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States are plowing billions of dollars into a high-stakes health care experiment thats exploding around the country: using scarce public health insurance money to provide housing for the poorest and sickest Americans.

This story also ran on CNN. It can be republished for free.

California is going the biggest, pumping $12 billion into an ambitious Medicaid initiative largely to help homeless patients find housing, pay for it, and avoid eviction. Arizona is allocating $550 million in Medicaid funding primarily to cover six months of rent for homeless people. Oregon is spending more than $1 billion on services such as emergency rental assistance for patients facing homelessness. Even ruby-red Arkansas will dedicate nearly $100 million partly to house its neediest.

At least 19 states are directing money from Medicaid the state-federal health insurance program for low-income people into housing aid and addressing the nations growing homelessness epidemic, according to the Centers for Medicare & Medicaid Services. Even though theres little agreement that this will provide a long-term fix for vulnerable patients health or housing, the Biden administration is encouraging other states to jump in. Several are in the pipeline, including Tennessee, West Virginia, and Montana and New York got the green light from the federal government in January.

Using health care funding to house people is a big philosophical debate, said Alex Demyan, assistant director of Arizonas Medicaid agency. We know health care cant solve all the problems, but we also know that housing agencies are maxed out and we have enormous need to help stabilize people.

Homelessness jumped 12% in the U.S. last year, to an estimated 653,104 Americans, the highest level on record, even as the nation dramatically increased its inventory of permanent housing and temporary shelter beds.

As people languish on the streets, often struggling with addiction, severe mental illness, and untreated chronic diseases, health care officials and political leaders are turning to health insurance money for relief. They argue that housing aid will improve health and save taxpayer money by keeping people out of institutions such as nursing homes, hospitals, and jails.

But evidence supporting this argument is mixed.

For instance, in a trial by researchers at the University of California-San Francisco, homeless people in Santa Clara County, California, who were randomly assigned to receive long-term housing and services used the psychiatric emergency department 38% less than a control group over four years while increasing their use of routine mental health care. But participants were still hospitalized at high rates and continued to rely on the emergency room for routine medical care or rest.

State Medicaid programs have long dabbled in housing, but with the blessing and encouragement of the Biden administration, they are launching more services for more people with heaps of new state and federal money. The trend is part of a broader White House strategy that encourages Medicaid directors to offer social services alongside traditional medical care, with the goal of making their residents healthier.

A health care dollar can do more than just pay for a doctor visit or hospital stay, Xavier Becerra, secretary of the U.S. Department of Health and Human Services, told KFF Health News. We should be using the federal health care dollar for wellness care: Get them before they get ill, and keep them healthy. Is there anyone who would deny that someone who is homeless is going to have a harder time also keeping their health up than someone who is housed with running water and heat?

Becerra acknowledged these initiatives as experiments. But he said the federal government can no longer ignore the rampant death and disease that is plaguing homeless populations around the U.S.

Were simply saying, State, if you can prove to us that with this Medicaid dollar you will improve someones health or health outcome, then you have essentially served the purpose of the Medicaid program and youre saving taxpayers more money, he said.

But not all health care leaders or even homelessness experts believe this is the best use of Medicaid money, especially by a safety-net program that faces routine criticism for failing to provide basic health care to many enrollees.

If youre on Medicaid, you often have to wait months and months for a specialty visit, even if its a life-threatening concern, so I worry about what people wont be able to get because of this, said Margot Kushel, a leading homelessness researcher and primary care doctor at Zuckerberg San Francisco General Hospital and Trauma Center who primarily treats low-income patients.

Its not that I dont want the money to be spent, but is it best spent in health care? she asked. It’s much better than nothing, but it’s far from providing the long-term housing and stability that people really need.

Kushel said the danger is that most Medicaid housing assistance can be used only once or is time-limited, such as rental payments, which typically end after six months.

By the time folks get into housing, theyre already really, really sick, she said. What happens at the end of six months when rental assistance like free rent runs out? Email Sign-Up

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Housing as Health Care

Across the country, state Medicaid programs are stretching the definition of health care and getting into the business of social services, delivering a range of nontraditional benefits such as healthy home-delivered meals for patients with diabetes and air filters for patients with asthma.

