Caring as Communities Podcast: Creating Coalitions of Care
It’s said that “it takes a village,” and caring for vulnerable and complex patient populations is no exception.
Listen as Dr. Enrique Enguidanos discusses with Victor Murray, Camden Coalition of Healthcare Providers, and Cesar Armendariz, Inland Empire Health Plan, what makes an effective coalition, strategies for getting started, and how communities are pulling together the skilled and financial resources to make these coalitions a reality.
Caring as Communities Podcast: Addressing Homelessness & Healthcare
The COVID-19 pandemic has highlighted shortcomings in our systemic approach to homelessness. Join Dr. Jim O’Connell, Founder of the Boston Health Care for the Homeless Program, and Bobby Watts, MPH, MS, CPH, and CEO, National Health Care for the Homeless Council as they discuss what needs to happen at local, state, and federal levels to better house and care for the health of these vulnerable individuals.
Podcast Episode 6: Addressing Racial Disparities in Healthcare- Part 1
Dr. Terralon Knight:
Dr. John Vassall:
- How to be an Anti-Racist, Ibram Kendi
- Caste: The Orgins of Our Discontent, Isabel Wilkerson
- Hillbilly Elegy: A Memoir of a Family and Culture in Crisis, J.D. Vance
Dr. Kellee Randle
Equity Plus Ventures
Podcast Episode 1: COVID-19 and Healthcare Post-Pandemic
CBCS and Collective Medical are collaborating on a monthly podcast series addressing a variety of social determinant health issues. The inaugural podcast focuses on a post-pandemic world.
As healthcare organizations reach COVID-19 peaks and leaders begin to look at post-pandemic healthcare protocol, it becomes clear that the healthcare scene post-COVID will be very different than it was before the pandemic.
Join Collective Medical’s Head of External Affairs, Kat McDavitt, and our CEO and Founder, Dr. Enrique Enguidanos, in this inaugural podcast as they interview Dr. Joanne Roberts, Senior Vice President and Chief Value Officer at Providence St. Joseph Health System, and Deborah Kozick, Associate Director of Delivery System Reform at the Center for Health Care Strategies to see what changes we can expect to see moving forward, and how this will impact our nation’s most vulnerable patients.
- Challenges faced with an influx of inpatient care
- Employee retention during recession and pandemic
- Positive “lessons learned” as a result of COVID-19
- Forward-moving initiatives to address patients with behavioral health, social determinants of health, and other vulnerable populations
Improving care for high resource patients
An opportunity too costly to miss out on
We have an opportunity within healthcare to make an impact – a huge impact…
Healthcare costs now consume 18% of the GDP, $3.5 trillion in 2017 (1). But a very small cohort of individuals account for an inordinate amount of this expenditure – the Department of Health and Human Services informs us that 1% of individuals account for 21% of all healthcare costs (2). While a portion of these patients have few options other than expensive medical treatments, a significant portion of this cohort struggle with psychosocial issues that are poorly addressed in many communities, resulting in significant unnecessary expenses. According to 2016 CDC data, almost a fifth of annual emergency department visits, a total of over 24 million visits at a cost of $11.2 billion, are attributed to frequent utilizers – those with 5 or more visits within the prior 12 months. Amongst frequent ED utilizers nationwide:
- 30% are homeless
- 40% have a primary mental health disorder
- 50% have a primary substance abuse disorder
When these individuals struggle in accessing the service they need and crisis ensues, they come to the one place they know will always be open – their local ED. We are blessed with wonderful emergency medical services throughout our nation, but our ED’s are not designed nor equipped to address these issues. At best EDs can address the medical crisis that may be immediately at hand, but typically the patient is discharged back into the same environment, and when the next crisis invariably occurs, the cycle repeats itself.
Over the last decade, frequent utilizer programs in New Jersey (3), North Carolina (4), Minnesota (5), Maryland (6), Washington (7), Oregon (8) and Alaska (9) have all demonstrated dramatic success – reductions in hospital utilization varying from 40-60% within a year of program implementation, with dramatic net cost savings, demonstrated in each of these programs, and a cadre of metrics indicating improved quality of care. Most of these programs are designed around models of care that can be reproducible within almost any community across the country. While each of these programs have components that are customized to communities, there are traits that are shared across all of the programs and other traits that are common amongst many of them, and repeatedly found to bring significant value when implemented.
This is the first of a short series of articles. We hope in this introductory article we have heightened your awareness of this very important issue our nation is facing. Over the next few weeks we will be sharing a series of articles, each of which will highlight each of the following “best practices” shared by successful high utilization programs implemented across our country to date:
- Staff live in communities being served
- Community resource engagement
- Customized patient care plans
- Common community IT system
- Immediate access fund
- At-risk payment models
High utilization patients have suffered for decades as our medical communities have struggled to address their needs. We now know that we can do better. We can make a difference – a significant difference. It is time to make an impact….
- National Health Expenditure Data, 2018 – CMS.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata
- Department of Health and Human Services Statistical Brief #421: Differentials in the Concentration in the Level of Health expenditures across Populations Subgroups in the U.S., 2010. file:///Users/papa/Dropbox/CBCS/Articles/Costs%20of%20Utilizer%20Care/AHRQ%20-%20Cost%20of%20Top%201%25,%202010%20-%20STATISTICAL%20BRIEF%20%23421_%20Differentials%20in%20the%20Concentration%20in%20the%20Level%20of%20Health%20Expenditures%20across%20Population%20Subgroups%20in%20the%20U.S.,%202010.htm
- Camden Coalition Hot Spotting Program – https://hotspotting.camdenhealth.org/
- Community Care of North Carolina – https://www.communitycarenc.org/
- Hennepin Health – https://www.commonwealthfund.org/publications/case-study/2016/oct/hennepin-health-care-delivery-paradigm-new-medicaid-beneficiaries
- Health Care Access Maryland – http://www.healthcareaccessmaryland.org/media-listing/access-health-program-achieves-demonstrable-reductions-in-avoidable-hospital-utilization-by-addressing-social-determinants-of-health-and-linking-residents-with-community-resources/
- Consistent Care Program – https://consistentcare.org/
- The Health Commons Project – https://oregon.providence.org/our-services/c/center-for-outcomes-research-and-education-core/population-health-dashboards/the-health-commons-project/
- Mat-Su Health Foundation HUMS Program – http://www.healthymatsu.org/What-We-Do/Strategies/minds-1.html