by Ashley Thurow

I recently had the distinct honor of participating in a roundtable discussion with twelve healthcare leaders from across the Western Slope hosted by the administrator of the Centers for Medicare & Medicaid Services (CMS), Chiquita Brooks-LaSure. As the federal department responsible for administering Medicare, Medicaid, CHIP (Children’s Health Insurance Program), and the federal health insurance marketplace known as, CMS is focused on advancing health equity, improving health outcomes, and expanding affordable care and coverage. 

Administrator Brooks-LaSure has made it a priority to travel across the nation and hear from professionals and health care leaders on the ground who interface with both CMS and patients with the goal of helping all eligible Americans enroll in programs they qualify for, understand their coverage, and use it to improve their health. Her time in western Colorado was focused on trying to better understand how to support innovation, address health equity, explore opportunities to partner, and identify barriers that hinder innovation in rural and underserved areas.

Despite being a rural community, I encouraged Administrator Brooks-LaSure to be prepared to encounter the unexpected. We are unexpectedly innovative, collaborative, and sophisticated. This ingenuity comes as no surprise to local residents and leaders who work collaboratively to create solutions bigger than the individual for the betterment of our community. 

When the COVID-19 pandemic hit, CMS was no different. They had to quickly innovate and pivot to allow for telehealth visits, in light of clinic closures.  This allowed healthcare access to continue and has been very beneficial to many patients.  The roundtable participants urged CMS to continue to allow payment for telehealth and home health services, which are even more important in rural communities where access is limited.

The digital divide is a reality in rural areas, and many patients do not have strong enough broadband to support video streaming in addition to virtual voice calls.  We encouraged the administrator, in addition to video-enabled telehealth, to continue to allow audio-only visits in order to reach the most underserved patients. 

We also strongly encouraged the administrator to bring Medicaid into focus. A theme from most of the roundtable participants was the need to reach patients with the most need for access and health resources. We expressed how important we believe Medicaid is as a vehicle to bolster health equity and outcomes.

But availability and accessibility doesn’t always result in use of Medicare, Medicaid, or Marketplace offerings. In fact, several roundtable participants expressed their concern about numerous patients who enroll, but commonly, don’t know how to navigate their benefits once enrolled. 

I shared Monument Health’s approach, which “invites people in” to the healthcare system.  At Monument Health, we have a goal that every member gets connected with a primary care provider. If a member doesn’t already have a primary care home, we reach out to them to invite them in. This allows us to connect with our members, get to know them and their unique health needs, and establish them with a primary care home that’s a good fit for them. This is just one way we help them understand and navigate their care. If we could extend this work to more Medicaid participants, and financially incentivize providers to engage in it, we would have meaningful impacts on the future of our society. 

With this context, we encouraged the administrator to consider extending Medicare programs that reward population health work to also support Medicaid participants. 

Although CMS is committed to testing and creating new models of care, exploring innovation, and working closely with regional offices to understand healthcare trends and local data through The Center for Medicare & Medicaid Innovation (CMMI), gaps in care still exist and health equity and access are barriers to care, especially in rural areas. CMS is working to identify those gaps, innovate, and make sure everyone who is eligible has care and understands how to navigate it.

Administrator Brooks-LaSure hosted a productive conversation and truly listened to understand where gaps in care exist, where the opportunities for innovation are, and how to promote health equity and access in rural Colorado. 

It was an honor to participate in the roundtable discussion. It affirms to me that Monument Health, along with our partners, are having a positive impact on the health of our community.

Ashley Thurow, Executive Director