Lessons from Eliot Fishman, Director at CMMI, on Medicaid from a Federal perspective
Jun 25, 2024
auto_awesome
Eliot Fishman, Director at CMMI, discusses Medicaid payment models, program integrity, and collaboration between Federal and State governments. He shares insights on value-based care, revenue growth strategies, and innovations in maternal health and substance use treatment. The episode concludes with tips for founders to engage with CMMI and a light-hearted discussion on exploring green spaces in Washington DC with a furry friend.
Elliot Fishman's varied career path provides a strong foundation for shaping Medicaid policies at the Federal level.
Outcome-based reimbursements in Medicaid drive quality care, cost-effectiveness, and innovation in health interventions.
Deep dives
Introduction to Elliot Fishman and His Public Health Policy Experience
Elliot Fishman's diverse career in public health policy, transitioning from management roles in health systems to government agencies like Medicaid, Medicare, and CHIP, provides a unique foundation. His involvement in consulting roles at health management firms and nonprofits has enriched his perspective on healthcare policy and implementation.
Insights from Early Policy Days in Health Systems
Elliot Fishman's early career experience in an integrated delivery system in New York City shaped his understanding of episodic payment methodologies, especially in areas like post-acute care and hospice services. This hands-on experience informed his approach to balancing patient care, government reimbursement methodologies, and quality-based payment structures.
Impactful Programs and Lessons Learned
Elliot Fishman reflects on lessons from his experience, highlighting the significance of business imperatives in healthcare systems and the need for realistic reimbursement frameworks. He shares insights on unmet needs in healthcare services, illustrating challenges in ensuring proper program integrity and addressing healthcare gaps effectively.
Innovative Approaches to Medicaid Programs
Elliot Fishman discusses the importance of outcome-based reimbursements for Medicaid programs, emphasizing a shift towards tailor-made payment structures. By aligning financial incentives with long-term health outcomes, efforts are focused on enhancing patient care quality, achieving cost-effectiveness, and encouraging innovative health interventions.
This episode is part of Pear VC's series on Medicaid, covering the basics that founders need to know to build innovations that support communities in need.
Today, we're excited to get to know Eliot Fishman, a director at CMMI who focuses on policy and programs that affect Medicaid beneficiaries.
Eliot comes to us with a long history of impact in public health policy. Eliot started his career as a policy associate at Mt. Sinai Health System in NYC and then went on to Manatt, Phelps & Phelps. He transitioned into a management policy role on the provider side again at MJHS, a large health system in the New York Area before he left to join the government.
Eliot then served at NJ Department of Health and Senior Services and Centers for Medicare and Medicaid Services for several years across different groups on Medicaid, Medicare and CHIP. Eliot also served in consulting roles at Health Management Associates and at nonprofits like Families USA.
In this episode, we learn about payment models within CMMI that attempt to foster innovation in care delivery for Medicaid, program and payment integrity and value-based care models as well as how the Federal government collaborates with State governments to improve care delivery.
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode