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Roundup: Foundation-Funded Efforts in Cardiovascular Health, Medicaid



June 30th, 2010

Today I am focusing on what foundations are funding in the areas of cardiovascular health and Medicaid. Some of the funders mentioned in this selective sample of foundation efforts may be new to you.

Medicaid is back in the news. According to the media and the National Conference of State Legislatures, it is not at all certain that Congress will extend the enhanced Medicaid match (which was established in the 2009 stimulus bill) for another six months, until June 30, 2011. Most states were hoping for that federal funding to help their budgets, as the New York Times notes.

Cardiovascular Health

Two foundations that are funding in this area:

The AstraZeneca HealthCare Foundation, based in Wilmington, Delaware, started the Connections for Cardiovascular Health program in April 2010. This program will fund 501(c)(3) organizations (or similar nonprofit groups) “working to improve cardiovascular health” in the United States, according to this corporate foundation’s Web site. The foundation will award grants of $150,000 or more annually. Among the criteria for a grant is that the applicant will “respond to the urgency around addressing cardiovascular health issues, including cardiovascular disease or conditions contributing to cardiovascular disease.” The foundation also notes that initiatives should be “focused on measurable results,” and applicants “must be able to demonstrate sustainability of the initiative” after AstraZeneca HealthCare Foundation funding ends and “must be able to demonstrate ongoing activity in helping to improve cardiovascular health.”

The deadline to apply for this new program is July 31, 2010. Click here for a list of frequently asked questions about the program.

The Medtronic Foundation, based in Minneapolis, Minnesota, also funds in the area of cardiovascular health. Its HeartRescue program has recently expanded its focus. Historically, the program aimed to educate people so that they “understand the risk factors” for sudden cardiac arrest (SCA), “recognize SCA when it happens, and take immediate action to help save a life when it does,” according to the foundation’s Web site. Rich Fischer, communications manager for the foundation, explained in an e-mail that now “HeartRescue funding is allocated to support community to statewide initiatives that focus on a ‘systems-based’ approach to [SCA] response.” He said that by “working with select, premier partners, efforts will be focused on developing an integrated community response to SCA, coordinating education, training, and the application of high-tech treatments among the general public, first responders (police/fire), emergency medical services (EMS), and hospitals.” As of now, full grant applications are “accepted by invitation only,” Fischer noted. He explained that in the future, interested applicants will be able to submit a letter of inquiry, but they cannot apply for this program without prior approval.

Related resources:

The January/February 2007 issue of Health Affairs has as its theme cardiovascular disease and society. Because the issue has been in print for more than three years, all content is now accessible online at no charge. Authors include David Cutler, Arnie Milstein, and Mark Smith.

Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health, Institute of Medicine (IOM) Consensus Report, released March 22, 2010. Among the members of the committee that prepared this report is Derek Yach, formerly of the Rockefeller Foundation.

Medicaid

Publications:

Medicaid Coverage and Spending in Health Reform: National and State-by-State Results for Adults at or below 133 Percent FPL, written by John Holahan and Irene Headen of the Urban Institute, and released May 26, 2010, by the Henry J. Kaiser Family Foundation’s (KFF’s) Kaiser Commission on Medicaid and the Uninsured. The KFF points out on its Web site that “health reform will offer Medicaid coverage to millions of low-income adults for the first time and help establish a national floor for Medicaid eligibility that contrasts sharply with the wide variation in eligibility across state Medicaid programs today.” In the report, the authors state that their “analysis provides national and state-by-state estimates of the increases in coverage and the associated costs” under the Patient Protection and Affordable Care Act, compared with “a baseline scenario without the Medicaid expansions.”

Key findings are that nationally and across states, under what the authors call a “standard participation scenario,” (1) “Medicaid expansions will significantly increase coverage and reduce the number of uninsured,” especially among adults; (2) “the federal government will pay a very high share of new Medicaid costs in all states”; and (3) “increases in state spending are small compared to increases in coverage and federal revenues and relative to what states would have spent if [health] reform had not been enacted.” The report notes that “states with low coverage levels and higher uninsured rates today will see larger reductions” in the number of uninsured people than other states will. Examples of states expected to see bigger reductions are Alabama and Texas.