While the federal government historically has banned the use of Medicaid money for direct rent payments, that has changed.

In 2022, Arizona received federal approval for an initiative called H2O, which will prioritize homeless people and those at risk of losing housing who also have a mental health condition and chronic illness. When it launches in October, it will primarily provide two services: rent payments for up to six months; and transitional housing, which can include shelters with intensive services.

Arizona saw a 5% jump in homelessness in 2023 from the previous year. Its program will supplement a separate state-funded Medicaid initiative that provides 3,000 rent vouchers for people in southern Arizona who have a severe mental illness and are homeless or at risk of becoming homeless. About 5,000 people are on the waiting list for a voucher.

Weve seen such positive health outcomes and cost reductions as a result, so it made total sense to us to expand our work in that space, Demyan said. That program slashed ER visits 45% and reduced hospital inpatient admissions 53% at the six-month mark after patients started receiving services, while increasing less costly preventive care 56% and saving $4,300 per member, per month, according to state data.

California, home to nearly 30% of the nations homeless population, saw a nearly 6% jump in homelessness in 2023, to about 181,000 people.

The state launched its massive CalAIM initiative in 2022 to offer a wide variety of social services to a small sliver of the states roughly 15 million Medicaid enrollees. A large share of the resources are going to housing services for homeless people or those facing eviction, such as covering security deposits and enlisting case managers to hunt for available apartments. State leaders are also asking the Biden administration for permission to provide six months of rent.

If youre saddled with a great deal of either physical or behavioral health conditions, whether its diabetes or HIV, high blood pressure or schizophrenia, without housing, its really hard to stabilize those conditions, said Mark Ghaly, secretary of the California Health and Human Services Agency.

But he cautioned that Medicaids core focus must remain getting people healthy, even if theyre living outside, which is a monumental and expesive challenge because conditions like diabetes, heart disease, and HIV require continuous treatment and often multiple medications.

I do not think that health care is responsible for solving homelessness in California or anywhere else, Ghaly said. But if housing instability or lack of housing is one of the key drivers getting in the way of being healthy, then absolutely we need to pay attention to it.

Health insurers that provide Medicaid coverage in California can choose whether to provide housing services, but Oregon is requiring Medicaid insurers to do so.

Homelessness grew 12% in Oregon from 2022 to 2023, but the state is targeting patients at risk of becoming homeless. Participants will be eligible for six months of rent and other services when the program launches in November, said Dave Baden, deputy director of the Oregon Health Authority.

Were really trying to focus on people teetering on the brink, Baden said. If youre already homeless, you really need longer, sustainable housing dollars to keep that person housed.

Its not just states experimenting with this approach. Kaiser Permanente is one of the health systems that has invested its own funds into housing. In recent years, the health care giant has committed hundreds of millions of dollars to help maintain or build thousands of affordable housing units, in addition to providing housing-related Medicaid benefits for its members.

We have to do something. The crisis is out of control, said Bechara Choucair, its chief health officer. Are you covered by Medi-Cal?

We want to hear about your experiences and, with your permission, may incorporate your story into our coverage. Please tell us what it has been like for you as you have sought and received care, including the good and the bad, the obstacles and the successes.Share Your Story

Mission Creep

Sherry Glied, a professor at New York University and former Obama administration official who is an expert in health care economics, warned in a recent health policy analysis of mission creep in health care. She cautioned that health care institutions getting into the business of social services could be a dangerous distraction.

Glied pointed to at least 57 health systems and 917 hospitals around the country that have launched social service initiatives, with most focusing on housing. Because many institutions struggle to meet patient safety and quality care standards, Glied argued that they should instead improve basic care and leave housing to social service organizations that specialize in this work.

Providing people with food or housing is pretty far removed from the core mission of health care, she told KFF Health News.

Peter Lee, another former Obama administration official and the founding executive director of Californias Obamacare exchange, said health care providers should consider offering some housing and social services, but he fears such initiatives may divert money from traditional medicine and prevent patients from getting adequate care.

