Jennifer Colamonico
Welcome to HMS Vital Viewpoints on health care. Concise conversations with experts that identify practical solutions to make health care and human services work better. I'm your host, Jennifer Colamonico, and I'm thrilled to be your guide as we explore new ideas for solving challenges that confound our uniquely American systems charged with delivering health and health care in a world that has far too much information and far too little wisdom.
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Subscribe now and together we will explore the hard earned wisdom that could change the way you think about your professional challenges. Caprice Knapp is a health economist and evaluator with more than 20 years experience working on Medicaid and Children's Health Insurance program in the private sector for state and federal governments, and as a university professor. Caprice was the federal policy director for Molina Health Care.
She was also an associate professor of health outcomes and policy. In addition, Caprice worked in the Governor's Office of State Planning and Budgeting in Colorado. She was a Robert Wood Johnson Health Policy Fellow in the U.S. House of Representatives on the Energy and Commerce Committee, and then she was the North Dakota medicaid director from 2019 to 2022. She has authored more than 80 peer reviewed publications, 60 government reports and two books, and Caprice currently serves on the Congressional Budget Offices panel of health Advisors.
In addition to being a managing director here at. So, Caprice, thank you for being with us today.
Caprice Knapp
Thanks to nice to. Nice to be here. Thanks for having me.
Jennifer Colamonico
Your background is so interesting and varied. Not only geographically. You've worked in several different states. You've worked in the private sector, in the public sector and academia. And so I was just excited to get to know you a little bit more and, hear about your journey. How did you get to where you are, and what kind of motivated that journey?
How did you get your start?
Caprice Knapp
No, that's that's a great question. I'll be honest, it used to bother me a little bit that we've moved around so much. My husband was in the Air Force. But in fact, I think looking back on, you know, almost 25 years, I think it's been a blessing because you get to do so many different things and meet so many different people.
And so as we moved, my first goal was always to figure out how to find a job that was connected to Medicaid. When I did my dissertation at the University of Florida, it was about government policies, about children, about child outcomes. And so I knew I wanted to be in that space. Because, of course, Medicaid is really where we serve a really high number of kids and moms.
And so as we've moved, I've tried to be open to different opportunities that's more surrounded by Medicaid, you know, and I think like as a traditional academic, you would think, oh, no, you know, I want to go and spend 20 years. I want to be a tenured professor. But I think being open to trying different things has been the most exciting thing about my career.
So I think it actually has ended up being a blessing, and I think it's really influenced the way that I approach the work and the way that I try to maintain relationships in the business as well.
Jennifer Colamonico
It's funny, we spend a lot of time talking about innovation, and we think about that in big, you know, shiny object ways. But that is pretty innovative thinking, right, in terms of being able, just as you just described it, seeing a problem from these multiple vantage points. You know, in particular, there are probably not too many Medicaid directors who are health economists.
So, you know, when thinking about that role in North Dakota, how did your experience inform that role and the choices that you were able to make?
Caprice Knapp
As an economist, there's a couple things that ground you. One is I'm an applied economist, which means you get a lot of stats training and a lot of data and data analytics training. And so that's always useful, I think in any position where you're looking at health policy and health strategy and health outcomes, because you want to try to be grounded in the data as much as you can.
And we have so much data, so much data in Medicaid, so much data and health care, to the point where sometimes it even is, becomes overwhelming, right, to try to prioritize. But the part about it that I think so from an economics point of view, I've always been able to take the the methodology and the skills that I had to look at things from a firm perspective that surround cost effectiveness or resource use.
I think the policy piece of it and being Medicaid director is really where this hit home for me is it's not always about money, right? And so sometimes we would come in and we would present, policy solutions to the legislature, or we would need to work with advocates or the provider community. And maybe sometimes that the, the, the dollars in the budget didn't make sense, but it was the right thing to do for the patients, or it was something that was important to the families.
And so I think when you have that intersection of, you know, trying to make data driven decisions, try to make evidence based choices in terms of policies and interventions, and then you lay that on top of what's important to people. It it turns out to be not always a perfect solution, but obviously. But it turns out to be, I think, something that moves something down the field.
And that's is something, even if it's in the smallest way. And I think that's really rewarding.
