Nashville General Hospital CEO Joseph Webb, DSc, FACHE, explains how health systems are addressing care gaps in the country's most underserved areas.
Editor's Note: Joseph Webb, DSc, FACHE, is the CEO of Nashville General Hospital.
It is no exaggeration to say that area codes determine as much about health and life expectancy as genetic predisposition, lifestyle, or daily habits. A community's built environment, including housing, parks, roads, and access to food and healthcare facilities, varies widely between rural, suburban, and urban communities, and it has a profound impact on the health of the people who live in them.
Gaping disparities exist, and on a wide scale. In fact, more than 80% of counties across the country lack access to services needed to maintain, much less improve, their health. That's approximately 30 million people in the continental United States who live in "healthcare deserts."
That sad fact has a real impact on all aspects of healthcare, including at its most basic level. Ongoing, regularly scheduled checkups with a primary care provider corresponds with better outcomes and reduced healthcare spending and the odds of a premature death. But that's for people fortunate enough to have access to that care. For those who live more than 30 miles from a provider and cannot reach one by foot or public transportation, lack of access to preventative services is more than just inaccessible. It is literally a matter of life or death.
People in rural areas are more likely to die from preventable or treatable diseases, such as heart disease, cancer, chronic respiratory ailments, and stroke than their urban and suburban counterparts. An analysis by the American Medical Association found that while overall mortality for Americans decreased between 1999 and 2019, mortality rates for rural residents between 25 and 64 years old rose by 12% in that same period.
The Growing Problem of Shrinking Access
The number of healthcare deserts in Tennessee makes it 15th in the nation. Twenty-three of its 95 counties, representing more than 36% of the state's population, or approximately 2.5 million residents, are designated as healthcare deserts, and slightly more than 27% of that population is rural. The healthcare services they lack include pharmacies, primary care providers, hospitals, emergency services, and community health centers.
Related, but no less impactful, factors include income, health literacy, and even internet access. Telehealth could help rural residents, but only a little more than 55% of Tennesseans have access to high-speed internet, compared to the nationwide average of 99.2%.
Changing demographics play a role, too. As urban Nashville gentrified, long-time residents were priced out, and so they moved out, which created new areas without sufficient access to healthcare.
This phenomenon is hardly contained to our region. The University of Texas reported that gentrification in Austin pushed low-income persons of color out of economically ascendant neighborhoods and into outlying areas that now have a rising population of disadvantaged residents. This "Great Inversion" has occurred in metro areas throughout the United States, and in Austin alone suburban poverty increased by 129% between 2000 and 2015.
Add to that an ongoing wave of rural hospital closures. More than 100 such facilities closed between 2013 and 2020, and 40% of all rural hospitals, already at risk of closing before the pandemic, were crippled further. Tennessee has seen the second-highest number of hospitals close since 2010.
Joining Forces to Bridge Healthcare Disparities
Low health literacy drives increased healthcare costs and poor outcomes, so elevating health literacy is obviously essential to creating healthier populations and communities. Collaboration with existing community organizations, such as churches, can be a powerful force in bringing education around health to people where they already live.
Local problems are driving local solutions. Tennessee Governor Bill Lee's recently proposed $52.6 billion budget includes $82 million to reimburse public hospitals for uncompensated care, primarily in rural areas, with more than $18 million dedicated to attracting 150 primary care residents to those regions.
Here at home, Nashville General Hospital is reaching beyond its service area through the Congregational Health & Education Network (CHEN), created in 2017 to address health disparities by training and providing resources that remove barriers to care in local communities. The CHEN framework is built upon four pillars: education starting in kindergarten, health literacy, access to care, and member support. And the soon-to-open Nashville Healthcare Center-Bordeaux in North Nashville will provide a comprehensive array of primary and specialty healthcare services in what once was a healthcare desert.
Eliminating healthcare deserts requires the combined efforts of fiercely dedicated individuals, proactive and imaginative community stalwarts, and deeply committed governmental entities and healthcare organizations. Only by working as a cohesive, goal-driven team can we address the wide-ranging disparities that create shortfalls in care among those who have been underserved for entirely too long.
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HealthLeaders editor Melanie Blackman is joined by Maxine Carrington, the Chief People Officer at Northwell Health. Maxine, who joined Northwell in 2008 as a manager of labor relations, has worked in...
Northwell Health SVP and CIO Sophy Lu says health systems have to embrace consumerism—and the technology needed to support it—to establish personalized care experiences.
