Excellus BCBS’ Post

Rural regional centers struggle to access quality, advanced health care right at home, but not in Greater Bemidji thanks to the leadership of Sanford Health. It is great to have such innovative organizations supporting and investing in the greater Bemidji region. https://lnkd.in/g-iveVBG

Nancy Yu MD, MMM, CPE, in her article for Modern Healthcare, discusses the challenges and importance of addressing social determinants of health (SDOH) in patient care. She highlights how value-based care models can expand access to information and resources to help meet patients' unique needs. Dr. Yu, who now serves as Sr. National Medical Director at Optum, shares insights from her experience at Southwest Medical in Nevada, where they have been practicing value-based care for over 30 years. They have learned that addressing the social and economic challenges of patients is crucial for delivering patient-centric care. By screening for SDOH using tools like the modified Protocol for Responding to & Assessing Patients’ Assets, Risks & Experiences (PRAPARE), clinics can identify issues such as transportation, food insecurity, financial strain, and social isolation. Addressing these issues not only improves patient outcomes but also reduces hospitalizations. Dr. Yu emphasizes that value-based care focuses on understanding patients' unique circumstances, including SDOH, to develop comprehensive care plans that meet their needs. #SDOH #ValueBasedCare #PatientCentricCare #socialdeterminantsofhealth #PRAPARE https://lnkd.in/g6ChzbCM

Pharmacy Closures Impacting Medically Underserved Communities. “#Pharmacies have always been the frontline health care access points for families in medically underserved areas, but that’s going away,” Adepoju said. “In these areas, which are mostly minority communities with serious socioeconomic challenges, it is adding to existing health care disparities. ” Adepoju and Karunwi hope their study serves as a call to action by highlighting the urgent need for collaborative efforts from policy makers, health care providers and community stakeholders to ensure every person, regardless of their means, has equal access to the crucial services. #pharmacydeserts #PBMReform https://lnkd.in/g8h7pUtx

This story from Natasha Robinson is a great read, evidences a lot of goodwill on the part of health funds to provide Out of Hospital Services Innovations (OHSIs). But we are just getting started, in 2022 OHSIs were just $83m, equivalent to just 0.53% of total health fund outlays. In this sector there are so many exciting things we can do with OHSIs, like care coordination, community programs substituting admissions and additional hospital in home programs targeting cardiac, psychiatric, orthopaedic and urological related condition exacerbations. PHInsights is working with PHI funds and community care providers to develop these models that could see OHSIs being 10% of total outlays by 2032, that's $1.6b a year. this will save PHI policyholders something between $600m and $850m per annum. more coming soon, watch this space ..... https://lnkd.in/g9dVRj7D

A good way to start this week! Mayo Clinic seeks to address #healthequity. Alan Roga, MD, FACEP, CEO of TruLite Health: “Healthcare is not even close to equitable in the United States. If you’re not male, white, educated, straight, don’t have money, or live in an urban zip code, your outcomes are worse. And we did an actuarial study and found that if you’re Black or Latin with a chronic illness like diabetes or high blood pressure, it’s $5,300 more per patient per year when looking at Medicare data — so economically and morally, it’s compelling to address this,” Mayo Clinic partners with TruLite Health to address this. https://lnkd.in/gYvampiE

Healthcare disparities or inequalities are the most common problems happening in the world. Differential access to medical care, treatment modalities, and disparate outcomes among various racial and ethnic groups has been validated in numerous studies. The antecedents of such differences involve such “drivers” as cost and access to the healthcare system, primary care physicians, and preventive health services. According to global consulting firm Towers Watson, Singapore has "one of the most successful healthcare systems in the world, in terms of both efficiency in financing and the results achieved in community health outcomes". Even then, our current healthcare systems are evolving as we speak. https://lnkd.in/gBfjvzi4

To fill the lack of studies on community HIE impacting primary care transitions,"Sloan-Aagard, Crawford and colleagues found that HIE-lookup reduced the likelihood of rehospitalization by 61% and ED use by 53%". #centralishealth #hie #primarycare

Value-based care means an enhanced consideration of individuals' needs and our ability to meet them with precision. This cannot be done without social determinants of health (SDOH) being a part of the conversation. By analyzing SDOH, patient outcomes and patient-centric healthcare may advance. Patients have unique, individual needs, and holistic patient care means considering the whole of each person-- SDOH such as socioeconomic status is clearly thus part of this. In promoting the harnessing of SDOH, collaboration between healthcare and social services is beneficial. Data can also help us dive deeper into painting fuller images of our patients. This shift is one that favors health equity and more successful healthcare. #SDOH #ValueBasedCare #Healthcare #MarketAccess #PatientOutcomes

To fill the lack of studies on community HIE impacting primary care transitions,"Sloan-Aagard, Crawford and colleagues found that HIE-lookup reduced the likelihood of rehospitalization by 61% and ED use by 53%". #centralishealth #hie #primarycare

The expansion of the hospital at home and the transformation of health.