Jennifer Colamonico
Yeah. Oh, progress is good progress. You spent some time abroad. Was that during your academic work or during your your graduate studies?
Caprice Knapp
Two, two areas. One is when I was at the University of Florida, I worked in pediatric palliative care, and it's one of the very first projects I was ever asked to work on in academics, and no one in the department wanted to do it. We had a contract, and I can understand why. It's it's it's pretty tough.
You're working with children and families, and you're really trying to understand what they need or what the models of care are. And of course, most of the kids in the program have terminal illnesses. And so it's it's tough. And when I started that project, Florida was the very first state in the country to take that program and move it into Medicaid under a waiver.
And since that time, other states have added on. And so when we started, we were looking at, you know, the state was developing the program. I was coming in and doing some monitoring, evaluation of the program and really some facilitating also of the state and the providers to get them together and figure out like, what is this program going to look like?
And as we looked around the country, there was literally maybe 1 or 2 other programs. There really was nothing. So we started to look abroad and ended up spending time in the UK, which is really where you know that the bulk of that work is, looking at models in pediatric quality of care in low income countries as well.
And so when I arrived at Penn State, they said, we have this global health initiative, we need someone to help us run it. And so I took that on. And so really, that role at Penn State, there were pots of money that we shared with seven different universities. And it was really help, help, guiding which projects we were going to fund.
But they had to be joint. And so that was really cool. So we would have a project that would include, like both Penn State and a University of, of in India or Mount Quest University, which is in Ghana and a university in Germany. So it's been really again, I said this before, some of the problems are the same, like no matter where you go, but it's just the perspective you have and how you approach solving them that that looks differently.
Jennifer Colamonico
Well, I've, I've always felt like Medicaid, when Medicaid innovates, you know, you have to you have to innovate. Kind of lower cost solutions. And looking globally, I'm sure is an inspiration in that way, you know, resource strapped countries finding ways to, to do good things. And, you know, we always think about innovation at the expensive end, but I think it's even more interesting to think about it at the resource constrained end, because, you know, great things can happen.
And, you know, in human centered ways.
Caprice Knapp
Yeah. And I can do some really cool examples of where I saw that, you know, did quite a lot of work in the Philippines. And when we would go out to the communities that work, because obviously the Philippines is a chain of islands. And so sometimes when you get to some of the smaller islands, there's, you know, a few people and we did a project once that was on maternal outcomes.
And every single woman that had a baby on the island that we were on, they sent a community health worker to her home every day for like a month to check on her. And this is before community health workers were like a big thing. And I just thought, like, that makes so much sense. And they were laypeople. They were not nurses.
And then they would come back to the public health office and they would talk about, you know, do we need to send a doctor out? Same thing that I saw in India. In terms of kids that were getting vaccinations and how cool it was to see how those vaccine programs were run. And and so you're right, our system is so complicated.
But at the foundation of that system is primary care, dental care and behavioral health. And I do think other countries have a lot for us to learn from. It will allow it if we'll let ourselves and our minds be open to the way that they, approach health care. I learned a lot. And really, when you see people solve problems with limited resources, you're forced to be innovative.
Yeah.
Jennifer Colamonico
Yeah. So it's really exciting that I feel like we're starting to embrace more of that. Let me pivot a little bit to quality. Not really a pivot because I think it's very related. But that's the the work that you're doing right now. I think, you know, I've been in health care for a while in and around health care for a while.
And the topic of quality, I find is so interesting because on one hand, everybody kind of thinks they understand what quality means. And on the other hand, you know, in in health care, it's very specific and sometimes different than what like a consumer or a patient would define as quality. And so, so it's a more complicated, kind of concept that is, is so important.
So I guess, first of all, how did you get interested in this space? Where in your career did you kind of, begin thinking about how to, you know, improve quality and what quality means in health care?
Caprice Knapp
Yeah. So again, that very first project that I did in pediatric palliative care at the beginning of my career, one of the things we had to do at 1115 waivers, we had to evaluate it right. And so I started to really sift through all the literature, all the existing tools that were out there to measure quality. And you can imagine this is a really niche population.
