HJBR Sep/Oct 2019

Healthcare Journal of Baton Rouge  I  SEP / OCT 2019 53 Stewart T. Gordon, MD, FAAP Chief Medical Officer, Medical Affairs Louisiana Healthcare Connections takes a coordinated, integrated approach, and an important part of that is helping our members overcome non-health fac- tors that are negatively impacting their health, like homelessness and food inse- curity.” These factors, called social determinants of health, or SDOH, affect a wide range of health, functioning, and quality of life out- comes and risks, according to the Cen- ters for Disease Control and Prevention (CDC). Examples include the availability of healthy foods, safe and affordable housing, access to education and health services, and public safety, among others. “What we know is that healthcare re- ally represents only about 10 percent of a person’s health,” said John Kight, DNP, RN, FNPC, NEA-BC, Senior Vice President of Population Health for Louisiana Health- care Connections. “When basic needs like food, shelter, and transportation are not met, families are forced to neglect their health needs. As a result, healthcare costs increase as health outcomes decline.” Creating an integrated network of com- munity-level resources and healthcare provider partnerships has long been the foundation of Louisiana Healthcare Con- nection’s approach to transforming health, Kight said. “The unfortunate truth is that Louisi- ana has often fallen at the wrong end of the scale in terms of health and healthcare rankings. Our state has a significant num- ber of healthcare provider shortage areas, geographic disparities in care, and poor performance in important predictors of health, like educational attainment, em- ployment status, and income level,” Kight explained. “Reversing these issues won’t happen overnight, but it can happen. And we are committed to being part of the ef- fort to make it happen.” Over the past few years, the health plan has launched a number of SDOH-focused initiatives, including a community health grants program to fund community-level projects that address food insecurity, and a physician education campaign to promote the use of Z-codes in medical claims. “Every medical claim includes codes that indicate the types of services rendered by the physician, but many physicians are providing services that go beyond medical care,” explained Kight. “Z-codes are used by physicians to indicate non-health fac- tors that influence outcomes. For example, if a patient isn’t taking his or her medica- tion due to a financial problem, or not fol- lowing an appropriate diet because of food insecurity in the home, these are issues that can be documented with Z-codes. And when we see those codes on the claim, we know we need to provide some targeted outreach to that patient to help them over- come those barriers to care.” As this outreach has grown, so has the health plan’s need for a centralized SDOH strategy, leading to the creation of the Louisiana Healthcare Connections SDOH Center of Excellence. The center will be based in the company’s New Orleans of- fice, and will focus on providing compre- hensive, whole-person care to its 450,000 members across the state, Kight said. “This team will coordinate resources and implementation to eliminate gaps in healthcare and social services,” he ex- plained. “Their focus will be on providing our members with personalized assistance and helping them to better navigate what can be a very complex system of care.” The team that will power the SDOHCen- ter of Excellence is being built now, Kight said. “We are in the process of developing a team that will include population health experts, clinicians, social workers, com- munity health workers, and more. Togeth- er, they’ll work with our network providers and integrated care management team to make sure our members don’t fall through the cracks in the system.” The SDOH Center of Excellence is ex- pected to be fully operational before the end of the year, and will play a key role in the health plan’s mission to transform health in Louisiana, according to Kight. “When families have access to the right combination of quality healthcare and appropriate community-level resources, health improves and healthcare costs go down,” Kight said. “To us, it’s not an inno- vative strategy. It’s a common sense solu- tion for the health of our state.” n “Our team was built on the idea that improving health takes a coor- dinated, integrated approach, and an important part of that is helping our members overcome non-health factors that are negatively impacting their health, like homelessness and food insecurity.” – Teritha Harkless-Thomas, LSCW