A health system's digital strategy won't work unless it's aligned with current trends and technologies, much like a car won't function at its best if its wheels aren't in alignment. And it's up to healthcare leadership to guide that transformation.
According to the HIMSS 2022 Future of Healthcare Report, roughly 90% of health systems surveyed expect to have a digital strategy in place within five years, and more than 60% say they're in the middle of that journey. But that strategy has to be planned carefully, focusing on how information is gathered from various locations, analyzed, and used to improve care pathways. Digital strategies won’t work unless there's a clear direction from leadership on value and ROI.
"We're in the business of delivering care," says Sophy Lu, senior vice president and chief information officer at New York's Northwell Health. And for that process to work best, she says, "We need to be in perfect synergy … with the patient experience."
And that begins with data.
"Data is the fuel for innovation," Lu said during a presentation at this year's ViVE conference in Nashville. This includes data from the health system's various platforms, like the EHR, as well as information from outside the network, culled from and about patients as well as payers. That data helps to create a plan to address a patient's healthcare needs and preferences and to work with payers to facilitate the patient's healthcare journey.
With so much data coming from outside the enterprise, health systems must invest in the technology to integrate and analyze that often-unstructured information. Lu says it's important for health system leaders to set the tone for that strategy by supporting digital health platforms that use data to improve the patient journey.
"Whatever we can do to enable that ease of experience will help us," she says.
It's a strategy that has been around long before the pandemic, Lu says, yet COVID-19 exposed just how slow the healthcare industry has been in effecting change. In many cases, she says, health systems are using legacy technology and antiquated processes for collecting, analyzing, and using data. Either they haven't committed the resources to upgrading that technology or they don’t feel they have the money to make those improvements.
"It takes a lot of energy technologically to integrate and validate" consumer-focused care with old tools and platforms, she says. "You have to invest in that change."
Many health systems are pulling in digital health partners to help execute that strategy. Northwell Health is working with b.well Connected Health, based in Baltimore. Company Founder and CEO Kristen Valdes says healthcare organizations often lack a background in understanding consumerism and need help on the intricacies of meeting patient needs, a concept she calls "shopability."
That includes learning how to work with partners to identify and implement consumer-friendly services, something the healthcare industry has traditionally avoided.
"The technology behind that is actually not a challenge," she says. "Change management is complex, [as is] learning how to collaborate. A lot of [health systems] need help as they make that transition toward consumerism."
Federal efforts to support interoperability and data transparency are helping to push healthcare organizations closer to sharing data, Lu and Valdes say. But the going isn't easy for an industry that has traditionally chosen to protect its own data in silos. Some are reluctant to share that data, especially with patients.
"They have to [come around to the idea] of how do I not just comply with a rule," Valdes says, but also invest in transformation that puts that data before both the patient and the provider and prompts them to collaborate.
In this era of shifting attitudes toward data, Lu says Northwell Health has to be "the harmonizer," leveraging data from multiple sources to create a longitudinal health record. Health systems that, as Valdes says, "own the process" will likely stand out among in an increasingly competitive field for care services.
"This is a journey toward personalized care," Valdes says. "How do we take a consumer and build an experience around them?"
The tool aims to predict a patient's chances of dying within 5-90 days of admission, helping care teams to decide when and how to integrate ACP into care management.
OSF Healthcare is using AI to help doctors and nurses integrate end-of-life discussions into care management plans.
A research team at the Illinois health system led by OSF Senior Fellow for Innovation Jonathan Handler, MD, tested an AI model that predicts the likelihood of a patient's death five to 90 days after admission. That information is then used by care teams to decide when to begin advanced care planning (ACP) for patients and their families.
The tool could help health systems improve care for a large number of patients. Surveys estimate only 22% of Americans have documented their end-of-life wishes. ACP can reduce the use of complex or intensive treatments at the end of life, thus reducing the cost and length of hospital stays and the amount of anguish placed on family members.
"Although experts agree on the importance of ACPs, clinicians cite time constraints and poor communication with other providers as barriers to having end-of-life discussions," Handler and his team wrote in a recently published study. Reduced access to healthcare in mixed-rurality populations may make ACP even more unlikely. Due to these barriers, many patients do not have documented preferences at the end-of-life and therefore do not achieve what has been termed an 'ideal death.'"
The researchers tested the tool on a dataset of more than 75,000 inpatient visits both before and during the pandemic, ensuring that the tool holds up over time and is equitable across genders, races and ethnicities, and against rural and socioeconomic factors. According to the study, the model helped to identify more than half of patients within the 5- to 90-day range.