And so where we landed is on health related quality of life tools, some of which were designed for adults, some of which were designed for children. And so I really started to move in the space of measure development. We did a lot of work using psychometric analysis, which is testing survey tools, anchoring them to certain data, seeing if those tools actually are picking up what you're trying to measure.
And then as I stayed in that role for the next ten years, I did a lot of work with sort of Medicaid. And that was at the very beginning where Florida was moving from fee for service to managed care. And so this idea of using measures and this idea of measuring quality really first started as that move happened.
And so again, because we were at the university, we have access to all the data. We started to do those measures as well for the state and so I do think there's a connection between the skills that you learn on the academic side in terms of data integrity and data analysis and interpretation. And now you're seeing it moved into the health care setting where, like you said, we're not always getting it right, but we're trying and we're at least you can't.
What are they saying. Quality. You can't improve on what you don't measure. Right. And so in some ways it's it's a gift and a curse. Right. It's great because we can start to measure and understand what we're getting in terms of value and what the patients are experiencing. On the other hand, there's so much data and we always have questions about are we measuring the right thing?
And like you mentioned, Jen, there are a lot of gaps in what we're doing in terms of what's important to patients. Like, are we really capturing the data that of what matters to them, but still some exciting work in that area?
Jennifer Colamonico
What were that just out of curiosity? I mean, pediatric palliative care, like what is the measure of quality there that you found that was most impactful?
Caprice Knapp
Yeah. So we actually, did psychometric analyzes and tested two things. One was looking at quality of life. And so the idea is that even if you have a terminal illness and even if you know you're spending the last 3 or 4 years of your life in concurrent care, both with your specialist and your primary care physician, you can still define the quality of your life and see how that is impacted.
So, for example, you might say, what's important to me is that I can still read a book. I love reading books. I want to try to maintain that ability to read books as long as I can. I like going on walks outside with my mom. And so your quality of life is different. For example, then you know what we think of when we fill out a quality of life scale, you know, are you out of breath?
Yeah. And so we really had to shift and, come up with a scale that measured what was important to the kids at that time, and then to look at it longitudinally and say, you know, are the interventions we're doing, allowing them to maintain as much of what's important to them as possible. And again, just really fascinating and and a completely different way to think about measurement.
Jennifer Colamonico
It is there, you know, thinking about how people interpret quality and how, how, the health care sector wrestles with it, you know, what is the what do you wish people would just get about it? You know what? What is it that you think people really don't understand that would that would kind of if they understood it would move us forward?
Caprice Knapp
Yeah. I mean, I think there's a couple of things that I wish people would get is, again, you can't improve something you don't measure. And there are good and bad parts to that. The good part is people are invested in quality. People want to, you know, as someone who pays for that at the state level or the health plan, they want to know that what you're getting is a value, to the patient.
And it's exciting because when I've again worked around the world, there's very little data collection, there's very little quality oversight in countries that aren't the same development level that we are. So it's it is exciting and it's a way to provide some guardrails and some guidance and some regulatory frameworks. On the other hand, I've seen it in some ways turned into a compliance tool, which is not really, I think, the goal.
And so sometimes it's frustrating when we think about quality and, you know, we have this whole menu set of measures and we're trying to think about, you know, how do we choose the ones where we invest the money. And then it will help us in the long run with whatever are ratings. And I understand that there's a value to that.
There's a need for that. And it's a lever and it's a lever we can pull on the policymaking side that perhaps we can't pull in other areas, like cost and access, always. But on the other hand, it is important. It's not a compliance tool. And then the last thing I think people I would really like for them to get is, I mean, this cost money, it takes skill.
And the folks that work in this area are very talented. And so, you know, sometimes I think in the enterprise, it's not a revenue generating part of your enterprise. Sometimes it gets cut in budget cuts sometimes. And I'm guilty of that too. You know, when it came to my own program, I had to like, prioritize about what we were going to do.
But at the end of the day, it is really critical and it is a flagship and what we're all meant to be doing in terms of administration, health care. And so, you know, I always want to think of let's make sure these programs are funded. Let's make sure we have adequate training programs that people have access to them, and that across a different types of payers and providers, we think about the discrepancies about how expensive it is, right?
