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.”

Round-Up: Health Care for the Elderly, Health Policy, Nurses, Value of Care—Reports, Funding Available, and More


June 23rd, 2010

Here are some more items that have come across my desk in recent months that you may want to check out.

Health Care for the Elderly

Request for Proposals (RFP):

The Step Up to Stop Falls: Falls Prevention Collaborative aims “to help older adults to continue living safely in the community for as long as possible by reducing falls.” Two types of grants will be awarded by its funder, the Community Health Foundation of Western and Central New York. Only teams within certain counties in New York State may apply for funding. Deadlines for proposals are 8 July and 15 July 2010. Read the Program Announcement here.

Fellowship Program:

Health and Aging Policy Fellows Program. This program, based at Columbia University and directed by Harold Alan Pincus, is supported by the Atlantic Philanthropies. Among the 2009–10 fellows is Chad Boult of the Johns Hopkins University’s Bloomberg School of Public Health. The program also has a partnership with the John Heinz Senate Fellowship in Issues of the Aging and with the Healthy Aging Program at the Centers for Disease Control and Prevention (CDC). The deadline to apply for the 2011–12 class of fellows will be in April 2011; that fellowship year will run from October 2011 through 30 September 2012.

Related resource:

“Health Policy Brief: Health Reform’s Changes in Medicare,” Health Affairs, 20 May 2010.

Health Policy

Job Openings:

The Commonwealth Fund seeks a senior director for health care delivery policy. “It is anticipated” that this position will be in AcademyHealth’s Washington, D.C., office, said an e-alert. The person selected for this position will report to Stephen Schoenbaum, Commonwealth’s executive vice president for programs. Click here for a position description.

Commonwealth also has openings for a research associate and a program assistant described on that same page. From what I can tell, those positions appear to be at the Commonwealth Fund in New York City.

Fellowship Program:

The Commonwealth Fund’s Harkness Fellowships in Health Care Policy and Practice. Qualified people from Australia, Germany, the Netherlands, New Zealand, Norway, Switzerland, and the United Kingdom may apply for this fellowship for mid-career professionals, according to an e-alert. “Academic researchers, government policymakers, clinicians, managers, and journalists” are invited to apply to spend a year “in the United States conducting a policy-oriented research study, working with leading U.S. health policy experts and gaining in-depth knowledge” of the U.S. health system, as well as the system in their home country. The Commonwealth Fund also organizes seminars for fellows throughout the year. For fellowship eligibility requirements, a description of the “anticipated product” that each Harkness fellow will be expected to prepare, and other details, click here. The deadline for applying is 13 September 2010. Questions? Send e-mail to Robin Osborn at Commonwealth, ro@cmwf.org.

Nurses

Announcement:

The Robert Wood Johnson Foundation’s Executive Nurse Fellows program has a new national program office: the Center for Creative Leadership, located in Greensboro, North Carolina. Linda Cronenwett and David Altman are the new program directors. Read more in an April 2010 press release.

Publications:

“The Nurse in Your Health Care Future,” Thomas Aschenbrener, Oregonian (Portland), 24 May 2010. The writer of this op-ed is the president of the Northwest Health Foundation (NWHF), also located in Portland. (The foundation funds only in Oregon and southwestern Washington State, except for one national program–see below.) In this piece, Aschenbrener mentions the challenge of providing health services to millions more people in the United States, following the passage of national health reform legislation. He says that we need to look at approaches that are already effective. “One area of great success,” he notes, is “nurse-run clinics.” In fact, he imagines that by 2025 there will be “a health system where virtually all primary care in the United States is delivered by nurses and nurse practitioners.”

Read about the collaboration between the NWHF and the Robert Wood Johnson Foundation (RWJF) called Partners Investing in Nursing’s Future (PIN). Projects throughout the United States are eligible to apply.

A Summary of the December 2009 Forum on the Future of Nursing: Care in the Community, Institute of Medicine (IOM), released 3 June 2010. This workshop summary contains “the opinion of the presenters,” according to the IOM’s Web site. The forum, an activity of the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, focused on community health, public health, primary care, and long-term care. Former U.S. Health and Human Services Secretary Donna Shalala chairs the initiative.

