Healthcare Equity in Universal Care Programs

Before the Patient Protection and Affordable Care Act (ACA) of 2010 in the US, Medicare or Medicaid experimentation was long, difficult, and indecisive. In order to speed up the transition from fee-for-service to value-based care, the Centers for Medicare & Medicaid Services (CMS) established the CMMI.

A total of more than 50 model tests involving 28 million patients and more than 528 000 health care practitioners have been conducted by the CMMI since its founding. Medicare, Medicaid, the Children's Health Insurance Program, and private insurers all worked together to make the switch to value-based treatment. Only 6 of the more than 50 models tested by CMMI in its first decade resulted in considerable savings for Medicare. Advances in primary care, episodic care, accountable care, and state-based transformation efforts led to the development of CMMI models for specific populations, including those with end-stage kidney disease (ESKD), diabetes, and heart disease, as well as those at substantial risk for preterm birth.

In the Study Innovation Centre Strategy Refresh, 5 objectives have been identified for advancing Transformation

1.????Drive accountable care

2.????Advance health equity

3.????Support care innovations

4.????Improve access by addressing affordability

5.????Partner to achieve health system transformation

In the UAE Health Insurance context, we have taken the most challenging initial steps by employing Health Insurance instrument & an ecosystem as a mandate (Emirates of Abu Dhabi and Dubai) and adopting the most appropriate nomenclature to decode medical expenditure. The next stop in our journey is realizing “Healthcare for All” . How can the various industry stakeholders advance Health Equity within our respective sphere of influence. ?The blue-collar segment, remain at the risk of being under-served in information, opportunity, and access to care. Their participation on driving accountability rest on the above aspects.

The Innovation Centre Strategy Refresh Report by CMI points us in this direction.

Report: https://innovation.cms.gov/strategic-direction-whitepaper

Credits:

McDonough JE, Adashi EY. The Center for Medicare and Medicaid Innovation—Toward Value-Based Care.?JAMA.?2022;327(20):1957–1958. doi:10.1001/jama.2022.6927