In the past five to 10 years, there has been a lot of recognition that health is about much more than actual health care. Very true, Lee said. The question is how do you address those issues while health care itself is not doing too great. The brass tacks of this is making sure people with diabetes have great diabetes care, that people get checkups in time, that people can get the regular health care they need.

State Medicaid programs, which provide care to at least 80 million Americans, often struggle to deliver basic medical services, such as childhood dental visits and breast cancer screenings. In California, the state spending the most on housing services, children on Medicaid did not have timely access to care for mental health or substance use in 2022, according to an audit published in November.

Despite these shortfalls, most of the states that have been given the federal go-ahead to experiment with housing services have secured funding for five years. California is among the states that hope to make the benefits permanent.

Though a Republican presidency could interrupt this trend, states say theyre committed even if their initiatives dont pass a traditional cost-benefit analysis.

The singular focus on a financial return on investment is not as clear as it was previously, said Cindy Mann, a federal Medicaid director under Obama.

States are just seeing how little sense it makes to treat people and then release them back to the streets without the support they need.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Angela Hart: ahart@kff.org, @ahartreports Related Topics California Health Industry Insurance Medi-Cal Medicaid Public Health Arizona Arkansas California Legislature Homeless Legislation Montana Oregon Tennessee West Virginia Contact Us Submit a Story Tip

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Dune: Prophecy star Olivia Williams says series is the first time she has felt confident her scenes would not be cut

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November 19, 2024

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Dune: Prophecy star Olivia Williams says series is the first time she has felt confident her scenes would not be cut

British actress Olivia Williams has said that in more than 30 years of acting on screen, starring in Dune: Prophecy is the first time she has felt confident her scenes would not be cut from a project.

Williams, who has appeared in films including The Sixth Sense, Rushmore and An Education, and portrayed Camilla Parker Bowles, before she became Queen, in the final two seasons of The Crown, can now be seen in the TV prequel to the blockbuster Denis Villeneuve films.

She stars alongside her close friend Emily Watson, with the pair playing the Harkonnen sisters – two women fighting forces that threaten the future of humankind.

Emily Watson and Olivia Williams in Dune - Prophecy. Pic: Sky Atlantic/ HBO
Image:
Emily Watson and Olivia Williams star together in Dune: Prophecy. Pic: Sky Atlantic/ HBO

Based on the Dune and Sisterhood of Dune novels, the Sky Atlantic show is set 10,000 years before the birth of Timothee Chalamet‘s character, Paul Atreides, in the films, and follows the two women as they found the fabled sisterhood that will later become known as the Bene Gesserit.

Timothee Chalamet and Zendaya in Dune: Part Two. Pic: Warner Bros. Pictures
Image:
The series is a prequel to the Dune films, which star Timothee Chalamet and Zendaya. Pic: Warner Bros. Pictures

Despite knowing each other for 30 years, and even working at the Royal Shakespeare Company (RSC) at the same time, the show marks Williams and Watson’s first time on screen together.

Williams says they are often asked why they have never acted together before. There’s a simple answer, she tells Sky News. “It’s because there are no scripts for two women of the same age to lead a story.

“We’re used to playing the character that can, if the film’s running a bit long, be cut out because you don’t genuinely affect the plot of the show. Well, just try cutting the Harkonnen sisters out of this story!”

She adds: “We knew that our work would be used – which, in 35 years, I’d say is the first time that’s happened.”

Olivia Williams as Reverend Mother Tula Harkonnen in Dune - Prophecy. Pic: HBO/ Sky Atlantic
Image:
Williams plays Sister Tula Harkonnen. Pic: HBO/ Sky Atlantic

In Dune: Prophecy, Watson plays the Mother Superior of the Bene Gesserit Sisters, Valya Harkonnen, whilst Williams plays her younger sibling, Sister Tula Harkonnen.

Watson, who recently starred alongside Oscar winner Cillian Murphy in Small Things Like These, says it feels wonderful to be given the freedom to portray strong, stoic characters.

“When we were first cast, we went and sat in the National Portrait Gallery and sat in front of portraits of Queen Elizabeth I, Mary, Queen of Scots, Bloody Mary, and just thought about that time when those very powerful women were front and centre, and terrified and deeply paranoid because everybody wanted to either marry them or kill them.”

