Addressing Social Determinants of Health for Health Equity

Transcript

Bryce

Welcome to Digital Health Transformers, a podcast series. This podcast explores the dynamic world of healthcare innovation, one conversation at a time. I’m your host, Bryce Barger, and today, we have an awe-inspiring guest at the forefront of transforming the healthcare landscape.

Today, we welcome Glenn Wirick, Chief Commercial Officer with Adhere Health, as our distinguished guest. Glenn is a healthcare-focused marketing and sales leader with over 30 years of experience in technology, healthcare, sales and marketing strategy, and execution. Glenn’s vision is to leverage technology to maximize healthcare outcomes for high-need patients while driving revenue and business growth.

Working at the intersection of go-to-market, healthcare, and technology with Adhere, Glenn builds high-performing teams that generate better revenue for the company, positive performance for its clients, and improved healthcare outcomes for high-risk patients. Adhere Health is a healthcare tech company that aims to help plan payers, providers, and other risk-bearing entities improve medical adherence, including increased medical Medicare star ratings and MLR improvement. Join us today for an engaging conversation with Glenn as we delve into his impactful journey and his thoughts on social determinants of Health.

Thank you for joining us today, Glenn. How are you?

Glenn

I’m doing great, Bryce. Thanks so much. I’m really happy to be here.

We’re about to talk about a couple of my favorite topics.

Bryce

Yes, sir. I’m super excited to have you guys on a company of Adhere’s caliber and hear about your professionalism and journey. So, by starting with that personal and professional story, your journey reflects a diverse professional background.

Could you share a special moment or experience that shaped your passion for addressing social determinants of Health? And what are some of those specific challenges that you faced?

Glenn

Well, I’ll start by saying that we probably all have experience with aging loved ones, right? In that journey, they may be struggling with their healthcare. And that’s certainly been true with me.

Both my parents-in-law and my parents are going through some of those challenges. So that helps make it very real for me. But what also brings this home is that I work with an organization called Cancer Can’t in my spare time.

It’s up here in the Pacific Northwest where I live. And their name is kind of as in cancer can’t win. It’s a charitable organization that empowers cancer patients with needed ancillary services like transportation, short-term housing, areas of financial support, et cetera.

When someone is going through cancer and what, you know, it’s helped focus for me is any one of us, when we have a medical issue, might have the kind of issues that I’m seeing amongst this group. For example, what I wouldn’t have thought of before, a cancer patient might live in a rural area. They have to come to the city center.

They have to get chemo treatments and some infusions, and therefore, they have to stay overnight. Well, now they need lodging. They’re paying for food on the road.

They might have a diminished ability to earn income, yet they still have to put food on the table for their family. And it’s just that it has made this thing so real for me. It’s gratifying to work, but it also makes real how these challenges occur across our society. Yeah, for sure.

Bryce

Definitely, and, you know, getting into identifying and addressing the social determinants of Health, you guys drive strategies to provide valuable insights. Could you share an example of a successful initiative where these strategies have had a successful impact?

Glenn

Yeah, absolutely. And because of how our company works, we’ve got many of these, but I focused on a particular Medicare Advantage plan. The story I’m about to tell is specific to this plan, but it’s also typical across other plans.

So our focus, when we’re working with health plan members, i.e., patients, is to get better at being medically adherent, and why would we want our members to be medically adherent? It’s because, number one, they will have a better health experience. If they take their medications correctly for their chronic conditions, they’re less likely to end up in the emergency room.

It saves them money. It saves them time and more Health. However, it also saves the health plan money and helps them achieve star ratings for the CMS guidelines.

The way that we address members who struggle with adherence is to focus first on SDOH barriers and social determinants of Health. We can help identify members’ struggles through compassionate, motivational interviewing, such as having a car broken down in the driveway. That means they need to get to the pharmacy to get their fill.

They don’t think of that as medication, and they’re probably not telling their healthcare provider they have an issue with their car. But because we can understand the issue with the car, we can get transportation services for them, for example, so that they can get that fill. And so, at a particular health plan, based on the fact that we were able to take a very difficult cohort of members and focus on SDOH first, we were able to drive over 35% of these otherwise nonadherent members to become tacky for that year.

That means tens of thousands of members have a better healthcare experience, and the health plan meets all its metrics. So, it can be impactful.

Bryce 

Yeah. You know what I love about that, too? It’s a different approach where we’re looking at the full picture. You’re not focusing on one thing.

It’s the healthcare picture as a whole. What are some of the challenges that you face with these SDOHs? I love that. How do you believe healthcare organizations can effectively identify and prioritize the most impactful social determinants of health within the kind of communities they serve? What are some of those ways that healthcare organizations can identify?

Glenn

Yeah. This has multiple tangents, but it starts at a high philosophical level. Right.

This means that what happens at a lot of large health plan organizations, which are very large companies and large entities, is that they have different groups addressing different member needs throughout the continuum. All right? Very often, there will be a group somewhere, often a care management team, with some responsibility for identifying SDOH barriers and resolving them.