"We sought a model to predict post-inpatient mortality to meet a different need – to help prioritize and encourage timely ACP conversations during an inpatient stay," the OSF team wrote. "The model’s intended use is to predict mortality soon after the length of an average inpatient stay. Therefore, the 5-to-90-day window was chosen to: 1) begin after the average 4-day length of an inpatient stay, 2) allow at least 4 days for an ACP if the inpatient stay is longer than average, and 3) create enough urgency to stimulate the ACP."
In their conclusion, Handler and his colleagues say their model holds up well over time and can help to "consistently and equitably help prioritize patients likely to benefit in the near-term from theses crucial conversations."
The Farm Family Resource Initiative offers telehealth access for mental health services to rural farming and ranching communities, where suicide rates are two to five times higher than other populations.
Rural health system executives looking to address the soaring mental health crisis may be interested in how Illinois is addressing the issue.
Illinois Governor JB Pritzker announced this week the state-wide expansion of the Farm Family Resource Initiative (FFRI), a program coordinated with the Southern Illinois University (SIU) School of Medicine to improve access to mental health services for rural communities, especially those in the agricultural industry.
"As governor, as a father, and as someone who has personally witnessed the mental health epidemic among family and friends, there is nothing more important than making sure every Illinoisan has access to the mental health services they need to lead happier and healthier lives," Pritchard said in announcing the program expansion at the 2023 Farm Progress Show in Decatur. "Our greatest problems require our most creative solutions — and I am confident that this grant program will simultaneously break down barriers and open up doors for our state's number one providers."
The program, supported by federal funding from the US Department of Agriculture's National Food and Agriculture (USDA NIFA) program, creates a statewide telehealth network for mental health services, along with a grant program to support Future Farmers of America (FFA) state chapters developing new projects aimed at encouraging and improving healthcare access through rural communities and their schools.
The effort addresses a particular pain point in rural healthcare. Farming and ranching communities are traditionally less open to talking about mental health issues, and as a result don’t access local hospitals or clinics when they need help. According to the Livestock Project, suicide rates among farmers are two to five times higher than the national average.
For health systems serving these communities, the challenge lies not only in providing resources, but reaching out to these populations and convincing them to access care. With that in mind, healthcare executives are looking at telehealth and digital health tools and platforms to bridge those gaps.
Illinois launched the FFRI several years ago as a pilot project in six counties, offering both telehealth services and a helpline. Officials say the program has worked so well, improving access and clinical outcomes, that it's being extended to all 102 counties in the state.
Through the program, rural families can access up to six free telehealth sessions with mental healthcare providers through the SIU School of Medicine.
The program could be a model for other states and health systems looking to address mental healthcare at a population health level, targeting groups such as forestry workers, fishermen, migrant workers, and Native American communities.
The health system is the latest to test the technology on administrative tasks to address stress and burnout, and will also explore opportunities to use it as a caregiver tool.
HCA Healthcare is collaborating with Google on a generative AI platform designed to handle time-consuming administrative tasks for clinicians, and has already seen success in an ED pilot.
The Nashville-based health system, comprising some 182 hospitals and 2,300 ambulatory sites of care, is the latest organization to test large language model (LLM) technology to improve workflows and reduce stress and burnout among clinicians and staff.
“We’re on a mission to redesign the way care is delivered, letting clinicians focus on patient care and using technology where it can best support doctors and nurses,” Michael J. Schlosser, MD, MBA, FAANS, the health system's senior vice president of care transformation and innovation, said in a press release. “Generative AI and other new technologies are helping us transform the ways teams interact, create better workflows, and have the right team, at the right time, empowered with the information they need for our patients.”
The collaboration with Google is the latest activity in a partnership launched in 2021, which initially focused on privacy and security issues. It signals a growing interest among healthcare's biggest networks to apply AI to address key pain points in business operations.
In a pilot program launched earlier this year, HCA Healthcare integrated AI technology with smartglasses developed by Augmedix to enable 75 emergency department physicians in four hospitals to document conversations with patients. The platform used natural language processing and Google's AI tech and multi-party speech-to-text processing to convert the conversations into notes, which the physician would then review before entering into the medical record.
The health system and Google are also working on applying AI to nursing operations. They're developing a platform that can generate handoff reports, with specific attention paid to medication, vital signs, labs, patient engagement, and response to treatment. The goal is to give nurses a tool that reduces the time and energy spent on documenting patient encounters and gives them more opportunities to interact with patients.