Jodhi May as Empress Natalya Arat Corrino and Mark Strong as Emperor Javicco Corrino in Dune - Prophecy. Pic: Sky Atlantic/ HBO
Image:
Jodhi May and Mark Strong also star. Pic: Sky Atlantic/ HBO

The two actresses first met outside the Black Swan pub in Stratford-upon-Avon when they were starting out in their careers with the nearby RSC.

Williams says it “doesn’t feel real” that their careers have become as successful as they have.

“It is an extraordinary thing that I said I would stop at 30 and go and try to be a lawyer. I didn’t intend to be working as an actor and now I can’t believe my luck.

“You get to the end of every job and you go, was that the last time I will act? And that is a really tough way to, you know, bring up a family and you can’t get a bloody mortgage or life insurance with a lifestyle like that. So anyway, that was my real-life whinge.”

Read more:
Boy George on the price of fame
A crushed car and trouser scraps: From fan club to band

Watson said the experience of leading a big-budget series together was not lost on her, and she felt an onus to help create a positive environment for the younger actors.

“We were like the CEOs and we were making sure that everybody was seen and felt part of something and were feeling okay about how everything was going down. And it felt like a really healthy way to do it.”

Dune: Prophecy is available to watch on Sky Atlantic and Now

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Home secretary to announce extra £500m for neighbourhood policing

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November 19, 2024

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Home secretary to announce extra £500m for neighbourhood policing

An extra £500m of additional funding will be given to neighbourhood policing, the home secretary is set to announce.

Yvette Cooper will also lay out plans for a new unit to improve the performances of police forces across the country to end the “postcode lottery” of how effectively crimes are dealt with.

The Home Office says the unit will directly monitor police performance in areas prioritised by the government, including tackling violence against women and girls and knife crime.

The home secretary will make the announcements in her first major speech at the annual conference of the National Police Chiefs’ Council and Association of Police and Crime Commissioners on Tuesday.

Politics latest: PM branded ‘desperate’ after talks with China’s Xi

Ms Cooper is expected to say: “Public confidence is the bedrock of our British policing model but in recent years it has been badly eroded, as neighbourhood policing has been cut back and as outdated systems and structures have left the police struggling to keep up with a fast-changing criminal landscape.

“That’s why we’re determined to rebuild neighbourhood policing, to improve performance across police forces and to ensure the highest standards are being upheld across the service.

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“The challenge of rebuilding public confidence is a shared one for government and policing.

“This is an opportunity for a fundamental reset in that relationship, and together we will embark on this roadmap for reform to regain the trust and support of the people we all serve and to reinvigorate the best of policing.”

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‘Miscalculation’ over government’s handling of assisted dying issue

As well as the new government performance unit, ministers also hope to improve the relationship between the public and the police by standardising and measuring police response times – something that is not currently monitored.

In the aftermath of the summer riots, sparked by the Southport stabbings on 29 July, Ms Cooper said respect for the police needed to be restored after the “brazen abuse and contempt” shown by the perpetrators.

She said too often people feel “crime has no consequences” and that “has to change” as she promised to restore confidence in policing and the criminal justice system.

Dr Rick Muir, director of policing thinktank the Police Foundation, said: “A serious reform programme like this in policing is long overdue.

“Too often in the past, officers at the frontline have been let down by outdated technology, inadequate training and inefficient support services.

“Until these issues are addressed, the public won’t get the quality of policing they deserve.”

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Sports

MLB Awards Week results and analysis: Skenes, Gil each win Rookie of the Year

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November 19, 2024

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MLB Awards Week results and analysis: Skenes, Gil each win Rookie of the Year

  • Bradford Doolittle, ESPN Staff WriterNov 18, 2024, 07:02 PM ET

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    • Sports reporter, Kansas City Star, 2002-09
    • Writer, Baseball, Baseball Prospectus
    • Co-author, Pro Basketball Prospectus
    • Member, Baseball Writers Association of America
    • Member, Professional Basketball Writers Association

Welcome to MLB Awards Week.

November has become awards season in baseball, which increasingly serves as a way to keep eyeballs on the game before the hot stove season ramps up. So far, we’ve gotten the Gold Glove Awards, Silver Sluggers, the All-MLB Team and more.

Now, it’s time for the biggies — the four major awards determined by Baseball Writers’ Association of America voting and that will feature prominently in baseball history books and Hall of Fame résumés of the future. The winners are being announced live each night on MLB Network, starting at 6 p.m. ET.

On Monday, a pair of starting pitchers — Paul Skenes of the Pittsburgh Pirates and Luis Gil of the New York Yankees — got the week rolling, winning the Jackie Robinson Rookie of the Year Award in the National League and American League, respectively.

Here’s the rest of the week’s schedule:

Tuesday: Managers of the Year

Wednesday: Cy Young Awards

Thursday: MVP Awards

Below, we list the three finalists in each of the big four categories, with what you need to know before the results are announced, and who our panel of ESPN MLB experts believes should take home the hardware. We’ll update each section with news and analysis as the awards are handed out.

Jump to:
Rookie of the Year: AL | NL
Manager of the Year: AL | NL
Cy Young: AL | NL
MVP: AL | NL

American League Rookie of the Year

Winner: Luis Gil, New York Yankees

Final tally: Gil 106 (15 first-place votes); Colton Cowser, Orioles, 101 (13); Austin Wells, Yankees, 17; Mason Miller, Athletics, 16 (1); Cade Smith, Guardians, 12 (1); Wilyer Abreu; Red Sox, 11; Wyatt Langford, Rangers, 7

Experts’ pick: Gil (7 votes); Cowser (1 vote); Smith (1 vote)

Doolittle’s take: This was a race in which you could have plucked the names of any of about seven players out of a hat without worry of finding a wrong answer. Of course, by the time Monday rolled around, we were down to three names in that hat, the finalists, but the statement holds true. There was no wrong answer, which is probably why the voting was so close.

With no clear front-runner, voters had to weigh some narrative aspects alongside a muddy statistical leaderboard, one that gave different answers depending on which site you happened to pull up. That’s why AXE (see note) exists — to create a consensus from these different systems — but it didn’t do much to clarify the AL rookie derby.

Gil and Wells, both essential rookie contributors to the Yankees’ run to the World Series, excelled with a lot of eyeballs on them all season, and that certainly didn’t hurt their support. Cowser’s role as an every-day player for the playoff-bound Orioles also had a high-visibility context. It feels like that, as much as anything, is why this trio emerged as finalists in a hard-to-separate field.

The emergence of Gil and the gaps he filled in an injury-depleted Yankees rotation were too much to ignore. It was a surprising emergence: Gil is 26, and he debuted in professional baseball way back in 2015 as a 17-year-old in the Minnesota organization. But when you talk about impact, you can conjure up all sorts of ill scenarios for New York had he not led AL rookies with 15 wins, 141 strikeouts and a 3.50 ERA (minimum 10 starts).

The voters got it right, if only because they could not possibly have gotten it wrong.

Here’s how my AXE leaderboard had it:

1. Smith, Guardians (117 AXE)

2. Langford, Rangers (116)

3. (tie) Miller, Athletics (115)

Abreu, Red Sox (115)

Gil, Yankees (115, winner)

6. Wells, Yankees (113, finalist)

7. Cowser, Orioles (111, finalist)

Note: AXE is an index that creates a consensus rating from the leading value metrics (WAR, from FanGraphs and Baseball Reference) and contextual metrics (win probability added and championship probability added, both from Baseball Reference), with 100 representing the MLB average.

ROY must-read:

Bump in the road or ominous sign: Has Luis Gil hit a wall after his red-hot start?

National League Rookie of the Year

Winner: Paul Skenes, Pittsburgh Pirates

Final tally: Skenes 136 (23 first-place votes); Jackson Merrill, Padres, 104 (7); Jackson Chourio, Brewers, 26; Shota Imanaga, Cubs, 4

Experts’ pick: Skenes (8 votes); Merrill (1 vote)

Doolittle’s take: Skenes emerged as the winner of a star-studded NL rookie class that was deep in impact performances put up by high-upside prospects who should only get better as the years progress. It was also a classic debate, one that stirs the passions whether you are driven by traditional approaches or the most current of performance metrics: Can a starting pitcher really produce more value than a position player given the disparity in games played?

