7
|
Bachman SS, Wachman M, Manning L, Cohen AM, Seifert RW, Jones DK, Fitzgerald T, Nuzum R, Riley P. Social Work's Role in Medicaid Reform: A Qualitative Study. Am J Public Health 2017; 107:S250-S255. [PMID: 29236537 DOI: 10.2105/ajph.2017.304002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To critically analyze social work's role in Medicaid reform. METHODS We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. RESULTS Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work's practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work's involvement in systems-level practice include lack of visibility, insufficient clarity on social work's role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. CONCLUSIONS Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level.
Collapse
Affiliation(s)
- Sara S Bachman
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - Madeline Wachman
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - Leticia Manning
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - Alexander M Cohen
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - Robert W Seifert
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - David K Jones
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - Therese Fitzgerald
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - Rachel Nuzum
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| | - Patricia Riley
- Sara S. Bachman and Madeline Wachman are with the Center for Innovation in Social Work and Health, Boston University, Boston, MA. Sara S. Bachman is also a guest editor for this supplement issue. Leticia Manning is with the US Public Health Service, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, Rockville, MD. Alexander M. Cohen is with the Health Integration Program, Cambridge Health Alliance, Outpatient Psychiatry, Cambridge, MA. Robert W. Seifert is with the Center for Health Law and Economics, University of Massachusetts Medical School, Shrewsbury. David K. Jones is with the Department of Health Law, Policy and Management, Boston University School of Public Health, Boston. Therese Fitzgerald is with Health Care Research, Analytics & Insights, Massachusetts Medical Society, Waltham. Rachel Nuzum is with the Federal and State Health Policy Initiative, The Commonwealth Fund, New York, NY. Patricia Riley is with the National Academy for State Health Policy, Portland, ME
| |
Collapse
|