Gun violence in the United States has reached alarming highs in recent years. Nearly 50,000 people lost their lives to guns in 2021, and guns are now the leading cause of death for children, teens, and young adults across the country. Gun violence also has a disproportionate impact on young Black men — and on people of color in general.
Gun violence’s toll is human and financial: about $1 billion is spent each year treating gunshot wounds, more than 50 percent of which is paid by Medicaid. Those who survive shootings bear the medical and psychological complications their entire lives, and consequences reverberate through families and communities. Many victims of gun violence are Medicaid-eligible, yet coordinated hand-offs among Medicaid agencies, health plans, providers, and community-based organizations are often lacking. This inaction at early critical moments often leads to worse outcomes (and increased expense) downstream. But there are emerging, evidence-based ways to address gun violence, most notably hospital-based violence intervention programs (HVIPs).
This panel discussion brought together clinicians, practitioners, and community leaders — representing national and local perspectives from Chicago, Connecticut, and Philadelphia — to discuss how the integration of gun violence prevention and Medicaid can create better outcomes for patients, savings for payers and systems, and safer communities. Leaders in the field of violence prevention, as well as experts in health care and Medicaid, shared concrete examples of work underway, explored strategies for integration, and discussed obstacles and opportunities for progress.
Related Resources
See the below resources from our panelists:
- New Coverage of Community Violence Prevention Services Under Medicaid – Provider Bulletin outlines new community violence prevention services under Connecticut Medicaid, including reimbursement policy and billing codes.
- Connecticut’s State Plan Amendment (SPA) on Community Violence Prevention – CMS’ Notice of Approval for Connecticut’s SPA, including approved text for coverage and reimbursement of community violence prevention services.
- Resources on Public Funding for Community Violence Intervention – Resources on Medicaid, federal, state, and local financing opportunities for violence intervention services curated by the Health Alliance for Violence Intervention (HAVI).
- The Medical Costs of Firearms Injuries in the United States: A Systematic Review – Article in The Journal of Emergency Medicine (August 2023) coauthored by HAVI’s Kyle Fischer analyzes studies on medical system costs associated with treating firearm injury.
- READIChicago – This 12-month program connects people most highly impacted by gun violence to cognitive behavioral interventions, transitional jobs training, and other social supports to reduce gun violence.
- Civic Coalition to Save Lives – This multi-stakeholder collaboration was created to reduce gun violence in Philadelphia.
Agenda
I. Welcome and Introduction
Speakers: Allison Hamblin, MSPH, President and Chief Executive Officer, Center for Health Care Strategies (CHCS), and Estelle Richman, Executive Director, Civic Coalition to Save Lives and Chair, CHCS Board of Trustees
A. Hamblin welcomed participants and introduced E. Richman who gave an overall introduction and insights into her work in Philadelphia.
II. Overview of Violence Intervention and HVIPs
Speaker: John Rich, MD, MPH, Director, RUSH BMO Institute for Health Equity and Member, CHCS Board of Trustees
J. Rich gave an overview of HVIPs as a gun violence prevention strategy, shared insights from his research and clinical experience, and highlighted the importance of linking HVIPs and other reimbursable strategies with Medicaid.
III. Community-Based Interventions and Medicaid Solutions
Moderator: E. Richman
E. Richman facilitated a discussion exploring opportunities to strengthen gun violence interventions in partnership with Medicaid. The panelists began with a brief overview of their work in the field and were joined by J. Rich as well as A. Hamblin.
Panel:
- Kyle Fischer, MD, MPH, Policy Director, Health Alliance for Violence Intervention
- Jayeti Newbold, PhD, Director of Strategic Initiatives, READI Chicago
- Brad Richards, MD, MBA, Chief Medical Officer, Connecticut Department of Social Services
IV. Moderated Q&A
Moderators: A. Hamblin