It’s a debate mostly settled in the MVP races, where pitchers only occasionally bob up to forefront of the conversation. The one in the NL Rookie of the Year race this season between Skenes, Merrill and, to a lesser extent, Chourio was a classic example.

Sure, Skenes was absolutely dominant; he’s a finalist in the NL Cy Young race, for goodness sake. Still, we’re talking about 23 games. Meanwhile, Merrill’s gifts were on display in 156 contests for the Padres, while Chourio played in 148 games for Milwaukee. Yes, the value metrics are supposed to clarify these comparisons, but, still, how do you weigh that kind of disparity between players with entirely different jobs?

In the end, I’m not sure there’s a right answer to that debate, nor is there a wrong answer to this balloting. Each of the finalists would have been a slam-dunk winner in many seasons. Skenes might very well be the best pitcher in baseball by the time we get to these discussions a year from now, if he isn’t already. In less than a year and a half, he has been the top overall pick in the draft, started an All-Star Game and become a finalist in two of the NL’s major postseason awards.

You can certainly makes cases for Merrill and Chourio. But you can’t really make a case against Skenes, 23 games or not. Since earned runs became official in 1913, Skenes became the fourth pitcher with a strikeout rate of at least 11 per nine innings while posting an ERA under 2. He’s just that much of an outlier.

Here’s how my AXE leaderboard had it:

1. Skenes, Pirates (131 AXE, winner)

2. Merrill, Padres (128, finalist)

3. Chourio, Brewers (123, finalist)

4. Masyn Winn, Cardinals (119)

5. Imanaga, Cubs (117)

ROY must-reads:

Why Pirates called up Paul Skenes now — and why he could be MLB’s next great ace

Ranking MLB’s best rookies: Is Paul Skenes or an outfielder named Jackson No. 1?

American League MVP

Finalists:

Aaron Judge, New York Yankees

Bobby Witt Jr., Kansas City Royals

Juan Soto, Yankees

Experts’ pick: Judge (9 votes; unanimous)

Doolittle’s take: While the outcome seems like (and almost certainly is) a no-brainer, don’t let that make you lose sight of the overall dynamic around this award. In a nutshell: This is one of the greatest MVP races ever, in terms of historically elite performances from players in the same league.

The dominant performances went beyond the finalists. Five AL players posted at least 7.9 bWAR, led by the three MVP finalists, as well as Boston’s Jarren Duran and Baltimore’s Gunnar Henderson, who both finished with higher bWAR totals than Soto. Only once before has the AL had five players produce at that level in the same season — way back in 1912.

While Soto was never far out of the picture, this was a high-octane two-player race for most of the season between the mashing dominance of Judge and the five-tool mastery of the dynamic Witt. Judge won the bWAR battle by a good margin (10.8 to 9.4) and seemed to pull away at the end of the season. Even if you don’t like to think of this in terms of bWAR, it’s hard to look past league-leading totals of 58 homers and 144 RBIs and a third-place .322 batting average, all on the league’s best team.

The real drama surrounding this award is tied to that of the NL: Will we have two unanimous MVP picks? If so, that would be just the second time it’s happened. The first? Last year, when Shohei Ohtani (then with the Angels) and Ronald Acuna Jr. (Braves) pulled it off.

MVP must-reads:

Aaron Judge is the fastest ever to 300 home runs — but how many more will he hit?

Better than Bonds in 2001 and Ruth in 1921? How Aaron Judge’s season stacks up to the best in MLB history

Only Juan Soto can decide if his future is with the Yankees

Baseball’s next superstar? Bobby Witt Jr.’s rise to MLB’s top tier

National League MVP

Finalists:

Shohei Ohtani, Los Angeles Dodgers

Francisco Lindor, New York Mets

Ketel Marte, Arizona Diamondbacks

Experts’ pick: Ohtani (9 votes; unanimous)

Doolittle’s take: When the DH became a part of big league baseball back in the 1970s, those who defended it tended to point out how it would allow older superstars to hang around for a few more years. Thus the default image of the DH was the aging, plodding slugger trying to generate occasional glimpses of what he used to be.