Related resource:

“Strategically Addressing the Nurse Shortage: A Closer Look at the Nurse Funders Collaborative,” Denise A. Davis and Melanie D. Napier, Health Affairs, May/June 2008. In this GrantWatch article, the authors look at “a group of foundations, government agencies, and corporations convened by the Robert Wood Johnson Foundation.”

Value of Care

Report:

Leadership Commitments to Improve Value in Healthcare: Toward Common Ground, IOM, released 14 June 2010. Funders of this workshop summary include the Blue Shield of California Foundation, California HealthCare Foundation, and Burroughs Wellcome Fund. The IOM convened “stakeholders to discuss opportunities and cooperative strategies to improve the efficiency and effectiveness of care throughout the nation,” according to its Web site.

Related resource:

“How Can We Make More Progress in Measuring Physicians’ Performance to Improve the Value of Care?” Thomas P. Miller, Troyen A. Brennan, and Arnold Milstein, Health Affairs, September/October 2009.

A Foundation’s Win At Public Health Policy on Smoking


June 15th, 2010

Using Political Tactics and Strategies at the State Level to Achieve a Ban on Smoking in Indoor Public Places and Workspaces 

As a foundation committed to shaping health policy, we at the Sunflower Foundation made a decision to fund a public policy campaign as a special initiative, rather than a grant program, primarily because there was no nonprofit organization that had the capacity to direct an extensive political campaign in the window of time available. This experience has significantly informed our work in public policy, and we are sharing the strategies and lessons we learned with colleagues and other nonprofit organizations interested in public policy work.

The campaign was funded by Sunflower Foundation, with support from the Health Care Foundation of Greater Kansas City. Sunflower Foundation is classified as a public charity organization and reports its lobbying expenditures under section 501(h) of the Internal Revenue Code. Please note that only foundations classified as public charities can engage in lobbying. Private foundations may support public charities that lobby, but there are specific rules they must follow. Click here for more information on the legal aspects related to foundation lobbying.

******************************************************************************

After a decade of observing proposed legislation on public smoking bans die for lack of support in the Kansas Legislature, the Sunflower Foundation decided to develop and support a grassroots campaign for the sole objective of getting a statewide law passed that prohibits smoking in public settings. After two years of planning, the campaign was launched in January 2009. Fifteen months later (March 2010), Kansas Gov. Mark Parkinson (D), whose personal commitment to the issue was significant, signed into law the Kansas Clean Indoor Air Act. The ban on smoking in indoor public places and workspaces, including bars and restaurants, is effective 1 July 2010. (Certain venues are exempt.)

What we knew…

Going into the campaign for clean indoor air, we knew that we had public opinion and evidence-based science on our side. According to a public opinion poll commissioned in 2008 by the Sunflower Foundation, 71 percent of Kansas voters were in favor of a state law. The opposition to such a ban on smoking was well organized, and those helping the opposition were politically influential, however. The case that they made against the law focused on civil liberties and local control. Those who opposed the legislation organized Kansas business owners around business rights and fear of economic losses, even though data from states with smoking bans did not justify this fear.

What we did…

To break the cycle, we hired a national firm that works at the grassroots level to teach us how to mount an effective grassroots campaign. The firm told us what we already had come to know: People matter, and their voices need to be heard. To complement the grassroots advocacy, we hired an experienced Kansas lobbying firm to work with our legislators. We also began an aggressive online advocacy campaign, beginning with a traditional Web-based messaging and media approach and adding social media, including Facebook and Twitter, to our strategies. Finally, we brought the public health partners together to work out in advance their responses to any issues that might divide them (for example, smoking ban exemptions). This “lines in the sand” exercise was done to help the partners withstand the opposition’s “death by a thousand cuts” attempt to weaken the legislation to the point of complete ineffectiveness.

What happened…

Our work began tentatively in 2009 and in earnest in 2010. In 2009, the Kansas Senate passed a smoking ban bill that was sent to the House. Knowing that there were not enough votes in favor in the Kansas House in 2009, our lobbying team worked with legislative leadership so that the bill would move to conference committee and carry over to the 2010 session. Once we knew where the twenty “maybe” votes were, the campaign ramped up its grassroots advocacy efforts and targeted the home districts of those representatives.

