe is really profound,” says founder Jen Hyatt.

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How Cataract Surgery Helped Me See the Future of Health Transparency

Dec 12, 2014, 1:34 PM, Posted by Risa Lavizzo-Mourey

Robotic Surgery

More and more health care costs are shifted to consumers. So why, asks RWJF President and CEO Risa Lavizzo-Mourey, can’t we easily discover and compare health care costs and quality?

Here’s how the subject came up. Recently, Lavizzo-Mourey underwent cataract surgery at an outpatient center in Philadelphia. No matter whom she talked to—and she was shunted from one person to the next—she could not learn the all-in cost of the procedure.

Lavizzo-Mourey finally did manage to find out the cost of her surgery: $2,000, including co-pays and deductible. But the whole episode, she says, is illustrative of a larger problem.

Writing in a recent blog post on the professional social networking site LinkedIn, Lavizzo-Mourey asks: “Could there be a clearer example of the lack of transparency in the U.S. health care system?”

To get the information we need, the Robert Wood Johnson Foundation is funding a set of studies to help us better understand how greater price transparency influences consumer and provider decisions. “And in March,” Lavizzo-Mourey adds, “we will host a summit on transparency that will attempt to come up with more answers."

Along those lines, RWJF last year issued a challenge to developers to devise consumer-friendly tools to parse the abundant hospital price data released by Medicare. The winner? Consumer Reports, for the Consumer Reports Hospital Adviser: Hip & Knee, a personalized app for health care consumers seeking the best hospital for hip or knee replacement surgery.

You can help us move the cost and quality needle forward. Do you know of any other price/quality apps or tools? Let us know.

A Brave New ‘Post-Mendelian’ World

Dec 12, 2014, 9:00 AM, Posted by Lainie Ross

Lainie Ross, MD, PhD, is a 2013 recipient of the Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research and a 2014 Guggenheim Fellow. During her fellowship year, she will work on a book tentatively titled, From Peapods to Whole Genomes: Incidental Findings and Unintended Consequences in a Post-Mendelian World.

Lainie Ross

Human Capital Blog: What are some of the incidental findings and unintended consequences you will discuss in your book?

Lainie Ross: First, let me explain what I mean by “incidental findings.” Incidental findings refer to unanticipated information discovered in the course of medical care or research that may or may not have clinical significance. They are not unique to genetics. In some studies, up to one in four diagnostic imaging tests have incidental findings, although most do not have immediate clinical consequences.

One example of an incidental finding that I discuss in the book involves incidental findings uncovered while screening candidates for research participation. This can range from discovering high blood pressure (known as the “silent killer”) to extra sex chromosomes in people who volunteer as “healthy controls.” This raises the question of what is a clinically significant or “actionable” finding, and what information should be returned to the research participant. These types of questions are critical, especially because many research consent forms have historically stated that “no results will be returned.”

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How to Build a Healthier Millennial

Dec 11, 2014, 4:50 PM, Posted by Dwayne Proctor, Kristin Schubert

Game of Life Photo: Will Folsom

 

Millennials get a lot of attention as today’s trendsetters. What are they buying? What social media are they using? How are they voting?  But there is an equally important question that is rarely raised: How healthy are 20-somethings? A new report explores that last question, and the answers are not good. An even better question might be: What’s standing in the way of healthier, more productive lives for millennials?

Adults between the ages of 18 and 26 are "surprisingly unhealthy," according to the report from the Institute of Medicine (IOM) and the National Research Council (NRC). One out of every four young adults is obese, and those numbers are rising. One in 10 has suffered from untreated mental illnesses within the past year. What lies behind these disturbing trends might be a much bigger issue than what young people choose to eat or how they handle stress. The report points to big-picture causes—broken pathways from quality education to solid jobs, and widening disparities that make it harder for marginalized young adults to succeed.

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Data for Health: Live from Charleston

Dec 2, 2014, 6:21 PM, Posted by Renee Woodside

The Robert Wood Johnson Foundation had been running a five-city listening tour to learn how to better use Data for Health; the final stop was Charleston, SC, on December 11.  

While the cities we have visited have all been very different the first U.S. capital of Philadelphia to Des Moines, the corn capital; from the desert city of Phoenix to San Francisco, city by the bay—all are committed to using data and information to help improve the health of their communities.

One of the things I keep hearing is that health data needs to be communicated in a way that’s easy for a patient to interpret. I sure can relate to that! I can remember being in the hospital, on full bed rest for a week before I had my twins. And although I generally had confidence in my doctors, it was a little scary to not totally understanding why they decided to schedule my C-section early. They talked about the chances of this and the chances of that, but it was not clear to me what they were really saying, and quite frankly, in such a stressful situation, I wasn’t thinking very clearly. 

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