Modernizing Medicare and Medicaid Means Addressing the Affordability Crisis

  • Published On  Oct 28, 2021
  • Publication  Healthcare Finance
  • Author  Nathan Eddy


Medicare and Medicaid populations must not be ignored in health modernization efforts, said panelists during the HLTH conference in Boston. On October 19, the panel took up the challenge of finding new ways to lower costs and improve outcomes for patients enrolled in Medicare, Medicaid, Medicare Advantage and dual eligible populations.

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The panel, moderated by Natalie Davis, CEO of the United States of Care, included Alicia Stokes, vice president of strategy planning and performance for government markets at Blue Cross and Blue Shield of North Carolina; Dr. Marisa Rogers, executive medical director of Oak Street Health; Jay Bhatt, chief clinical product officer and medical director at Medical Home Network; and Misu Tasnim, director of digital services at the Centers for Medicare and Medicaid Services.

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Bhatt said it was important to look at modernization efforts from the perspective of reducing the patient's total out-of-pocket spending.

"We've looked at creating a kind of data liquidity and real-time data, along with a workforce that's able to access it and put it to work, built on health-risk assessments," he said. "That means structured workflows, addressing reliability and doing it consistently every time in a way that can deliver outcomes of reducing total cost of care."

By investing in those tools, resources, structures and partners to support those data-driven outcomes, Medical Home Network has been able to realize $100 million in shared savings over the last five years, Bhatt said.

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