Using data from the state voter files, we contracted with a phone messaging firm to call thousands of registered voters in the targeted districts and asked each of them about their position on clean indoor air. Four groups of constituents were identified: those potentially interested individuals who might sign the Clean Air Kansas pledge and provide names of other potential contacts; supporters or individuals who signed the Clean Air Kansas pledge and provided their names and contact information; members of Clean Air Kansas who undertook one action for the cause, such as calling their legislator or attending a meeting; and individuals who participated in two or more actions on behalf of the campaign—the aptly named “Super Advocates”—who were then recruited for campaign work or to testify before the legislature.

The campaign also used the concept of “pings,” or personal contacts between a legislator and a supporter (such as face-to face meetings, phone calls, or a handwritten letter). The goal of pings is to create an environment around the targeted lawmakers in which it seems everyone is talking about the issue—thus moving the conversation beyond the statehouse to the policy makers’ communities.

The Voices Project—A Breakthrough

As the grassroots activity increased, Kansans began sharing their personal stories and why they wanted a state indoor smoking ban. Working with the phone messaging firm, the campaign designed an innovative system that gave those people we called the option to record a personal message. The results were amazing.

Within one month, over 10,000 supportive Kansas voters had been identified, and more than 4,000 compelling “audio postcards” were collected from the targeted districts. The stories ran the gamut from hope to heartbreak, and the storytellers ranged from employee to business owner, and from health professional to smoker–each with a different personal reason for supporting the campaign. To manage the volume of stories, the team created custom CDs. These CDs were given to the lawmakers in the targeted districts weekly, as they left the legislative session for their long drive from Topeka back to their home districts.

Many lawmakers recognized the voices of their friends and neighbors, although they had never discussed this issue with most of them before. The recordings were also catalogued and featured on the campaign’s Web site, which enabled the media to connect real people and real stories across Kansas to the issue. Read a news article by the Kansas Health Institute’s News Service here.

The Clean Air Kansas campaign and its consultants won a 2010 Pollie Award for their innovative use of technology for the Voices Project.

Lessons Learned

First, it’s crucial to know where the public is on an issue as you develop a public policy strategy. Polling is an excellent way to make that determination, and it’s a good idea to oversample the areas that fit the political landscape in which you’re working. (In Kansas, for example, that meant Republican primary voters.)

Second, we learned that, as advocates, we tended to focus too much on legislative processes. We need to be sure that policy makers are hearing the same advocacy messages in their everyday lives as they do in their legislative lives.

Third, we need to incorporate political thinking and strategies in all of our public health policy work. The most effective campaigns include direct lobbying, grassroots advocacy, and media—especially social media. All of these components were crucial for this legislative victory.

It’s time to employ the power of the grassroots, new media, and lobbying so that we can achieve our health goals and help those we serve live healthier, safer lives.

The Sunflower Foundation was established in 2000 as the result of a $75 million settlement from litigation involving the Kansas attorney general, the Kansas insurance commissioner, and Blue Cross Blue Shield of Kansas. The settlement agreement charged the foundation with serving the health needs of Kansans.

Round-Up: Philanthropy Efforts in Global Health


June 10th, 2010

Some interesting items have come across my desk in recent months that you may want to check out.

Reports:

“Innovation in Action: Policies to Accelerate Development and Delivery of Global Health Tools,” Global Health Technologies Council, April 2010. The council is funded by the Bill and Melinda Gates Foundation. This short policy report “examines the financing and regulatory issues that affect global health R&D [research and development], highlighting why innovation and product development are critical to the overall US global health strategy.” The report’s recommendations for Congress and the Obama administration center on “public financing policy actions,” “strong, coordinated regulatory systems,” and “incentives and innovative financing mechanisms” that can “encourage a diverse set of actors with R&D expertise” to concentrate on “solving the health challenges of the developing world.”