HCA Healthcare has been refining the platform after receiving nurse feedback and is now testing the technology at UCF Lake Nona Hospital in Orlando, Florida.
Beyond addressing workflows and administrative functions, healthcare organizations are interested in using AI as a clinical decision support (CDS) tool, enabling care providers to quickly and easily access the information they need at the point of care. Researchers at Boston's Mass General Brigham recently announced that a test of ChatGPT as a CDS tool found that the LLM platform was 72% effective in making clinical decisions and 77% effective in making a final diagnosis.
With that in mind, HCA Healthcare is first examining the value of AI for caregivers through Google Cloud's Med-PaLM 2 LLM platform. The idea there is to create a tool that caregivers can use to access resources and find answers to medical questions.
“Having an LLM tailored for medical questions and content could be beneficial for certain critical use cases,” Schlosser said in the press release. “We expect Med-PaLM 2 will be especially useful when we’re asking complex medical questions that are grounded on scientific and medical knowledge, while looking for insights in complicated and unstructured medical texts.”
Tampa General Hospital's vice president of innovation and managing director of TGH Innoventures talks about looking beyond the 'shiny new objects' to find real ROI
Finding innovation in healthcare that works is challenging. An idea must be developed and tested by those who would use the new strategy or technology, all while mapping out value and showing data that prove clinical or business outcomes. And that ROI had better show up now, not next year or even next month.
"It's a lot like Whack-a-Mole," says Rachel Feinman, vice president of innovation at Tampa General Hospital and managing director of TGH Innoventures, the hospital's innovation center and corporate venture fund. "And all those shiny new objects out there aren't really helping us."
With concepts like AI and virtual care on the landscape, healthcare executives aren’t about to ignore the innovation space altogether, but they need a firm grasp on the plausible at a time when budgets are thin and the pressure to get better is heavy. Some organizations are launching their own innovation centers and spinning out their own startups, with the idea of growing and nurturing ideas from within.
Rachel Feinman, vice president of innovation and managing director of TGH Innoventures, Tampa General Hospital. Photo courtesy Tampa General Hospital.
At Tampa General, Feinman and her team partnered with the People Development Institute (PDI), a career development and growth facility developed by the hospital and the University of South Florida's Muma College of Business, to launch IdeaMVP, a program modeled after Shark Tank that enables health system staff to shepherd an innovative idea or technology from concept to solution. The solution is then evaluated by Tampa General's C-suite and, if found good enough, greenlit for implementation.
Feinman says hospital staff often have a unique view toward solving difficult problems, and they know what needs to be done.
"We have to have a broad view on what is innovation," she says, "but we also have to be clear that it's solving a need or a problem within the organization. There are a lot of [start-ups] out there right now that have great ideas in search of a problem."
"This isn't for the faint of heart," she adds. "At the end of the day, you are talking about adding something to somebody else's already-busy plate. It had better be good."
Feinman has a unique skill set to lead Tampa General's innovation strategy. After graduating from law school and spending more than a decade in that field, she pivoted to executive director of the Florida-Israel Business Accelerator, creating a pipeline between the Sunshine State and a country well known for its active healthcare technology innovation space (one look at the large Israel pavilions at HLTH or HIMSS is all it takes). She came to Tampa General in 2021 and has been instrumental in putting the hospital squarely in the innovation arena.
Feinman, who works closely with the IT department and reports directly to the hospital's two CIOs (information and innovation), says technology is an ever-growing tool to improving outcomes and workflows, but it's only a tool. Innovation to her is mostly about strategy, or about thinking up new ways to do things that are better than the old ways.
"Innovative projects hardly ever fail because of the technology," she says. "They fail because of change management. If that isn't [addressed correctly], nothing goes forward."
To that end, she says, the PDI is an important resource to help those within the organization understand how to design an innovative service, including how to secure buy-in and manage expectations around new workflows. For example, a nurse with a great idea of how to improve in-patient care must factor in both patient and nurse viewpoints, while an IT staffer who has come up with a new algorithm needs to make sure everyone associated with that technology, from nurses to doctors to IT support, understands why this new tech will help.
Feinman and her team are also at the head of a seismic (if very slow) movement in healthcare: The shift from episodic to value-based care. She acknowledges that "we still live in a fee-for-service reality," but says the future lies in VBC. That means identifying actual value in healthcare services and, just as importantly, learning how to collaborate with payers to support those services.