You shouldn't just be focused on quality if you have all the resources, has a big, large national plan, it should be also important and we want access to the same tools for the smaller plans that are in this space as well.
Jennifer Colamonico
So then talk about the connection to incentives, because, you know, we kind of coming out of the the value movement where, you know, we're supposed to be paying for quality instead of volume, right? And so, but it gets complicated in that way. Right. And, and if are we paying people for the right things. So where do you think that our current reimbursement algorithms, or rules where.
Where do we where are we getting it wrong right now.
Caprice Knapp
So the exciting thing about incentives is it's behavioral economics. All this. Right. Right. I mean, is, is like the living, breathing example of how you can, you know, push a system and nudge patients, providers and payers to get you there. And so the question then is, like you said, are there unintended consequences associated with that, or are there things we need to be mindful of as we develop these programs?
For example, when I think about the reimbursement system, I think about how much more is spent on providers for institutional based care versus home based care and how in Medicaid we don't have a default, which says you must try home based and community care first before you do institutional care. And I'm not sure why we don't, you know, when you set up a payment system that really puts a premium on deep services, that's what you're going to get, right?
And so as we see more of these models evolve, want to be sure that we're not just incentivizing quality in hospitals and nursing homes. That's important. We absolutely know that. But how do we then push it to the lower end of the system? Primary care, behavioral health Sdoh age, dental care. And so, you know, again, I think the system is focused on the deep end, because that's where a lot of the reimbursement is.
And so that's what drives a lot of the value based models. But in fact, you know, we want to see it shift and provide incentives. And we do see some of that. But we've got a long way to go, especially in areas like behavioral health. We'd like to see a lot more progress made in advancing those models.
Jennifer Colamonico
And that's where you hear the loudest cries, right? Every year you sort of say, oh, we're paying doctors less. Well, you know, we're paying some doctors last, maybe because we need to pay other doctors more. Right? And this idea that there's enough money in the system, it's just where it goes. I think you make an excellent point about the deep services and and not to say that that's not important and complex and all of that goes along with that.
But we have to create the right incentives and higher, higher quality care doesn't always have to be more expensive care. Right? I think that's there. There's sort of has evolved this correlation that really shouldn't exist. You know, one thing I find really interesting is, is employers, obviously employers pay for a lot of health care, in America.
And they're, they're kind of like incentivized in different ways based on what they think their employees want. Right. And so that's I think oftentimes where you get into some of this fuzziness. Well, what does quality mean? If I'm a big corporation and I have a bunch of, you know, upper, you know, white collar or highly paid workers, what does quality mean to them?
And like, should it be different? It probably shouldn't. Elizabeth Mitchell from the purchaser business group on health. Was that our, value conference on value in the spring, as you were? And she said something to the effect of, you know, employers thought that they were paying for value, but it turns out that they weren't. So like, they're kind of realizing, like, wait, we've been paying a lot more.
We haven't really gotten one more quality. You know, they did. So are we wasting like, are we wasting money on low value care that doesn't improve quality? Like, how do we actually have that conversation in a way that, you know, or maybe it's it's inevitable that the specialists and everybody else kind of gets upset about it. But like, how do we have this national conversation?
Caprice Knapp
You know, I think it is the next frontier in what we're calling. You need to move. I mean, clearly in Medicaid and Medicare, they're government systems. They're highly regulated. We've made a lot of progress. Right. When I first started 25 years ago, nobody measured anything. And so just to see that evolve is fantastic. But the places where it needs to go and we pushed marketplace plans, aggressive plans, state run, exchanges, you know, even here in North Dakota, you know, we have programs that are run by the insurance commissioner and we get a look at, you know, what the premiums look like each year.
But I don't know what the quality is. Yeah, I do think that's going to be the next push. What's complicated is of course how you do that. Right. Because each state regulates their own, health insurance market. The aggressive plans, on the other hand, are regulated at the federal level. And so it's nice to hear Elizabeth and other people continue to ask questions, continue to push in this space, because it's not clear to me why we as consumers wouldn't demand that if we're seeing it for the most vulnerable.
I totally agree. Makes sense. But then why wouldn't we want that for ourselves? And so to the extent that the dynamic hasn't really, come to fruition in this conversation between employers and and, and payers and, and it's a complicated conversation, don't get me wrong. Like, I'm a big employer. I want the best for my employees. I'm a payer.
