Running head: STARTING WORK

Starting Work of the CMMI Award: A Critical Analysis Report

Alisha Beckford
Wilmington University













Running head: STARTING WORK

Abstract: Dr. Alisha Haushalter discusses her work on the program funded
through the Center for Medicare and Medicaid Innovation Award at NHPS. The
award was given to help a project that purposes to make reaching the goals of the
Affordable Care Act doable (Haushalter, personal communication, July 22, 2014).
This is done through having community liasions work with healthcare professionals,
each in their own professional settings (Haushalter, personal communication, July
22, 2014). The program has been demonstrated as valued, but could use
improvement in efficiency and communication (Haushalter, personal
communication, July 22, 2014).













Running head: STARTING WORK

Thus far, I have been interning with Nemours Health and Prevention
Services, and although I have been working on with the Community Infrastructure
team, I would continuously hear one of my fellow interns mention his work on
something called the CMMI Award. CMMI stands for Center for Meidcare and
Medicaid Innovation, and is being funded under the Affordable Care Act (Haushalter,
personal communication, July 22, 2014). Alisa Haushalter, a Director at NHPS, and
the project Director for this specific project explained that the award funded
components needed to assure that changing health care lined up with obedience to
the ACA (Haushalter, personal communication, July 22, 2014).
Dr. Haushalter explained that the need for this project stemmed from the
need to make sure the NHPS served population was receiving its share of proposed
benefits from the Affordable Care Act (Haushalter, personal communication, July 22,
2014). Haushalter noted that the drive for implementing the Affordable Care Act,
aside from trying to keep people insured, was to show health care providers that if
people are provided with the healthcare to prevent the diseases from worsening,
the long-term effect will be that less money is needed to spend on the healthcare it
itself (Haushalter, personal communication, July 22, 2014). With NHPS fighting for
the same thing, it is only appropriate that we would want to contribute, and would
do so with making sure it is implemented with community help, as well as
evaluating the results of the care (Haushalter, personal communication, July 22,
2014).
Running head: STARTING WORK
When it comes to implementation, the CMMI awarded project will focus on
assuring the outcomes of the patients, the quality of delivered care, and standard of
care training are being studied (Haushalter, personal communication, July 22,
2014). The disease that is specifically studied in this program is asthma, since this is
one of the main focuses of NHPS (Haushalter, personal communication, July 22,
2014).
I found the community involvement in this project to be very interesting. She
mentioned that in order to make sure the program was effective, a big change had to
take place: the community liasons and other community workers had to start
working with health practices, being more integrative than separate (Haushalter,
personal communication, July 22, 2014). One way in which the community leaders
became more integrative was in taking health professionals on tours of the
environments in which they patients lived, in order to show them exactly what the
patients had coming against them (Haushalter, personal communication, July 22,
2014). In return, the community liasions spend more time in the environments of
the health practices since the health system is so unique with strict requirments
(Haushalter, personal communication, July 22, 2014). I was surprised to find out
that this was something that had not been implemented for such a long time, and it
reminded me of when the Founder and Director of the Weight Management
program expressed his frustration over the lack of connection between him and his
patients home environment.
One component of this program in NHPS is the evaluation team, which
contains an evaluation scientist who studies the numerical results of the health
Running head: STARTING WORK
systems since making the efforts to make following the purpose of the Affordable
Care Act more doable (Haushalter, personal communication, July 22, 2014). This is a
necessary component because it is important to have someone on the team who can
choose the right measurement tools for evaluations as well as who can report the
information to the Center for Medicare and Medicaid (Haushalter, personal
communication, July 22, 2014).
During the explanation, I wondered what exactly the funding was going
towards for them to complete this project. The funding of the project from the
Affordable Care Act is used to fund new staff, as well as helpful implementation
components of the community (Haushalter, personal communication, July 22, 2014).
Some staff included community liasions as well as psychologists (Haushalter,
personal communication, July 22, 2014). Other things that were funded included
more indirect components, such as products for people in the community to prevent
asthma agitation, including pest management, as well as the health homes program,
Healthy Home Cleaning Kits (Haushalter, personal communication, July 22, 2014).
As the Director of the program, Dr. Haushalter acts as a coach and mentor
to those working under her on implementing this program, as well as providing the
Center for Disease Control with the health system outcomes, acting as the
spokesperson, as well as the principal investigator of the outcome information
(Haushalter, personal communication, July 22, 2014). She also keeps track of the
aspects that need to be changed, including the unmanageable time restraints for
reporting information to the Centers for Medicare and Medicaid Services
(Haushalter, personal communication, July 22, 2014).
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One strength of the system that Dr. Haushalter noted was that the work is
valued by other Nemours professionals so much that they are sought for insight on
other concerns within the Nemours health system (Haushalter, personal
communication, July 22, 2014). I admire this very much because I can relate to
worrying about whether the work I am doing is seen as competent and correct. To
not only be competent but uniquely contributive is complementary, and change that
needs to be done could take place by opening a door to the project team members.
As far as challenges, Haushalter made sure to note that the need to improve does not
disappear, but specifically includes being more effective with their change of the
health systems, as well as with extrapolating, translating, and communicating data
(Haushalter, personal communication, July 22, 2014). I recall an intern working on
the project mentioning that there was some poor communication in the data
collection process which resulted in a waste of time and work (Wu, personal
communication, July 15, 2014). In order to correct this, I would bring the issues up
in team meetings and make sure that team meetings within the departments and the
collaborative health systems are steady. I would enforce the practice of calling out
mistakes whenever they are noticed, regardless of whether the employee sees it as
their part of the project or not, within and outside of the department. I would also
ask that those working under me would give me steady reports not just of
information, but the eases and difficulties of collaborating with others. I would keep
the aspect of noting when the work is simply too much, as Haushalter described
earlier, and when to pass certain assignments on to others.
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When it comes to funding, if it were to cease under the Affordable Care Act,
or there simply was not enough, I would seek out grants, which is already a practice
within NHPS. This would be especially conducive being that at this point, there is
already work being done, and success and successful practices implemented. As for
employees and interns, I would seek people who have demonstrated succeeding in
detail-oriented work involving a great deal of numerical information, including
nursing, research positions, business and marketing. I would also seek those who
have demonstrated success in team work, including those who have had
management experience, even if they do not take on a management position within
the program. I would also seek those who have experience working on clinical
teams and/or backgrounds in public health or clinical social work.