Resolving Barriers to Care: Patient Activation is a Step Forward for Health Systems to Advance Health Equity in Value-Based Care 

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View of a Medical team working at the hospital all together

By Greer Myers, President, Guideway Care

When most healthcare executives hear the term “health equity” they usually associate it with an aspirational academic exercise, which will become its own cost center. It is an understandable misperception because most of the conversations around health equity point out the obvious problems created by health-related social needs, but very few entities act to solve for the issue in a meaningful way. Committees are formed to live in perpetuity and websites are updated to reference it as a “strategic priority.”

In reality, there is significant symbiosis between health equity and Value-Based Care. Tackling inequities improves the lives of patients and members, while simultaneously benefiting the financial performance of the organizations serving them. The challenge for most Value-Based Care organizations is how to take action to reduce inequities efficiently and effectively. How do you do good for the patient, member and the organization? The answer is to resolve both non-clinical and clinical barriers to care though a systematic approach, utilizing clinicians only at the highest level of their licensure.

Impact of SDoH on Outcomes and Health Equity

Value-Based Care organizations increasingly recognize that health inequities have a major impact on health outcomes, especially for vulnerable populations. Barriers to accessing care are amplified within the context of a complex disease. Left unaddressed, they harm clinical outcomes, erode quality of life and increase avoidable utilization. There are specific non-clinical barriers such as practical, informational, emotional, familial and spiritual issues that increase the risk of clinical deterioration. Specific barriers that may fall into these domains include financial, transportation, food insecurity, housing stability and family conflict.

SDoH risk factors exist with the individual patient and their community, typically falling outside of the health system’s visibility and control. However, these issues constrain the time and resources of clinical staff members who are often compelled to address these challenges. This is particularly problematic as COVID-19 continues to stress health system capacity for treating patients and amidst a critical nursing shortage nationwide. In fact, nurses report that up to 70% of their workload is dedicated to non-clinical, practical tasks that only address the bare minimum of SDoH. Likewise, while analytics can identify probable risk and technology can facilitate communication, neither can establish a peer-to-patient relationship that leads to real, meaningful patient activation and barrier resolution. 

A Viable Solution: High-Touch, Tech-Enabled Partnerships Close the Gaps

Vendor-partner relationships with hospitals, health systems, payers and provider organizations can positively impact patient and member lives and drive financial and operational improvement in Value-Based Care. Utilizing trained non-clinical resources to work with patients and caregivers to understand and resolve their barriers to care will result in a uniform care experience and optimal outcomes.

Ensuring the vendor hires and appropriately trains the best non-clinical navigators is a key component in the collaboration. Another crucial element is the operating platform used by the non-clinical navigators. It should guide and inform the navigators to resolve non-clinical patient barriers and automate the escalation of clinical patient barriers to the clinical teams in place. That approach allows the organization to capture data for required reporting and conduct quality improvement activities. The high tech is driving the human touch, which results in highly structured and protocolized peer-to-patient interaction. 

Having a vendor-partner act as an extension of existing clinical teams makes health equity actionable and benefits the patient, member and healthcare organization. It allows nurses and physicians to operate at the highest level of their license, lowers operating expense, decreases acute care utilization, alleviates clinical staffing shortages and drives consistency in results.

Guiding the Future of Health Care

An effective care guidance solution requires collaboration with like-minded partners dedicated to improving health and welfare for entire communities by developing joint programs with clear metrics for outcomes. The efficient and effective Service-as-a-Solution model delivers on the promise of health equity. 

Cultural changes do not happen overnight. The years ahead will require the ongoing enactment of meaningful policy, ongoing research and investment and thoughtful dedication to innovative solutions and technical advancements. Fortunately, the validated quality and financial results of non-clinical care guidance is helping to pave the way on this exciting journey to health equity.

About the Author

Greer Myers is President of Guideway Care. For more than a decade, partnering with hospitals, health systems, payers and provider organizations, Guideway positively impacts patient and member lives, while improving financial and operational performance for our client partners. Specifically selected and highly trained non-clinical Care Guides, utilizing Guideway’s proprietary technology platform, build peer-to-patient relationships to uncover and resolve non-clinical and clinical barriers to care though patient activation, resulting in a uniform care experience and optimal outcomes. www.guidewaycare.com