Things have changed. Ohtani did not don a baseball glove during a game this season and yet established himself as far and away the most dominant player in the National League. The numbers were staggering: .310/.390/.646, 54 homers, 59 stolen bases. He scored 134 runs and drove in 130, even though 57% of his plate appearances came as the Dodgers’ leadoff hitter.

As with Judge, the intrigue isn’t about whether Ohtani will win, but whether or not he’ll be a unanimous pick. And, let’s face it, there’s not much intrigue about that, either. If Ohtani does it, it’ll be the third time he has been a unanimous selection. No one else has done it even twice.

MVP must-reads:

51 HRs AND stolen bases?! How Shohei Ohtani transformed MLB — again

Breaking down Ohtani’s path to 50/50 — and the historic game that got him there

How Francisco Lindor became the heart and soul of the Mets

American League Cy Young

Finalists:

Tarik Skubal, Detroit Tigers

Seth Lugo, Kansas City Royals

Emmanuel Clase, Cleveland Guardians

Experts’ pick: Skubal (9 votes; unanimous)

Doolittle’s take: Long touted for his upside, Skubal put it all together in 2024, becoming the AL’s most dominant and consistent starting pitcher during the regular season, leading the Tigers to a surprise postseason berth.

Skubal became the AL’s first full-season winner of the pitching triple crown since another Tiger, Justin Verlander, did it in 2011. (Cleveland’s Shane Bieber did it in the shortened 2020 season.) With league-leading totals of 18 wins, 228 strikeouts and a 2.39 ERA, Skubal is well positioned to win his first Cy Young.

Lugo becomes the Royals’ rotation representative in the finalist group, honoring one of MLB’s breakout units in 2024, though teammate Cole Ragans might have been just as worthy. Entering the season, Lugo had never qualified for an ERA title, but in his first campaign for Kansas City, he threw 206⅔ innings, going 16-9 with a 3.00 ERA.

Clase struggled in the postseason but the voting took place before that, and it recognized his unusually dominant season, good enough to justify his presence in this group despite his role as a short reliever. In 74 outings, featuring 47 saves, Clase allowed just five earned runs. He’s still a reliever and, thus, a long shot to win the award, but getting this far says a lot. The last reliever to win a Cy Young Award was the Dodgers’ Eric Gagne in 2003.

Cy Young must-read:

It’s Tarik Skubal time: With season on the line, Tigers turn to ‘best pitcher in the world’

National League Cy Young

Finalists:

Chris Sale, Atlanta Braves

Paul Skenes, Pittsburgh Pirates

Zack Wheeler, Philadelphia Phillies

Experts’ pick: Sale (8 votes); Wheeler (1 vote)

Doolittle’s take: What an interesting group of finalists this is. Value-wise, it’s a close race.

Wheeler is the constant here, as he’s enjoying a seven-year run as one of the NL’s top starting pitchers. Wheeler is still looking for his first Cy Young and entered the balloting this time around with his best résumé to date. Yet Wheeler is coming up against two pitchers with arguably more compelling — and very different — narratives.

Skenes is baseball’s ascendant ace. Few pitchers have reached the majors with higher expectations in recent years. He met the hype head-on and, if anything, proved to be even better than we thought. With the innings volume of baseball’s best starters much less than it used to be, it is possible for an elite run preventer to save runs at a clip that puts him among the league leaders during a partial season. It wasn’t Skenes’ fault that he wasn’t called up until the second week of May. All he did after that was post a 1.96 ERA over 23 starts while displaying a remarkable degree of consistency. There wasn’t a true clunker in the bunch.

And yet Sale might have been more dominant if you consider defensive-independent ERA (or FIP), in which Sale’s 2.09 bested Skenes’ 2.45. Also, like Skubal, Sale (18 wins, 2.38 ERA, 225 strikeouts) became the first pitching triple crown winner of his league since 2011. In Sale’s case, he became the first to do it since L.A.’s Clayton Kershaw.

