Statewide Health and Human Services Outcomes Evaluations

Statewide Health and Human Services Outcomes Evaluations

Theo Kennedy (Theo)

has direct experience in outcomes evaluation for health and human services at the statewide level. As Director of Planning, Policy, and Regulation in the Department for Children and Families in the Vermont Agency of Human Services, Theo was responsible for updating and submitting the annual Agency Indicators (outcome measures) to show whether the Department was meeting the Agency’s goals of keeping Vermonters free from the impacts of poverty, ensuring they are healthy and safe, and making sure they have access to high-quality healthcare. He kept the scorecard that measured the Department’s success in specific areas, for example in ensuring eligible children are enrolled in Three Squares Vermont (the state’s SNAP program).

Vermont was technically the first public MCO for Medicaid in the nation, and in 2009 Theo led the first Performance Improvement Project (PIP), adhering to strict evaluation protocols established by the CMS. The focal project was to evaluate the questionnaire being used at the point of intake for bringing marginalized and troubled youth into the child welfare system in Vermont. The goal was to make sure all the necessary information was being gathered to make the child’s first meeting with a primary care physician and with a case manager meaningful, and to ensure that children were being routed through the best possible plan of care.

Healthcare Initiatives

Healthcare Initiatives

Working as Director of Health Rates and Forms for the Vermont Department of Banking, Insurance, Securities, and Health Care Administration (now the Vermont Department of Financial Regulation) at the inception of HIPAA, Theo led an initiative to explore the possibility of giving discounts on insurance premiums to incentivize healthy behaviors.

Theo recognized that in a bona fide Wellness Program, it is crucial to avoid creating standards that discriminate against segments of the population and it is important to visualize accommodations. For example, a discount on insurance premiums could be offered for joining a smoking cessation program or for buying a gym membership, but in the area of obesity some individuals’ health condition may prevent them from meeting goals established with a majority population in mind.

Theo suggested that one approach to meeting HIPAA’s goals is to offer the incentive to providers, establishing metrics for accountability and rewarding providers who meet the standards of best practice. A version of pay-for-performance, this model would establish that providers would be paid a specified amount for a certain service, but they would receive additional pay if they have met all the identified best practices for that health condition.

Another of Theo’s concerns with regard to insurance was the creation of parity within Medicare plans, placing people with disabilities, elderly people, limited-English populations, people with mental health issues, and other diverse populations on an equal footing in their access to health insurance coverage.

Snap Benefits

Snap Benefits

A project initiated by Theo Kennedy in Vermont led to the ability of SNAP beneficiaries in the state to use their benefit cards at local farmers’ markets, guaranteeing them access to the freshest and highest quality local food, often for more affordable prices than at local-foods grocery stores.

Theo explored the idea of working with the federal Department of Agriculture to subsidize healthy purchases made with SNAP benefits, hoping to find a mechanism for adding value to benefit dollars when they are spent on fresh or frozen fruits and vegetables, as opposed to processed foods. Without penalizing recipients for the level of benefit they are entitled to, such a program would create the incentive to eat healthier foods by making the beneficiary’s dollar go further in purchasing them. Although that idea did not come to fruition, it did lead to the ability of participants in Three Squares Vermont to get access to the high-quality fresh foods offered year-round at farmers’ markets throughout the state.