Toward the Tipping Point: WHO-HCWH Global Initiative to Substitute Mercury-Based Medical Devices in Health Care, 2 June 2010. The World Health Organization (WHO) and Health Care Without Harm (HCWH), an international coalition of more than 400 groups in fifty-two countries “working to transform the health care sector so it is no longer a source of harm to people and the environment,” published this report. The goal of this mercury-free health care initiative is “by 2017, [to] phase out the demand for mercury-containing fever thermometers and sphygmomanometers [blood pressure monitoring devices] by at least 70% and to shift the production” of all such devices containing mercury “to accurate, affordable, and safer non-mercury alternatives.”

Gary Cohen, president of HCWH, said in an e-mail interview that HCWH has “received funding from the Oak Foundation and the Skoll Foundation to support [its] international efforts to eliminate mercury from the healthcare sector.” He explained that “the Skoll Foundation’s orientation is to support organizations that have proved” that a model “works in one or a few places,” then it gives such groups funding “to scale up their experiences.” Cohen said that “the foundation was impressed with HCWH’s victory on eliminating mercury from the U.S. healthcare sector and wanted to support the organization to win a mercury phase-out at the global level.”

He added that “the Oak Foundation has been a supporter of our international program from the early days of HCWH and [has] supported the production of reports” as well as international advocacy efforts. Also, HCWH. “received funding from the Marisla Foundation to globalize [its] mercury and safer chemicals work,” he told the blog.

Read an interesting post by Julie Jacobs on the Skoll Foundation’s blog. She focuses on an article about Riders for Health’s work in Gambia. The article was published in the Summer 2010 issue of the Stanford Social Innovation Review. Read about how Riders for Health literally mobilizes health care workers so that they can reach people in Africa. A very good idea!

Recently announced funding:

“Gates Effort to Focus on Mother and Child,” Denise Grady, New York Times, 7 June 2010. This newspaper reports that the Bill and Melinda Gates Foundation’s plans to spend $1.5 billion (yes, billion is not a typo) “over the next five years on maternal and child health, family planning and nutrition programs in developing countries,” and this represents “a new emphasis for the foundation, whose health efforts so far have focused on infectious diseases, vaccines and HIV and AIDS.” Grady interviewed Melinda Gates to find out why the foundation is moving in this direction. India and Ethiopia are among the countries where this large amount of funding will be focused. Read the official Gates Foundation press release here.

The White Ribbon Alliance for Safe Motherhood, an international coalition, received a $4.5 million grant from the Gates Foundation and a $400,000 grant from the John D. and Catherine T. MacArthur Foundation “to help make pregnancy and childbirth safer for women and newborns around the world,” according to a 27 April 2010 press release. The grantee will “continue to build and energize a movement to save the lives of women and newborns.” Specifically, the alliance “will advocate for financial and policy commitments” to reduce mortality “and continue [its] global advocacy drive to ensure maternal and newborn health is on the agenda during key international development events.” The release points out that “reducing maternal mortality is a worthy goal in itself, but it is also a key indicator for measuring how well health systems are functioning for all people.” The coalition, based in Washington, D.C., and London, has member organizations in 148 countries, the release stated.

Read a 9 June 2010 press release regarding celebrities, including Celine Dion, Judi Dench, and Scarlett Johansson who have signed an open letter to leaders of G8 countries “calling maternal mortality ‘a human rights crisis demanding immediate action.’” The G8 leaders will be meeting in June 2010.

More foundations that fund in global health:

The Merck Company Foundation, based in Whitehouse Station, New Jersey. Please note that this foundation does “not accept or respond to unsolicited proposals.” This foundation, the Burroughs-Wellcome Fund, and a number of other funders supported a recent (March 2010 release) Institute of Medicine report, Infectious Disease Movement in a Borderless World: Workshop Summary.

The Rockefeller Foundation, based in New York City. This page describes the foundation’s global health initiatives.

Related resources on global health:

“Gates Foundation and USAID Announce Innovative Fund to Incentivize Mobile Money Services in Haiti,” 8 June 2010 press release. Although the earthquake in Haiti seems to have gone off the radar screen of major media these days, the Gates Foundation and the U.S. Agency for International Development have not forgotten this devastated country. The goal of this initiative is to provide Haitians “access to financial services by mobile phone.”

IAVI Report, March/April 2010. See the article on efficacy trials in AIDS vaccine research and the “brief” about the U.S. Centers for Disease Control and Prevention’s (CDC’s) new Center for Global Health in this issue of the International AIDS Vaccine Initiative’s magazine. IAVI receives funding from many donors, including the Alfred P. Sloan, Gates, Rockefeller, and William and Flora Hewlett Foundations, and the New York Community Trust.

Health Affairs June 2010 Issue on Health Reform: Wide Participation by Health Philanthropy


June 8th, 2010

Many articles in the issue are authored by foundation staffers and/or funded by foundations.

The June 2010 issue of Health Affairs was released today. The Robert Wood Johnson Foundation (RWJF) provided support toward the issue, which has the theme “Moving Forward on Health Reform.”

Inside, you will find the GrantWatch Outcomes column with content on health reform, global health, and health information technology (IT), plus news of foundation staffers and board members.

Numerous articles in the June issue are related in some way to foundations—for example, several foundation staffers are authors. The foundation-related articles include:

“Presidents and Health Reform: From Franklin D. Roosevelt to Barack Obama,” by James A. Morone. The author’s work was funded by the RWJF Investigator Awards in Health Policy Research program.

“Liking the Pieces, Not the Package: Contradictions in Public Opinion during Health Reform,” by Mollyann Brodie, Drew Altman, Claudia Deane, Sasha Buscho, and Elizabeth Hamel. All of the authors are with the Henry J. Kaiser Family Foundation; Altman is its president and chief executive officer (CEO).

“Could We Have Covered More People at Less Cost? Technically, Yes; Politically, Probably Not,” by Elizabeth A. McGlynn, Amado Cordova, Jeffrey Wasserman, and Federico Girosi. A large pool of funders including the Aetna, Amgen, California HealthCare, General Motors, United Health, and WellPoint Foundations; and the RWJF, supported this work.

“The Foundation That Health Reform Lays for Improved Payment, Care Coordination, and Prevention,” by Kenneth E. Thorpe and Lydia L. Ogden. The Peter G. Peterson Foundation’s Center for Entitlement Reform supported work on this analysis and commentary. Ogden’s work was supported by the federal Centers for Disease Control and Prevention (CDC).

“Innovation in Medicare and Medicaid Will Be Central to Health Reform’s Success,” by Stuart Guterman, Karen Davis, Kristof Stremikis, and Heather Drake. All of the authors are with the Commonwealth Fund; Davis is president of the fund.

“How Physician Practices Could Share Personnel and Resources to Support Medical Homes,” by Melinda Abrams, Edward L. Schor, and Stephen Schoenbaum. All of these authors are also with the Commonwealth Fund.

“Communities’ Readiness to Commit to High-Quality Health Care,” by Risa Lavizzo-Mourey. This Viewpoint is by the president and CEO of the RWJF.

“Partnering Private Primary Care Practices with Federally Qualified Health Centers in the Care of Complex Patients,” by Jonathan Weinkle, Karen Wolk Feinstein, and Keith Kanel. The authors of this analysis and commentary are all affiliated with the Jewish Healthcare Foundation (located in Pittsburgh); Feinstein is its president and CEO.

“Sustaining Health Reform in a Recession: An Update on Massachusetts as of Fall 2009,” by Sharon K. Long and Karen Stockley. This work was funded by the Blue Cross Blue Shield of Massachusetts Foundation.

“Health Reform in Massachusetts Cut the Uninsurance Rate among Children in Half,” by Genevieve M. Kenney, Sharon K. Long, and Adela Luque. The RWJF funded the research for this article, and one of its national programs supported Long’s time.

“Saving Billions of Dollars—and Physicians’ Time—by Streamlining Billing Practices,” by Bonnie B. Blanchfield, James L. Heffernan, Bradford Osgood, Rosemary R. Sheehan, and Gregg S. Meyer. The RWJF and the Commonwealth Fund supported this work under the Changes in Health Care Financing and Organization (HCFO) initiative. The article is a Health Affairs Web First, which was first published online April 29, 2010.