All this from a pitcher who once finished sixth or better in AL Cy Young voting seven straight seasons. He has never won, though, and the last of those seasons was 2018. Sale’s days as a premier starter seemed long gone … and then he did this. That’s a good narrative.

Cy Young must-reads:

Did Chris Sale pitch himself into the HOF this year?

Inside Chris Sale’s third act: From considering walking away to becoming an MLB superteam’s missing piece

The best stuff in baseball? How Paul Skenes is using his pitches to dominate MLB

American League Manager of the Year

Finalists:

A.J. Hinch, Detroit Tigers

Matt Quatraro, Kansas City Royals

Stephen Vogt, Cleveland Guardians

Experts’ pick: Quatraro (5 votes); Hinch (3 votes); Vogt (1 vote)

Doolittle’s take: The AL Central had four solid teams in 2024, three more than most thought the division would have, and the three surprise clubs are represented here as finalists.

All of these managers have compelling cases. Hinch guided the Tigers to their second-half surge even after Detroit subtracted at the trade deadline and had to navigate around a depleted starting rotation. He has finished in the top five of balloting four times but has never won.

Vogt, a first-time manager filling the shoes of Cleveland legend Terry Francona, also had to lean on his bullpen because of rotation issues and did so with aplomb.

Yet it’s Quatraro who really stands out, leading a Royals team that lost 106 games in 2023 to the postseason. Kansas City had lineup holes and a constantly evolving bullpen picture, yet Quatraro and his staff found a way to leverage his team’s strengths (rotation, defense, Witt) into an October appearance.

National League Manager of the Year

Finalists:

Carlos Mendoza, New York Mets

Pat Murphy, Milwaukee Brewers

Mike Shildt, San Diego Padres

Experts’ pick: Murphy (6 votes); Mendoza (3 votes)

Doolittle’s take: Mendoza had a fantastic first season in the Mets’ dugout, helping the team overcome a sluggish start and eventually end up facing the Dodgers in the NLCS. He did so with quiet, consistent leadership and that bodes well for his ability to last a long time in one of baseball’s most challenging environments.

Shildt, who won the award in 2019 while with the Cardinals, proved to be a feisty presence on a star-laden team with middling expectations that kept rising as the season progressed.

Murphy’s season is hard to beat. Handed the reins of a big league team for a full season for the first time at 65, Murphy was able to put his imprint on the young Brewers. This was no small feat given the departure last winter of his onetime protege, Craig Counsell, arguably the face of the franchise.

Milwaukee went young, suffered rotation shortages and had a number of moving parts in its lineup. Behind Murphy, the Brewers changed their style of play to better accentuate the athleticism on the roster, won 93 games and cruised to another NL Central title.

Earlier awards

Executive of the Year: Brewers president Matt Arnold named exec of the year

Doolittle’s take: I’ve written a couple of times this year that I think the Brewers might be the best-run organization in baseball right now, so that speaks to how I view the work of Arnold and his staff. I also have a kind of organizational mash-up metric I track during the season that considers things such as injuries, rookie contribution, payroll efficiency and in-season acquisitions, and Milwaukee topped that leaderboard.

And yet it’s somewhat stunning that Kansas City’s J.J. Picollo did not win this honor. He oversaw the team’s leap from 106 losses to the playoffs, using free agency to bolster the roster and staying proactive at the trade deadline (and the August waiver period) to provide essential upgrades that put the Royals over the top. It’s hard to do a better one-season job as a baseball ops chief than what Picollo did this season.

All-MLB: 2024 All-MLB First and Second Team winners

Doolittle’s take: Nobody asked me about these picks, but they read as if they did. I had the same first team. On the second team, I might have opted for Matt Chapman over Manny Machado at third base, but if that’s my one note, the selectors did a heck of a job. Or maybe I did.

Gold Gloves: Royals’ Bobby Witt Jr. among 14 first-time Gold Glove winners

Doolittle’s take: For all the uncertainty in making defensive picks, the consensus defensive metric I used more or less mirrored the Gold Glove selections. I would have taken Chourio or Washington’s Jacob Young as one of the NL’s outfielders in place of Ian Happ.

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