For their analysis, the authors also looked at another scenario that assumes “a more aggressive outreach and enrollment campaign” aimed at those who are newly eligible for Medicaid, as well as those currently eligible under the federal and state program.

The authors applied assumptions “uniformly across states.” However, they point out that “it is impossible to know how individual states will respond” to health reform.

More information is available here about the May 2010 briefing at which the report was released.

Medicaid: A Primer—Key Information on Our Nation’s Health Coverage Program for Low-Income People, Kaiser Commission on Medicaid and the Uninsured, June 2010. A revision of the December 2008 version of the primer, this publication answers important questions for Americans regarding this complex federal and state program. Questions addressed include what is Medicaid, who is covered by the program, what services does it cover, and how health reform will reshape it.

“Missouri Medicaid Basics: Spring 2010,” Missouri Foundation for Health (MFFH). The latest iteration of this short publication, released in May 2010, includes information on how the new federal health reform legislation affects Missouri’s Medicaid program, which is called “MO HealthNet.” It also includes a discussion of this program’s eligibility criteria and mandatory services. Factoids appear on the front page. Here are two: One of seven Missourians is on Medicaid, and the program pays for 48 percent of all births in Missouri. Ryan Barker, director of health policy for MFFH, prepared the brief, which also notes that about 26 percent of the state’s “total budget will go to MO HealthNet in state fiscal year (SFY) 2010.”

Related resources:

“Aid to States May Be Lost as Jobs Bill Stalls,” Michael Luo and Sarah Wheaton, New York Times, June 25, 2010.

Most Medicaid Children in Nine States Are Not Receiving All Required Preventive Screening Services, Office of Inspector General, U.S. Department of Health and Human Services (HHS), May 2010. This report focuses on Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program for children under age twenty-one. The study looks at just the medical, vision, and hearing screenings. A May 21, 2010, post on the Prevention Matters blog of Partnership for Prevention comments that “this report is a reminder that [health care] coverage alone isn’t enough to assure access.” On June 2, 2010, the partnership said that it had selected “children on Medicaid not receiving all required preventive screening services” (as detailed in this HHS report) as the Worst Prevention Idea of the Week.

The Pennsylvania Medicaid Policy Center is “an independent and non-partisan source of information and analysis about Pennsylvania Medical Assistance,” the state’s Medicaid program. The center is based at the University of Pittsburgh’s Graduate School of Public Health and is directed by Judith Lave. The Pew Charitable Trusts and the Pottstown Area Health and Wellness Foundation fund the center. I understand from Karen Feinstein at the Jewish Healthcare Foundation that this Pittsburgh-based funder plans to award another grant to the center, in addition to the start-up funding it provided.

 The center has posted an updated report on dental coverage for children under Pennsylvania Medicaid during 2009; authors of the report are Monica Costlow and Lave. According to a June 2010 press release, “despite program improvements, a significant number of children in Pennsylvania covered by Medicaid did not receive basic dental health services that could help prevent serious medical problems.”

“Ready, Set, Plan, Implement: Executing the Expansion of Medicaid,” Leighton Ku of the George Washington University, Health Affairs, June 2010.

The Rethinking Care Program of the Center for Health Care Strategies, funded by Kaiser Permanente (KP) and the Aetna and Robert Wood Johnson Foundations, with local support from the New York State Health and Colorado Health Foundations. This program, which began in 2008, focuses on Medicaid’s highest-need, highest-cost enrollees—many of whom have multiple chronic illnesses. The program aims to “improve care and control costs” for these enrollees. Rethinking Care serves “as a national ‘learning laboratory’ to design and test better approaches to care” for them. It links pilot projects in the states (projects have been established in Colorado, New York, Pennsylvania, and Washington State) with a national learning network committed to advancing Medicaid’s ability to serve these enrollees.

Ray Baxter of KP commented in an April 2009 press release announcing KP’s four-year grant of $2.5 million to Rethinking Care that “ultimately, the lessons from this work can help other purchasers, especially Medicare, the Veterans Administration, and employers with aging workforces, in their efforts to improve care and control spending for high-need, high-cost patients.”

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