More Foundation-Funded Efforts Related to Primary Care


June 3rd, 2010

Here are some more examples of foundations’ efforts. This is just a sampling, not a comprehensive listing, of what foundations have been doing.

Rhode Island Foundation and Rhode Island Lieutenant Governor Announce Creation of Statewide Coalition for Primary Care

Announced at a May 27, 2010, event, the new coalition, “which will coordinate efforts to improve access to primary care in Rhode Island,” is a result of the Making It Work: Health Reform in Rhode Island series, which is jointly sponsored by the Rhode Island Foundation and Rhode Island Lieutenant Governor Elizabeth Roberts (D), according to an e-mail alert. The series brings “national leaders in health reform together with business and community leaders, medical providers, insurers, educators, consumer advocates and policy makers, to chart the course for a new, affordable, high quality health care system in Rhode Island.”

This third event in the series was standing room only, according to the funder. Paul Grundy of IBM was the keynote speaker. Breakout sessions included discussions of “the role of hospitals in primary care,” “opportunities in the federal health care reform legislation,” and “health information technology and primary care.”

Owen Heleen, vice president for grant programs at the foundation, commented on its Web site: “Today’s meeting was a major step forward in our signature initiative in primary care. The innovation and dedication of the primary care community will allow our state to become a real pathfinder on the road to comprehensive health reform.”

Related resources:

“Lt. Gov. Backs Medical Home Project,” Denise Perreault, Providence Business News, May 27, 2010.

“RIGHA Foundation and Harvard Pilgrim Health Care Establish $1.6 Million Fund at the Rhode Island Foundation,” Rhode Island Foundation press release, April 21, 2010.

Read more on Rhode Island and primary care:

“Blue Cross to Pay R.I. Doctors More for Complex Patients,” Felice J. Freyer, Providence Journal, May 18, 2010. In this news article, Freyer mentions a May 2010 Health Affairs article by Robert J. Reid of Group Health Research Institute, in Seattle, and colleagues titled “The Group Health Medical Home at Year Two: Cost Savings, Higher Patient Satisfaction, and Less Burnout for Providers.”

“Rhode Island’s Novel Experiment to Rebuild Primary Care from the Insurance Side,” Christopher F. Koller, Troyen A. Brennan, and Michael H. Bailit, Health Affairs, May 2010.

Primary Care in General—A Sampling of Foundation-Funded Efforts:

Evolving Models of Behavioral Health Integration in Primary Care, a May 2010 report by Chris Collins, North Carolina Department of Health and Human Services; Denise Levis Hewson, Community Care of North Carolina; Richard Munger, Buncombe County (North Carolina) Human Services Support Team; and Torlen Wade, Community Care of North Carolina, was commissioned by the Milbank Memorial Fund. The authors suggest ways to meet “the unmet needs of the millions of Americans suffering from mental illness and substance abuse”—that is, integrating primary care and behavioral health care, according to an e-alert. The report summarizes available evidence on integration as well as states’ experiences using it “as a means for delivering [high-]quality, effective physical and mental health care.” The authors suggest eight models of integration. The report points out that “mental health care delivered in an integrated setting can help to minimize stigma and discrimination, while increasing opportunities to improve overall health outcomes.”

The Health Affairs articles cited in the  post today (June 3) and many other articles are in the May 2010 issue, which has the theme “Reinventing Primary Care.” The United Health Foundation, California HealthCare Foundation, CVS Caremark, ABIM Foundation, and American Academy of Physician Assistants funded this thematic issue. Watch the well-attended issue briefing, held in Washington, D.C., on May 4, 2010.

“Health Care Incentives Can Work,” Jim Knickman, president and chief executive officer of the New York State Health Foundation, Huffington Post, May 28, 2010. In this post, Knickman mentions another May 2010 Health Affairs article, by Daniel Fields, Elizabeth Leshen, and Kavita Patel titled “Driving Quality Gains and Cost Savings through Adoption of Medical Homes.” Since that article was written, Patel has been named director of the health policy program at the New America Foundation.

