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Baltimore riots spawn plan for hospitals to hire local citizens



A quaint part of the Johns Hopkins Hospital complex.

The Baltimore Sun reports that “Baltimore residents living in struggling neighborhoods hard hit by riots last April will be able to apply for 375 new jobs at area hospitals thanks to an initiative approved by state hospital rate regulators.”

Hospitals will pay “a share of the cost of the program and the rest {will} come from hospital rate increases. The plan calls for as much as $10 million in annual rate increases and $5 million a year from the hospital budgets.”

“Administrators at Johns Hopkins Hospital had called for 1,000 new jobs in an effort to counter the despair they witnessed in the unrest last spring over Freddie Gray‘s death a week after he suffered a severe spinal injury while in police custody.”

But “the plan drew praise from supporters who view the positions as essential to lifting up communities with few opportunities.”

NPR: Tackling Baltimore’s woes through public health


Radio broadcast: Baltimore’s new health commissioner to focus on social determinants of health as she tries to help heal the riot-scarred city.

Leana Wen, M.D., an emergency physician,  argues that Baltimore,  traumatized by poverty, violence and drug abuse, can be treated through a better public-health infrastructure.

“We have to make the case that actually, everything comes back to health,” she told NPR. “My hope is that we can really make Baltimore into a model for the rest of the country to follow when it comes to treating the core roots of our problems.”

Healthcare silos’ failure to communicate



The National Aquarium, in Baltimore.

Katherine E. Warren and Leana S. Wen write about the urgent need to break down silos in healthcare, especially in troubled cities such as New Orleans and Baltimore.

They write:

“In a city facing high burdens of disease, increasing rates of violence, and histories of institutional distrust, health silos serve to augment the impact of already destructive health disparities. In an environment of severely limited funding, poor allocation of personnel, funding, and social capital further weakens the potential impact of public health interventions. In Baltimore, the historical depth and complexity of public health issues like substance use disorders require multi-disciplinary and multi-agency approaches.”

An example of the problem:

“Recently, we had a meeting at the Baltimore City Health Department where we brought together members of the community and prominent members of a local academic medical center to discuss and strategize how to bring trauma-informed care to Baltimore. As the meeting began, we noticed that a senior member of our team was absent. After a brief search, we found her in a conference room that was just steps away. She was convening other members of the community and other leaders of that same academic medical center to discuss and strategize bringing trauma-informed care to Baltimore. Neither group had any idea the other was hosting a meeting on the very same topic.”


Baltimore lessons in public health


This JAMA article inspired by the recent Baltimore riots looks at the public-health strengths and weaknesses of the city and by implication those of other cities with such wide divisions in public health and widening racial and socio-economic inequality.




A new little co-op takes on a behemoth insurer


“David and Goliath (1599) oil painting by Caravaggio.

Herewith the story of Evergreen Health Cooperative, created under the federal Affordable Care Act to offer “patient-centered” care and cut healthcare-market costs. (We keep being slightly amused by term ”patient-centered” care. Isn’t that  the population that healthcare was always suppose to be centered on? Well, maybe not….Follow the money?)

Evergreen has two parts: a nonprofit insurance company with a traditional network of doctors and a health system that directly employs providers.

“We’re the first new commercial insurer in 20 years in Maryland as far as we know,” Peter Beilenson, M.D., a former Baltimore health commissioner, told The Baltimore Sun. “It’s not easy to have a successful startup in a state that basically has a monopoly,”  citing  CareFirst BlueCross BlueShield, Maryland’s dominant insurer.

Evergreen is one of 24 such co-ops in America, officially called Consumer Operated and Oriented Plans, and, as The Sun noted, ”many of them face similar behemoths.”

And the ACA doesn’t let these co-ops do traditional marketing. Further, government rules  make  it hard to sign up large employers that could bring  in many paying customers at once.
”That fierce competition {from big insurers} is the biggest hurdle to the co-ops’ success …. But there are a host of other potential stumbling blocks, including name recognition and funding, and the co-ops are responding by boosting their industry knowledge, aggressively marketing their services and cutting premium prices to lure customers, ” reports The Sun.

Evergreen looks to small businesses that it could attract on its own and enroll in groups. ”So far, about 1,000 small businesses employing {a total of} about 12,000 people have switched to the co-op.”

Research ”shows those insurers that follow the {co-op} model could save around 20 percent on hospitalizations alone, one of their biggest costs.”

We wonder how some of these co-ops might be integrated with Federally Qualified Health Centers.




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