I'm you know, there's really 1 or 1 plan in my state. And so, you know, I'm not sure, you know, how much negotiating has to happen between the two actors. But as a consumer, it's it's used to be the largest group of, you know, of how we got health insurance coverage. It's not anymore government, you know, government provided health insurance is pretty.
But as consumers, you know, why aren't we asking for the same level of quality, the same type of transparency? And I do think it's coming, and it'll be interesting to see how states take that on. We have an excellent colleagues, Zach Sherman, and we just had a conversation the other day about thinking about how state based exchanges can use their regulatory powers and framework to push quality in their state based exchanges.
So I do think it's coming. It just may look different.
Jennifer Colamonico
So you think it's a demand? I'm thinking, is it supply or demand? Right. Is it that the plans have to provide it, or is it that the purchasers want it and is that, you know, are we do we need to educate consumers about what quality should mean versus what they think it means? Or do we need to educate, you know, like who do we how do we begin that kind of demand process.
Caprice Knapp
Yeah. So I think that's it's to two sides right. One is demand. And I think about the national conversations that have been happening over the last year or two about prior. That's really been driven by consumers. Like we're tired of not being able to get the services that we want. And when we get caught in this loop and having worked at a health clinic, I understand the why you have prior on.
And so you can see that as that conversation started and then it got moved up the chain in terms of at the state level, at the federal level, the idea was we've identified something here that is important to our constituents that we need to solve, and we need to take on the accountability and responsibility for that could happen on the demand side for consumers in terms of how we all get our health care.
It would take, it would take some convening and some alliance building. But but it can happen. Then on the supply side again, if I have a state based exchange, if I'm paying for marketplace, like, why am I just going to keep letting premiums go up without demanding something for that? And the same thing is I'm an employer.
So I do think on the supply side, the levers look very similar to what the rest of us are facing. I've got consolidation. I have to think through how you negotiate, and I think the price transparency that's being, for hospitals and for health plans, I think that's going to help drive even further some movement in this space.
Jennifer Colamonico
Are there particular, I'm thinking, for example, you know, situations like maternal child health, maternal outcomes. Right. That's kind of an obvious when you have a catastrophe, when you have a situation where you have, you know, maternal mortality, particularly in certain populations, higher than it should be. I mean, that is, of course, an impetus to act. Do you think that the demand will come more out of specific.
I'll call them bundles. Right. Not technically bundles, but they can be bundles in some instances where we say, okay, here's a particular situation. You know, childbirth or or it could be cancer. It could be, you know, other kind of bundles, but are they does it have to be driven by those experiences? And are there places like that that we can kind of make the case?
Caprice Knapp
Yeah. I mean, when I was on the hill, there were three areas where I saw people coming together in a bipartisan way based on their experiences that it didn't really it was agnostic to the payer type behavioral health, long term care and maternal child health and so I do think there's power in shared experiences. There's power to it.
And, you know, people coming together, regardless of who the payer source is and wanting. And we've seen a lot of that, right, in maternal mortality, you know, stories that are coming up in the focus on data and push that we've seen at the federal side, in the state side. And even though Medicaid is a big driver in that, I think the pushes overall, though, for all types of payers and for all moms.
And so I think that's great. So to your point, yes, I do think that shared experiences can drive progress in those areas. Just would want to be careful because it's it's strange to me that we would think of not having it, just a baseline of the way we practice medicine, and that would need high quality. Right. And that there has to be some qualifying event that would reward us with high.
But like, why? Why should it be that, you know, I need to have, be in a certain population? You know, I have chronic diseases just like everyone. I have preventive health care needs. And so if we can drive a system. And what does that saying, like raise all, you know, raise all tides or, you know.
Jennifer Colamonico
Rising tide lifts all boats?
Caprice Knapp
Yes. You know. Yeah. Then then why wouldn't we use a more comprehensive approach? But to your point, sometimes the message works better with specific populations. And those were definitely three when I was on the Hill that you could hear people relate to. You could hear some of our members say, like, yeah, you know, my grandparents had, you know, nursing home issues or wanting to stay in their house and want something resonate.
