Community and health on the same page

Ben’s  new  (tle  slide  

Problem: Finding Community Services

•  Governments, foundations grant billions of dollars annually

•  Accessing services remains a challenge

•  Important for individuals, and post-ACA healthcare system

Instead, due to: •  Social, economic factors • Health behaviors •  Physical environment

80% of health outcome is NOT due to clinical care

But … •  Social service landscape is very unstable •  Difficult to determine who is eligible for a

service •  Fragmented funding, fragmented

information

Startup Storytime

Partners & Success •  Deployed at Desert Healthcare District,

University of Illinois Health System, City of Chicago DPH, City of Pomona, Heartland Health Outreach, FQHCs

•  Participating in first RCTs on clinical effectiveness of community health

•  HealthBox portfolio company •  Selected for Intel Innovation Pipeline

Match People With Programs They Need

Standard Purple Binder listing: all the information you need to actually access this service

Early Success & Failure •  Sold directly to social service agencies •  Won $35,000 first prize in pitch competition •  2,000 agencies signed up in months, with no

marketing •  But, conversion didn’t work -- huge

disconnect between need & ability to pay •  Had to rethink who our customers were

(“pivot”)

Everything Old is New Again

•  Purple Binder is not the first to identify the need (2-1-1, Health Leads, many others)

•  But Purple Binder does present a new business model to address it, based on technology and the ACA

Patient

Emergency Room

Primary Care

Public payor

Visit

Visit

$$$

$$$

Patient Public payor

Insurer plan

Hospital plan

Physician plan Capitation

Shared savings

Choice

Choice

Before

After

Genesis of the Health Portal •  Started from Mayor, Clinton Foundation

Blueprint for Health •  Identified need to connect people with

resources for health and wellness •  Hired consultant to figure out, what does

it mean to have a community health portal?

Outlining the Problem

•  Looked at existing health portals to determine what we wanted

•  Realized we needed to engage key leaders and find out what health portal would be for them (1 on 1, focus groups)

top-down ! bottom-up

Community leaders said:

“We want an easy, mobile system that connects people to local resources.”

Finding a Solution

•  Met Purple Binder at UCLA conference

•  Determined that this would meet our highest-priority needs

•  Brought back to community stakeholders for consensus and approval

Community Engagement Toolkit

1-on-1 meetings with key leaders

Mailing list and Prezi (interactive presentation) to inform and solicit community input

Collect existing resource lists

Engage subject matter experts (SMEs) to identify gaps

Branding with community input

Each agency reviews their resource listings

Next Steps

•  Deployment to close community partners, such as FQHC, FIND Food Bank, UCR residency program

•  Public launch

Community Research Process Compile initial resource lists (local gov’t databases, existing guides

from social workers, web scraping)

Research team contacts service providers to gather information on eligibility, availability, and intake process

Ongoing updates every 3-11 months, depending on service type

(1)

(2)

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Examples of Services on PB •  Food access •  Employment training •  Housing •  Utilities and rental assistance •  Behavioral health •  Legal aid •  Clothing closets •  Childcare •  Transit •  Low-cost dental •  Any other community service

•  Low-income / no-insurance medical care

•  Free eyeglasses •  AA/NA meetings •  Disease-specific support

groups •  Help applying for benefits

(SSI, SSDI, Medicare, Medicaid, SNAP, TANF)

•  Nutrition education

New Landscape for Community Services

•  Traditional funding continues to decrease

•  Growing awareness of how community services contribute to health outcomes

•  Health systems will start to fund more community services

… many of you already do this!

Patient

Emergency Room

Primary Care

Public payor

Visit

Visit

$$$

$$$

Patient Public payor

Insurer plan

Hospital plan

Physician plan Capitation

Shared savings

Choice

Choice

Before

After

Small % of Patients, High % Costs

Camden, NJ “hotspot”

1% of patients drive 30% of medical costs

Nationally

1% of people drive >20% of spending; 5% drive nearly 50% of spending

Components of Community Integration

1.  Partners (community organizations) 2.  Compensation models (at-risk,

capitated) 3.  Staffing (CHWs, SWs, etc) 4.  Operations (internal processes, tech,

reporting, PB, etc.)

Operations

Components of Community Integration

Staffing for referrals (CHWs, SWs, etc)

Community partners

Community partners

Community partners

Compensation & funding

Examples of Community Integration •  Viridian Health – operates nationally •  WellCare, FL •  Coachella Valley – FIND Food Bank, •  Purple Binder •  CHW programs

Healthcare Districts Are Ideal Leaders

•  Ideal position between traditional healthcare and community spheres

•  Bridging the gap between formerly separate systems

•  Opportunity to lead cutting edge of healthcare & human services integration

Community and health on the same page

Ben’s  new  (tle  slide