Author Archives: Andrea Ducas

How States Can Better Engage Medicaid Patients

Oct 29, 2018, 2:00 PM, Posted by Andrea Ducas, Tricia McGinnis

Experts weigh in on practical approaches for engaging Medicaid beneficiaries to ensure that services are designed to meet their needs.

People walking in a hallway of a government building.

Medicaid is the largest health care program in the United States and impacts the lives of more than 76 million Americans, nearly one-quarter of the nation’s population. The program can play a powerful role in influencing the health and well-being of individuals and families.

State Medicaid programs can only be truly successful, however, if they are responsive to the needs and priorities of the clients they serve—not providers, but patients and their families. Medicaid officials understand this. However, in the resource- and time-constrained environments in which Medicaid staff operate, finding the right avenues for gathering meaningful consumer input can be a challenge.

The Robert Wood Johnson Foundation has been trying to address these challenges through its work to transform health and health care systems. As part of these efforts, the Foundation along with the Center for Health Care Strategies recently engaged experts, including representatives from across the patient advocacy world, around this issue. These experts include leaders from Altarum, American Cancer Society Cancer Action Network, Community Catalyst, Georgetown Center for Children and Families, Nonprofit Finance Fund, and the Patient Advocate Foundation.

View full post

Closing Health Gaps: The Oklahoma Example

Dec 7, 2015, 8:00 AM, Posted by Andrea Ducas

With the right data to inform priorities, and a powerful commitment to equity, places like Tulsa, Okla., are making progress to close health gaps.

Adult and child reading a book in the classroom.

What would your ideal future look like? For me and my colleagues at the Foundation, it would be one where everyone has the opportunity to live the healthiest life they can.

An unfortunate reality in this country, however, is that while we continue to realize substantial gains in health, the things that help people become and stay healthy are not evenly distributed across states or even metropolitan areas. Access to healthy foods, opportunities for exercise, good-paying jobs, good schools, and high quality health care services may be readily available in one area, and difficult to come by or nonexistent in another just a few miles away.

Sometimes the differences are particularly stark: In some communities, two children growing up just a short subway or car ride apart could be separated by a 10-year difference in life expectancy.

So how do we square this reality with the Culture of Health we’re working hard with others to build? An important first step is recognizing those disparities and what’s driving them, and ensuring that people in communities across America have strategies – and the data – they can use to proactively close health gaps.

Let’s use Oklahoma, and within it the city of Tulsa, as an example.

View full post

Let's Keep the Payment Reform Momentum Going

Mar 31, 2015, 10:22 AM, Posted by Andrea Ducas

Recent advancements in payment reform have been massive and exciting. It's time to sustain the momentum and transform how we pay for and deliver care.

A hundred dollar bill. Modified image. Original photo by Ervins Strauhmanis.

When it comes to how health care providers are paid, change is in the air. I’m probably more excited than most people about trying to make sure our financial incentives are flowing the right way within the health care system. Here’s why.

View full post

Exactly How Much DOES That Appendectomy Cost?

Aug 1, 2014, 4:29 PM, Posted by Andrea Ducas

A nurse conferring with a doctor in a hospital.

Want to know one of health care’s dirty little secrets? While we know how much the country spends on care each year, we have little understanding of what it actually costs to provide care.

Think, for example, about an appendectomy. What does it really “cost” the health care system to perform that procedure? The answer is complex, and of course it includes everyone’s time—from the surgeon to housekeeping staff—and it also includes the drugs, equipment, space, and overhead associated with your stay.

The cost of your visit will also depend on who is delivering your care. A consult with a registered nurse (RN) is less costly to the hospital than one with a physician.

Then, consider insurance. If the price your carrier pays for that RN consult is $85, but the price another carrier pays is only $65, what does it actually cost the hospital—and how do those variances affect what you pay both out-of-pocket and for insurance premiums? Moreover, health care providers are currently not trained to think about the costs of the care they provide—and often have no incentive or means to even consider those costs.

These complexities have made it difficult to reform the way we purchase and pay for health care.

View full post

A New Way of Looking at Health

Feb 18, 2014, 3:58 PM, Posted by Andrea Ducas, Thomas Goetz

Infographic putting outbreaks of disease into context. “Putting outbreaks of disease into context” via VizHealth.org. The VizHealth site and the associated content are available under GNU Lesser General Public License version 3.0 (LGPL-3.0) and Creative Commons Attribution 3.0 United States licenses.

It’s not always easy to think in statistics.

While that statement might seem obvious, applying that knowledge when it comes to health and health care is anything but.

Think, for example, about your last visit to the doctor. (Doctors, put on your patient hats and bear with us.) In the first couple of minutes, you (we hope) had your blood pressure, weight, and other vital signs checked. You might have also talked about changes you could make—like exercising more or quitting smoking—and how they might decrease your risk of developing a chronic disease or help you live longer.

As a patient, all of this information is valuable, but it is not often meaningful or actionable: what does a systolic blood pressure of 175 actually mean? Exercising regularly might bring my risk for diabetes down, but by how much? And what does that difference translate to for me?

There are lots of ways to answer these questions, but up until recently there hasn’t been much clarity at all when it comes to how to communicate those answers effectively. That’s why we’re so excited to announce the launch of our newest project, Visualizing Health.

View full post

A Culture of Empowerment, a Culture of Health

Jul 22, 2013, 4:15 PM, Posted by Andrea Ducas

Doctor examines a patient in hospital room

The thin, paper-like hospital gown. Open. Exposing. Awkward. The perfect symbol for what health care in America represents for most of us.

As a bit of context, last week I spent three days with a group of amazing women from across the health care industry at an RWJF-sponsored forum hosted by the Association of American Medical Colleges. At that meeting, a key part of the discussion centered on where the opportunity for meaningful, collective, action might lie to catalyze dramatic system transformation. More than once, the hospital gown metaphor came up.

To me, though, this symbol represents much more than a call for system transformation—I see it as a battle cry for empowerment.

Let me explain.

View full post