“Improving Access to Primary Care in a Reforming Environment” was the title of a breakout session I attended at the Grantmakers In Health (GIH) annual meeting back in March 2010. This session focused on an initiative of the Quantum Foundation, located in West Palm Beach, Florida, to increase the number of federally qualified health centers (FQHCs) in Palm Beach County. Look at the now-closed RFP for this initiative here.

The initiative aimed to establish new FQHC sites and expand services at existing sites. The speakers at this GIH session included Claude Earl Fox, executive director of the Florida Public Health Institute (and former administrator of the federal Health Resources and Services Administration [HRSA]), Christine Koehn, vice president for programs at Quantum, and Toni May, Quantum’s director of community relations. This foundation had been funding free clinics but realized there was a need to focus on increasing the number of FQHC sites; the initiative included converting free clinics to FQHCs. Fox pointed out that among the advantages of FQHCs is that they have a guaranteed source of income, and they have access to health professionals from the National Health Service Corps. Quantum’s efforts included providing technical assistance and transitional funding to encourage free clinics to convert to FQHCs. Koehn suggested to session attendees that foundations wanting to increase the number of FQHCs could fund capital costs and renovations of buildings as well.

Among the lessons learned by Quantum staff, Koehn said, was that the capacity of the free clinics has increased when they converted to FQHCs. Free clinics serve a definite role, she said, but the foundation feels strongly that they should try to transition to FQHC status, as that is a more sustainable model. Quantum is not a funder that provides ongoing, sustainable funding for any one specific grantee. Fox later added that every clinic that converts to FQHC status is “serving as many or more uninsured” people as when it was a free clinic. May told the GrantWatch Blog in a telephone interview about another lesson Quantum had learned:  Because medical residents who work at an FQHC qualify for federal assistance with their student loans from medical school, talented medical residents want to work at the centers.

Watch a video of Foundcare, one of Quantum’s grantees. Are you thinking that Palm Beach County is all people without any challenges? Read the “Did You Know?” section accompanying the video.

Read a 2009 GrantWatch column describing the work of Baptist Community Ministries (a private foundation in Louisiana) to establish an FQHC in New Orleans.

“Structuring Payment for Medical Homes,” Katie Merrell of Social and Scientific Systems Inc., and Robert A. Berenson of the Urban Institute, Health Affairs, May 2010. The authors discuss four approaches to pay medical “practices that serve as medical homes.” The Commonwealth Fund supported the research on which this paper is based.

Some additional foundations that have funded or will fund in the area of primary care:

Healthcare Georgia Foundation, located in Atlanta.

Josiah Macy Jr. Foundation, located in New York City, which released an important April 2010 monograph: Who Will Provide Primary Care and How Will They Be Trained?

St. Luke’s Health Initiatives, located in Phoenix, Arizona, which recently published two issue briefs on primary care. The first, Goodbye, Hello—Framing the Future of Primary Care: An Arizona Perspective, Part One: The Primary Care Parade, was published in December 2009. The other, Goodbye, Hello—Framing the Future of Primary Care: An Arizona Perspective, Part Two: Bending the Possibility Arrow, was published in January 2010.

Harry and Jeanette Weinberg Foundation, located in Baltimore, Maryland. See “Goals for Health.”

Related resources:

“Doctor Shortage Creating Quiet Health Care Revolution,” MSNBC video, May 30, 2010. NBC chief medical editor Nancy Snyderman, who is a physician, says “many states have turned to nurse practitioners [NPs] as an answer for the ailing [health care system].” She discusses an NP practice in Easton, Maryland.

“Insurance Firm Has Incentive for Primary Care Doctors,” Josh Goldstein, Philadelphia Inquirer, April 30, 2010. Read about Independence Blue Cross’s plan “to pay physicians more if their patients’ health improves.” Among the goals of the initiative is “to ease a primary-care doctor shortage.”

GrantWatch RSS Feed
Sign up for monthly GrantWatch alerts.




This blog is protected by dr Dave\\\'s Spam Karma 2: 1310302 Spams eaten and counting...