Yeah. And that's that piece of it's not just data, it's also the stories that we tell. Then we can, you know, if that's an opportunity to advance, we should take advantage of that.
Jennifer Colamonico
Right? Right.
If you had a magic wand, what is the one thing that you would fix in this arena to kind of, I don't want to say get it on the right track because I feel like it is on the right track. But to really make big advances in quality.
Caprice Knapp
One is I think we need to be at quality 2.0 or quality 3.0. We have focus for a long time on the mechanisms of collecting the data, sorting the data, producing the measures, tracking the measures. And that's great because that is expensive. It is hard to do. It takes a specific skill set. That being said, reporting means nothing without action.
And so I think if we can look from a top down and look to the folks who are taking in that data that we report on, and then they are incentivizing and nudging us to do more with it, that I think is critical. And then from bottom up, like you said, how can we get consumers involved to create this groundswell of what they want?
I think that's really to me, the magic wand is let's listen more to consumers. Let's let's really push the envelope on what some patient reported outcome work is, and then let's take that and infuse that and require that to be infused in our plans going forward and our strategies going forward. We have some great work being done by Leavitt Partners focusing on patient reported outcomes, and that is so exciting to me.
We haven't had a lot of progress in that area, and yet we all say it's important to me like the magic wand is if we can infuse what patients really want into this whole data measurement, reporting and action and strategy, this whole framework for that, that I think would really move the needle, in terms of getting us high quality care that we all want, we all deserve.
Jennifer Colamonico
Well and as you said before, it's personal. It's also generational. I feel like, you know, like our my you know, I'm Gen X, I feel like my generation is and younger especially, you know, it's less about quantity of care. Right. And it's it's almost like, you know, whereas I feel like my, you know, the grandparents generation is there was a period of time where more was better.
And now I always feel like it's less is better. So the ability to not only tap into what the sentiment is, but what individuals feel that seems like with AI and everything else. Maybe that's the application, right, to figure out what is important to me, and then how do I achieve that as a as a measurable tool? Which is weird because in research it's usually large populations.
Right. But how do you get it at the individual? That's that's tricky.
Caprice Knapp
Yeah. And I also think it's about place. You know, I think what my daughter is demanding now that she's taken over her health care, she wants easy access to her records. She wants to do telehealth visits if she can. She she it's a lot of, you know, convenience and place based. Yeah. And, you know, she gets everything now through her my chart.
Whereas you know I have paper copy. So everything in a filing cabinet, she's like, why do you even do that? Mom, I don't understand. But I think, as you know, consumers are not only demanding high quality, but just the way in which they approach the health care system that's going to move the needle. Because, I mean, it's economics, right?
I mean, the demand is there. The market will follow. And that's exciting as we see more remote patient monitoring, home based care, telehealth, all those things really pushed by the demands for consumers and quite frankly, by Covid, which in that regard was a good thing to drive this, this new big, important area.
Jennifer Colamonico
Well, right. It pushed us to see what you could do. I mean, we've talked about this in other interviews, in different contexts around data and access to records. But people want more convenient care. They want cheaper, high quality, lower cost, high quality, more convenient. Which really was. Wasn't that the triple aim with just now the quintuple aim? I've lost track, but I mean, that was sort of at the heart of all this.
So, but it seems more possible now perhaps, than it more within reach, at least that I think. Is there anything else that you would add that people should be thinking about or understanding about this, these issues?
Caprice Knapp
Yeah. I mean, I would just say that, you know, when I think about quality and where it's going, we've got a couple of really exciting things on the horizon, which we all should be sort of thinking about. How do we wrap our brain around? So one is digital quality measurement. You know, Leavitt has a really great alliance that they are involved with at the at the federal level, which is working with eNCA, working with CMS.
Caprice Knapp
And I think and helping push out the standards for what this is going to look like. And what's so exciting about it is, you know, I was trained and I was in my experience was around you have claims data and then you have non claims based data. And if you're lucky, you know, that's because I sat there literally and extracted data from chart and put it in an Excel spreadsheet or an access database or you know, I found a, vaccine registry and I figured out how to import that data and then augmented with the claims that was hard.
