5 Things Utah: Keynote w/ Tracy Gruber, Experts talk VBC, Behavioral health integration – State of Reform

It was wonderful to see so many of you in person at our 2022 Utah State of Reform Health Policy Conference last month. From value-based care to health data sharing, from Medicaid to behavioral health, representatives from numerous silos of Utah health policy came together for forward-looking conversations on the most pertinent health care topics in the state.

Thank you very much to all who attended—Patrick and I thoroughly enjoyed seeing you all and we appreciate your engagement. Our AV team made a “What You Missed” video, where those who weren’t able to attend can get an idea of ​​what our first in-person event in Utah since 2019 looked like.

Keep reading for some highlights from the event!

Eli Kirshbaum
State of Reform

1. Keynote: Director Tracy Gruber on what the new DHHS will look like

The incoming Director of Utah’s new Department of Health and Human Services—the state’s merger of its Department of Health and Department of Human Services—Tracy Gruber joined us for the Lunch Keynote at last month’s conference. “Today we have the opportunity to build the most effective health and human services system in the nation, and could become a model. We need you, our partners, to innovate with us, collaborate with us, and consider the possible in the creation of a more cohesive, coordinated, integrated system …” Gruber said.

During her remarks, she dove into the details of the “massive” merger, the partnerships that are integral to its success, and what Utah health policy stakeholders can expect from the new agency going forward. Watch the full keynote here.

2nd panel: ‘The progress and future of value-based care in Utah’

Conversation during the conference’s panel on value-based care revolved around the One Utah Health Collaborative, with all panelists highlighting the benefit of value-based care for payers, providers, and patients. Mary Jane Pennington, President & CEO of Granger Medical Clinic, said the value-based program she implemented at her facility led to a 15% decrease in the Medicaid patient readmission rate.

“I am a huge proponent of [value-based care] … but it is hard, ladies and gentlemen, to do this,” said Donna Milavetz, MD, Executive Medical Director for Regence Blue Cross Blue Shield of Utah. “We need all those voices to come together to make those baby steps forward because I think that is the only way we are going to get there.” Milavetz said outstanding obstacles include needing to aggregate disparate health data and ensuring the system pays for “appropriate medical care”—care that a patient actually needs opposed to what they say they need.

3. What They’re Watching: Jennifer Strohecker, Utah Medicaid Director

Jennifer Strohecker, Medicaid Director with the Utah Department of Health, is focused on preparing for the end of the public health emergency and the Medicaid redetermination process. She is also working on building out the Utah Medicaid Integrated Care plans, which she said received help from the legislature this past session.

“An important aspect of our expansion project was a UMIC program which was an integrated health care program to align both the behavioral and physical health under one, unified contract. With these contracts, we have been able to address whole patient care where an individual is able to receive behavioral health services and physical health services in a more seamless delivery model,” Strohecker said.

4th panel: ‘An honest conversation about behavioral health’

Behavioral health experts strongly urged behavioral health care to be carved into Medicaid ACOs at last month’s conference. During a panel on Utah’s behavioral health system, Scott Whittle, MD, Medical Director at SelectHealth, said the current system is “impossible” to navigate due to the intertwined nature of BH care and physical care.

Mark Rapaport, CEO of the U of U Huntsman Mental Health Institute, said the state needs to focus on eradicating the stigma surrounding BH care—which the Institute is working towards with a 10-year campaign. He also emphasized the need for alternatives to emergency departments as crisis care sites, highlighting U of U’s new crisis care center as an example.

5. Medicare and inflation

In his most recent piece, State of Reform columnist Jim Capretta evaluates how the 8.5% inflation rate over the past year—the highest in four decades—could impact Medicare. Changes to the program include higher market basket base payments to providers serving Medicare patients, physician reimbursements that aren’t reflective of the growing inflation rate, and significant increases to Medicare Advantage payments.

Capretta also notes that increased inflation will hit the pocket books of Medicare beneficiaries, since higher Medicare costs will translate to higher premiums and deductibles. While acknowledging that future inflation is uncertain, he urges policymakers to plan for a continued high inflation rate and its impacts on federal programs like Medicare. “What is clear is that planning should begin now, including by policymakers responsible for Medicare, for a scenario in which high inflation continues beyond 2022.”

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