When talking to healthcare professionals, what are some of the barriers that are preventing healthcare systems from being able to address patient needs outside of clinical care? What role does technology play?
The classic analogy for the challenge healthcare systems face in addressing a patients social determinants of health is the physician with each foot in a different canoe. As the healthcare reimbursement environment evolves, providers are tasked with improving the health of their population while continuing to deliver great treatment to acute and catastrophic patients. And since we know that social, environmental and behavioral factors account for 60% or more of health, the ability to understand and affect these factors has become extremely important for healthcare providers. There are some processes providers may put in place to begin addressing non-clinical factors of health such as care management teams. However, the only way to truly scale an effective program that addresses social determinants and population health across an entire patient population is through technology. Technology is playing a vital role in expanding efforts to address patient needs outside of clinical care
How do you think we can work to break down these barriers?
Most health providers and plans are already developing programs to address social determinants for their patients and members. We even see The Centers for Medicare and Medicaid Services pushing toward a whole patient focus with programs like the Accountable Health Communities Model, Comprehensive Primary Care Initiative and others. The best way for health providers and plans to continue to break down these barriers is not only to continue to develop programs that address social determinants of health but to also embrace technological advances. Health providers and plans need a strong technical and operational infrastructure in order to help payers and providers migrate from a volume to a value-based system and improve health beyond the clinical setting. This is where Healthify comes in. Healthify is playing an important role in helping providers and plans leverage our best practices to quickly and successfully deploy programs that address non-clinical aspects of health.
How has your professional experience interacting with health systems and healthcare providers shaped your perspectives on efforts needed to achieve health equity?
I’ve spent virtually my entire career working with health providers and plans and from my perspective, I’ve seen an incredible commitment on their part to provide great healthcare for their patients and members. However, there is a movement in healthcare today to transition from a volume-based environment to a value-based environment and making that transition is challenging. Health providers and plans are now experimenting with different approaches to become successful clinically, financially, and operationally as it relates to population health management. Working directly with health entities has shown me that health providers and plans need to streamline their workflows for screening patients to identify a patient’s social determinant needs. Providers and insurers need an expansive directory of up-to-date resources and they need to be able to track and communicate with their patients’ throughout this process in order to ensure that their patient’s needs have been met. Health providers and plans all realize that we are headed in a direction where social determinants can no longer be ignored, but they’re now expanding the infrastructure required and the processes and workflows needed to be successful as healthcare moves in that direction.
What progress have you seen in this space over the last 20 years? What are you optimistic about?
One of the big things over the last 20 years, and it’s certainly accelerated in the last five or so years is this movement toward population health management and addressing non-clinical aspects of a patient's health. This has been driven by health plans being open to different reimbursement models that reward value-based care delivery and it’s been based on providers taking responsibility for their patients outside of the clinical setting and delivering on the triple aim. I’d also like to add that the advancement of technical capabilities has provided an infrastructure that allows health plans and, particularly, providers to take a more value-based care approach. For example, Healthify’s software that allows intervention on social determinants of health in an efficient and scalable way. The platform streamlines the workflows for screening patients, identifying a patient’s social determinant needs, provides easy visibility into an expansive and up-to-date directory of resources and then validates delivery of those resources for patients. This type of workflow was not visible 20 years ago.
I’m optimistic about the changes in healthcare delivery that these technological advancements will allow for. It’s going to enable us to identify individuals who are struggling with their health and intervene in a way that’s going to be most effective for that particular patient.
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