But we did it because the health plans expressed to us that, you know, this claims isn't really capturing everything. It's really important that we get the true experience of what the patients and what we're doing as a health plan. So this side of it, which is tough, which is the non claims data as we move to digital quality measurement and everything has the same standards.
There is no claims or non claims. It's all the same. And so to me that's super exciting because we can see a better picture of what the patient actually experienced through their lab values, through their data, through their screenings. Right. For stuff that's not in the claims that are depression screening. And so I think it will give us a better picture of what the patient's experience.
And I think it's also going to point out where some of the holes are that we don't quite know. So that's going to be exciting to see how that evolves. And I think by 2030 is when the federal government wants everybody to be pushed towards digital quality measurement. The second piece is we have these emerging areas that are important to all of us.
Social determinants of health, housing, food, employment. Also, we've seen movement on the whole community based side or traditionally, you know, measurement and quality wasn't there because either we didn't know how to measure it or because, again, it wasn't focused on the deep end part of health care, hospitals, nursing homes, things like that. So as we see now, quality being infused and being moved to the measurement phase, to the testing phase of those measures, that's really exciting.
As long as we can all be mindful of, yeah, we're going to need some revision on some of that stuff. We need to we need to track and monitor it. But again, these are really important critical parts of the health care system that in the past we weren't really know how to track and monitor then. So you've got some emerging areas, you've got some emerging new tools.
And then again I think the third area we already talked about was, you know, how can we be creative about patient reported outcomes. So how can we get serious about that. And, you know, how do you incentivize that? I've worked in states and with plans before where some people will have like a patient advisory council and some people will have someone on their committee that's a lay person that has to review your your policies.
And like there are different ways that we've tried it, but I don't know that any, any entity or any, program at the government level has really figured out the best way to do this. I'm just thankful that there are people still trying because it's a tough it's a tough nut to crack, but it is worth it. And I think it will really push us in a different direction based on what the solution is.
And again, those gaps that we're not even knowing exist are going to come to light. And as a consumer myself, maybe we'll be able to realize even more quickly that, oh, yeah, these advancements needed to happen. And now there's a framework by which they can.
Jennifer Colamonico
Well, and what you just described really is kind of from a measurement perspective, filling out the whole person. Right. Like we we were able to measure the part of the person that was in the doctor's office. But if we're able to measure the rest of your whole person, this in your experience, then maybe the patient reported outcomes becomes a little bit, I don't want to say easier because none of it is easy, but it's, you know, it becomes kind of a more obvious part to kind of complete, complete the package.
Caprice Knapp
So, yeah. And maybe you know, maybe that's through apps, maybe that's true. I mean, you know, we just are going to need to be open minded and really think about this in the most inclusive and, and innovative ways that we can. Because again, like you said, the goal here is to look at patient experience, not just patient satisfaction, which is 1 to 5.
Do I like it or not, but a patient experience. And that's going to be difficult to capture but so worth it.
Jennifer Colamonico
Well, thank you so much for making time to talk with us. And, quality is is such a more expansive and and interesting topic. And so it's such a crucial part of everything we're all doing. And so it's exciting to, to not only hear what you bring to it, as a leader in this space. But to share in your enthusiasm for where we're headed.
So thank you for being with us.
Caprice Knapp
Thanks so much. Really appreciate the time that we got to spend together today.
Jennifer Colamonico
This episode of Vital Viewpoints on Healthcare is sponsored by HMA Information Services. HMAIS is a subscription based service that provides state level data on publicly sponsored programs like Medicaid from the latest managed care enrollment, market share, and financial performance data to up to date RFP calendars and state by state overviews, HMAIS has all the information you'll need to power your initiatives to success.
Visit HMAIS.healthmanagement.com for more details. Thank you for tuning in to another enlightening episode of HMA’s Vital Viewpoints on Healthcare. We hope today's discussion has sparked new insights and perspectives. To learn more about our esteemed guests, please be sure to visit Healthmanagement.com/podcast. Until next time, stay informed, stay curious, and keep searching for the wisdom that will help to transform our healthcare landscape.
This podcast was produced by myself, Jennifer Colamonico, along with Tiffany Mckenzie in collaboration with our guests. The content is the property of Health Management Associates.