It also means understanding healthcare consumerization and taking the friction out of the healthcare experience. As the movement continues, value will be determined as much by the consumer as by the provider, and programs that don’t address consumer preferences and convenience will fail to gain traction.
"Healthcare is the last industry to [embrace] consumerization," she says. "That's the world that we are living in now, and that's how we have to respond."
The HHS' Advanced Research Projects Agency for Health is looking for 'proven technologies developed for national security' that can help health systems address cybersecurity attacks and ensure that patients continue to receive care.
Federal officials are looking for help developing cybersecurity solutions to address healthcare data breaches.
The Advanced Research Projects Agency for Health (ARPA-H), a division within the Health and Human Services Department, is seeking "proven technologies developed for national security" that can be used to counter cybersecurity attacks.
The effort comes as the nation's healthcare industry faces an increase in malicious attacks, including ransomware attacks. Some 344 data breaches were reported by US healthcare organizations in 2022, according to the Identity Theft Resource Center's 2022 Data Breach Report, the third straight year that healthcare was the top industry to face attacks.
One particular goal of the Digital Health Security (Digiheals) project, officials say, is to ensure that patients continue to receive the care they need in the wake of a cyberattack.
“The Digiheals project comes when the U.S. healthcare system urgently requires rigorous cybersecurity capabilities to protect patient privacy, safety, and lives,” ARPA-H Director Dr. Renee Wegrzyn said in a press release. “Currently, off-the-shelf software tools fall short in detecting emerging cyberthreats and protecting our medical facilities, resulting in a technical gap we seek to bridge with this initiative.”
“By adapting and extending security, usability, and software assurance technologies, this digital health security effort will play a crucial role in addressing vulnerabilities in health systems,” added ARPA-H Program Manager Andrew Carney. “This project will also help us identify technical limitations of future technology deployments and contribute to the development of new innovations in digital security to better keep our health systems and patients’ information secure.”
Healthcare organizations are asked to submit proposals through the Sharing Health Applications Research for Everyone (SHARE) BAA. Officials say they expect to issue multiple awards, depending on the quality of proposals and availability of funds.
The company's US head for the cardiovascular portfolio is leading the effort to find new treatments for women living with heart disease, especially those in underserved populations.
Elena Livshina came to the cardiac space by falling in love. Not with a person, but through a new discovery.
Back in 2016, the US head of the cardiovascular portfolio at Boehringer Ingelheim was deeply involved in the diabetes market as senior brand director at a company developing treatments for diabetes care, obesity care, hemophilia care, and growth hormone therapy.
When study results showed that a diabetes drug that she had been working with for years also reduced the risk of heart disease, she says it was "shocking" to suddenly discover that the drug had more than one benefit.
Elena Livshina, US head for the cardiovascular portfolio, Boehringer Ingelheim. Photo courtesy Boehringer Ingelheim.
"It surprised us all to discover that the diabetes drug was actually good for people with cardiovascular disease," she says. "And that's when I fell in love. I have to be honest, that was an amazing time."
Livshina shifted her focus from diabetes and became immersed in the cardiac therapeutic arena, creating ways to educate physicians and patients alike about the benefits of using anti-diabetes therapeutics as a cardiac treatment.
She began by leading the launch of the diabetes drug as a cardiovascular drug, which was the first in its class to move in this direction. It was a once-in-a-lifetime opportunity to introduce a new way of treating heart disease.
In 2021, Livshina took the reins of Boehringer Ingelheim's cardiovascular portfolio. A drug in that portfolio had been established as a diabetes treatment in 2014, but recently was approved to reduce the risk of cardiovascular death plus hospitalization for heart failure in adults with reduced ejection fraction.
The newer indication prompted Livshina to take on her next mission: To close the gap in care for women living with heart disease.
Through study results, Livshina and her team identified a huge disparity between heart disease care for men and care for women, and a more prominent difference in care between white, Black, and Hispanic women. She and her team decided to tackle this discrepancy head-on by creating unbranded initiatives that would address underserved populations.
"We had to go deeper than just women," Livshina says. "We developed a campaign for Black and Latino women to see what they needed, and what we as a company can do to bring education and practical tools to these women and their care partners. Unless we addressed those patient populations' needs and developed programs specifically for them and by them, we would not be successful."
Working with the Lilly Alliance, Livshina's team created Hear Your Heart, a healthcare initiative that provides resources and education for women living with heart failure, especially Black and Latina women.
