Scaling Medicaid Innovation with Rajaie Batniji, Sanjay Basu, and Afia Asamoah

TL;DR

Innovative approaches at Waymark aim to improve Medicaid outcomes using community-based care and machine learning.

Transcript

AIA I'm going to start with you great you were recruited in 2014 as like the first lawyer supporting Health tech product development at Google what was that all about and tell us more about how you ended up at Waymart I was sitting in my office at a law firm in New York City and got this voicemail message um from a Google recruiter and the the reas... Read More

Key Insights

• 🧑‍⚕️ Technology can enhance healthcare delivery by addressing social determinants of health, particularly for underserved populations.
• 🧑‍⚕️ Community health workers play a crucial role in bridging gaps between medical care and social support, ensuring holistic patient management.
• 🧑‍⚕️ Machine learning models enable targeted interventions for patients at risk of acute health crises, significantly improving healthcare outcomes.
• 🚨 Organizations like Waymark can successfully merge profit-driven and social missions, creating sustainable models for healthcare innovation.
• 👶 Evidence-based practices are essential for validating new healthcare models, ensuring they meet the needs of patient populations effectively.
• 😨 The integration of technology and community-based care can reduce avoidable healthcare costs while improving clinical outcomes.
• 😨 Trust and strong relationships within communities facilitate better healthcare delivery, impacting patient engagement and adherence to care plans.

Questions & Answers

Q: What inspired AIA to move from legal practice to health tech at Google?

AIA was motivated by her desire to leverage technology for impactful healthcare, particularly for underserved populations. After working in medical device and biotech fields, the prospect of a high-tech environment at Google, focused on expanding clinical care beyond traditional settings, intrigued her.

Q: How does Sanjay's clinical practice influence his work at Waymark?

Sanjay's firsthand experience in primary care informs his understanding of the social determinants affecting Medicaid patients. His work in community health allows him to appreciate the importance of a holistic approach to care, recognizing that many health issues stem from socioeconomic challenges rather than just clinical factors.

Q: What innovative strategy did Waymark implement to improve Medicaid patient outcomes?

Waymark utilized a machine learning model called the "rising risk signal" to predict which patients are likely to require acute care. By engaging with these patients early and addressing their social and health needs, Waymark achieved a significant reduction in emergency room visits and hospitalizations among Medicaid members.

Q: What is the significance of Waymark being a public benefit corporation (PBC)?

As a public benefit corporation, Waymark prioritizes both financial sustainability and a social mission focused on improving health outcomes for underserved populations. This dual commitment ensures that all future governance and operational decisions will align with their social charter of expanding access and quality in Medicaid care.

Q: How does the team at Waymark ensure effective community-based care delivery?

Waymark employs community health workers who are integral to patient care, helping to navigate social systems and providing support outside of clinical settings. This model fosters trust and engagement, helping patients meet their health goals through personalized assistance.

Q: What challenges does Waymark face in scaling its innovative healthcare model?

As Waymark seeks to grow beyond its initial partnerships, it faces challenges in maintaining consistent quality and training a new workforce of community health workers. Additionally, navigating the complexities of existing Medicaid reimbursement frameworks can hinder the integration of community-based solutions into standard care practices.

Q: How did the findings from Waymark's outcomes paper validate its approach to Medicaid care?

The published outcomes demonstrated that Waymark's interventions significantly reduced unnecessary acute care use while simultaneously improving medication adherence and overall patient quality scores. This suggests that their community-based, tech-enabled model effectively addresses both healthcare delivery and real-world patient needs.

Q: What role do community relationships play in Waymark's operations?

Building trust through local relationships is vital for Waymark's success in community health. Their approach emphasizes the importance of in-person interactions, ensuring that community health workers can effectively support patients by fostering connections with providers and understanding the nuances of individual health journeys.

Summary & Key Takeaways

• AIA discusses her transition from legal work in health tech to Waymark, aiming to enhance healthcare delivery through technology and community support for underserved populations.

• Sanjay highlights the importance of practice-based insights in developing effective Medicaid solutions, emphasizing the need for holistic, community-oriented healthcare models.

• Waymark's use of machine learning and community health workers has led to significant improvements in patient access and health outcomes, demonstrating the potential of technology in healthcare delivery.