But what we see very often is that’s an isolated effort. So, what we preach to our plan partners and help them implement is that SDOH should first be across every motion with every member at all times. Right.

That’s exactly what you said a minute ago, Bryce: it’s part of the healthcare journey for every member.

Bryce

Right.

Glenn

So, it should be addressed as such across all cases. And now, underneath that, data tools help identify, capture those things, and continue to drive what we’re learning about the members’ SDOH and healthcare journey into the analytics that helps further determine what the next clinical outreach should be and what we should be addressing. Those are important as well.

So, it starts at the top. Put SDOH in everything you do. And number two, because that’s your philosophy, let’s solve it with data and technology tools that enable the clinicians to do that in all their motions.

Bryce

Yeah, for sure. 100%. And moving into community empowerment and engagement and this aspect of it, how do you envision empowering communities to actively participate in improving their health outcomes in this way? Right.

Glenn

There’s a saying out there that the patient’s zip code is more important than the genetic code regarding their overall health outcome. And there’s so much data and analysis available that supports that. So, what you want to do is, first of all, understand that where a person lives is crucially important to the potential of their health outcome.

And then there’s another saying, and it is that it takes a village. That is true when it comes to health care. So, for communities to be most effective, communities could be the health plan and the community of providers inside of it.

It can be the actual community where we live, et cetera. What I would say is that for communities to be most effective at improving overall Health for the population is that first, data must be leveraged to drive the best next action at the right time for that patient to surface in ways that are highly usable by people within that support chain, clinicians, social workers, et cetera. And although progress in this arena has been made, there’s still a long way to go.

The first step is to recognize the importance of understanding and solving these SDOH barriers within health care. Once you accept that as part of the journey, it becomes a never-ending journey. And you leverage partners and available data to lean into that and continue to improve.

Bryce

100%. I think getting into the health equity and the technological interventions that you guys help with and that AHERA can be a tool for. How have those technological interventions played a role in promoting health equity? And in addressing the social determinants of Health?

Glenn

Yeah. And I’ll tell you, health equity is a really interesting topic right now in the frame of Medicare because everyone in the healthcare space knows health equity is important.

And the more we can give everyone the same high-quality standard of care, the better all the outcomes are, and the lower the cost goes. So everybody knows that. However, in its most recent ruling around star ratings for Medicare, CMS now has something called the Health Equity Index, also known as HEI.

And so it’s the first time making health plans and putting the money where the mouth is. Yeah, we’re not just saying health equity is important. We will now judge the health plan and how it handles health equity.

And so what I’m about to say seems obvious, but it’s still really important. That is, if you can truly identify the social determinants of health barriers across the population in an impactful way, resolve those, and track the ongoing results, you automatically improve health equity across that population. This gives you automatic access to achieving this HEI standard that CMS is now driving for the plan.

Bryce

What are some key considerations or challenges that we should be aware of or that people should be aware of when using technological interventions to address social determinants?

Glenn

Yeah, well, number one, this area, this space, is moving very quickly. The good news is that many qualified vendors and solution companies are bringing these capabilities to bear. The good news is there are options, not with just health plans, but across the entire healthcare continuum that can help identify the right types of issues that need to be addressed.

So, therefore, what do you do then? It starts with understanding these items’ importance and wanting to solve them. If you do, it’s a matter of identifying the right solution partner.

And what you want to be looking for are ones that are very committed to a data-driven focus. That is all about identifying the high-risk patients who truly need this support and what types of support they need, not just in the medical field but also in the realm of SDOH.

Then, you want to leverage technology to have multi-modal intervention capabilities. And what I mean by that, Bryce, is the aging populations are getting more, increasingly and increasingly, more tech-savvy. We know that people are less likely to answer a phone call from a number they don’t know.

And different people respond differently. Some people are good with the apps on their phones. Some people prefer a web portal or chat.

Some people do prefer a phone call. So, having a multi-modal outreach capability that meets the member where they are in their journey is a real key to making this work across the entire healthcare ecosystem.

Bryce

I agree. Again, I’m just touching on this as we close, and I appreciate you sharing this information about it here. Many people don’t think about the big picture; they think about those SDOHs and ways to overcome them to improve our communities and ourselves.

And it’s one of the reasons we really wanted to have you guys on is the boundaries that you guys are pushing forward and thinking outside of the box in a way and definitely outside of the box as far as traditional healthcare and what’s been in the past. So, Glenn, thank you so much for sharing that valuable insight on health equity and the social determinants. It’s been a pleasure discussing that with you.

These topics are very important not only to you but also to the country itself. So, your perspective is appreciated. I look forward to staying in touch with you guys and seeing what it will do next. Is there anything else you’d like to close or add to closing here?

Glenn

Yeah, I would say that on the subject of health equity and many tangentially related items, there will be a lot of movement in the market this year and in the upcoming years. There’s going to be movement in how CMS monitors and measures that. So, yeah, it’s a great area to pay attention to because it can be impactful to continue improving Health across the board for Americans everywhere. Percent.

Bryce

Thank you so much for your time today.

Glenn

All right. Thank you. It’s a pleasure.