"We needed to raise awareness of the issues and explore how [we can] help patients in very different ways, because it's not just about the medicine," she says. "We have an obligation not just as an industry, but as a healthcare community, to do more."
The campaign produced an immediate effect within the women's heart health community.
"What surprised me was the impact that it made from the very beginning," Livshina says. "We produced brochures and the website, and just by starting that conversation we could see already a ripple effect. Our next step is to offer unbranded content to organized health systems and providers, because it's important to them. It's important to everyone, quite honestly."
The campaign has seen 19.9 million social impressions, 1.7 million video views, and 2,400 resource downloads.
"The campaign stands out because it is specific to addressing gaps in health inequality, and really going deep into particular patient population groups and seeing what can be done there," Livshna says.
Establishing leadership values
Livshina uses her 19 years of work experience and her passion to motivate her team members. Being a woman in the industry has its challenges, so she helps others, especially women, to step up and take on challenges that stretch their skill sets.
"I love mentoring women, because you know what? We can do it," she says. "A lot of times … we are our own worst enemy, holding ourselves back."
She says mentoring is one of the more rewarding parts of her job, especially when she witnesses others being courageous and successful in taking their career to the next level.
"That's something that is extremely satisfying for me," she says. "I get goosebumps just thinking about [it]."
Much of her strength as a leader comes from her personality, she says.
"What's critically important about me is that I'm an extreme extrovert, and I like working with people," she says. "I love working in teams. But another very important skill is being open to learning from others."
She creates a learning culture within her teams so that everyone, no matter the level, is encouraged to speak up and express their point of view.
"This is so critically important, because two heads are always better than one," she says, "I firmly believe that you don't have to be the most senior or the most paid or have the highest title to have the best ideas."
A global perspective
Livshina describes herself and her family as "global people." Born in Russia, she has lived in Denmark, Switzerland, the UK, the Czech Republic, Australia, Canada, and the US.
"I am a Russian who married a New Zealander and we have American children," she says.
Growing up, Livshina says she loved math, and decided to start her career in finance. However, once she started working in the banking world, she found it didn't fulfill her need for purpose. "My career switch was very intentional," she says. "I went back to school, and that's how I ended up in pharma."
The move to the US was strategic, because it presented the type of career opportunities she was looking for.
"I really wanted to get to the US because it was the biggest market in the pharmaceutical space and I wanted to get closer to the patient and physician." She says. "I wanted to get closer to the market. So we moved about 10 years ago to the US from Switzerland, and I will never regret it. We absolutely love it here. Professionally, as well as personally, we've had the most amazing experiences."
Livshina and her husband still love to travel, and when they aren't working they are exposing their American-born children to all the different cultures of the world.
"We really enjoy bringing our kids to different worlds because it gives them exposure to different cultures, people, and experiences," she says, noting the family has been to New Zealand and the UK this year.
The health plan is issuing more than $4 million in grants to nine organizations through an innovative program to improve access to care and services for more than 75,000 homeless people in Los Angeles County.
A Los Angeles-based health plan is investing more than $4 million in an innovative program to improve healthcare access and services for the region's growing homeless population.
L.A. Care, which serves close to 3 million people in Los Angeles County, is awarding grants of up to $500,000 to nine organizations through its Street Medicine Initiative. The organizations will use the money to improve healthcare access through care management, preventive screenings, vaccinations, mental health screenings, and connections to housing and social services.
“L.A. Care’s Street Medicine Initiative will increase the number of street team members and services offered to the most vulnerable people in our communities, many of whom are L.A. Care members,” John Baackes, the health plan's CEO, said in a press release. “A secondary purpose of this initiative is to assist people experiencing homelessness with their Medi-Cal applications. The last thing we want is for people to needlessly lose health coverage simply because there was no address to send their renewal packet.”
The effort targets a care gap that affects the entire healthcare ecosystem. Without good access to care and other services, homeless populations can experience ever-worsening clinical outcomes, including serious chronic disease and several mental health issues. This, in turn, places a strain on public health agencies, community health clinics, and health systems, many of whom don’t see these patients until it's too late to help them.
The need for improved healthcare access is particularly acute in Los Angeles County, which declared a State of Emergency on Homelessness this past June. Officials estimate more than 75,500 residents are classified as homeless, an increase of 9% in just one year.
Funding for the program will come from California's Housing and Homelessness Incentive Program (HHIP), which was launched by the state with matching funds from the American Rescue Plan Act. HHIP is a voluntary incentive program enabling Medi-Cal managed care plans to receive reimbursement for programs that address social determinants of health.
