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Project targets root causes of poor health in poorer areas of Capital Region

Project targets root causes of poor health in poorer areas of Capital Region

MVP Healthcare providing $800K in partnership that unites health care, social services providers
Project targets root causes of poor health in poorer areas of Capital Region
MVP President and CEO Christopher DelVecchio discusses a healthcare collaboration Thursday.
Photographer: Marc Schultz

SCHENECTADY — Several area social service providers and health care administrators are teaming up to address the social factors that diminish the health of poorer residents of the Capital Region.

MVP Health Care and Healthy Alliance announced the project Thursday, joined by the mayors of Albany, Schenectady and Troy and leaders of the six nonprofits that will share $800,000.

They are: The Center for Disability Services, Equinox, Northern Rivers, Trinity Alliance, City Mission of Schenectady and The Unity House.

MVP is providing the funding as part of its annual investment in the community, with the hope of seeing better health outcomes at a lower cost. 

“We selected these organizations because of the quality of their programs, the care, the compassion, the history of transforming lives, but also the breadth and depth of their services and their geographical reach,” said Ellen Sax, senior leader of community engagement at MVP.

The partnership is a new effort in the wake of state and federal funding changes, and there’s a bit of an experimental aspect to it, said Christopher Del Vecchio, CEO of MVP. Each community-based organization has its own niche, such as emergency housing, food and mental health or drug abuse counseling.

Del Vecchio said the project grew from a walk around the rougher parts of Schenectady that he took one day with Dr. Jacob Reider, CEO of Alliance for Better Health, parent organization of Healthy Alliance.

“We thought, is there something we can do better? And we just kept talking about those ideas. We believe healthy communities are much more than the walls in a doctor’s office.”

Reider said the medical community routinely screens for the physical indicators of poor health, such as high blood pressure or blood cholesterol. “But doctors weren’t screening for social determinants of health. Fourteen percent of physicians nationwide ask questions like, ‘Do you know where your next meal is coming from?’ Or, ‘Do you have a safe place to live?’”

And those who do ask the questions often don’t have a way to address the problems the patients disclose. 

The project announced Thursday will electronically link healthcare providers with social services providers, Reider said. 

It’s more effective to address the social problems before they become medical problems, he said, citing childhood asthma as an example: It’s better to remove the child’s aggravating factors (dust accumulations, plush toys in the bed, parents who smoke in the home) than to take the child to a hospital emergency department after an attack.

“No kid with asthma belongs in the ED, ever,” Reider said. “If we think about the things that are important, the ED visit is a proxy for the suffering that kid has experienced for eight, 10, 12 hours.”

The fact that it costs less to remove the cause than to treat the result is secondary, he added.

Schenectady-based MVP provides health insurance to 700,000 members in 76 counties in New York and Vermont.

NEW CHAPTER

The move will continue the work begun in 2014 with New York state’s Delivery System Reform Incentive Payment program, or DSRIP, a federally funded effort to reduce hospital admissions and emergency department visits.

Twenty five performing provider systems  were created statewide to accomplish this through system transformation, clinical improvement and population health improvement.

The federal government in 2014 allowed the state to spend $8 billion of accrued Medicaid savings over the next five years, including $6.42 billion on DSRIP. The state missed some of its benchmarks and also didn’t spend the last $625 million of the money. 

It sought a one-year extension of DSRIP to spend the remaining money and sought a three-year renewal (“DSRIP 2.0”). The federal government rejected both requests and is allowing the program to sunset, prompting Gov. Andrew Cuomo on Tuesday to attack the federal government for what he called an $8 billion cut to the state’s healthcare system.

Cuomo listed the amount that would be denied to the state’s various PPS organizations. In the greater Capital Region, they are:

  • Adirondack Health Institute, $20,930,831, Clinton, Essex, Franklin, Fulton, Hamilton, St. Lawrence, Saratoga, Warren and Washington counties;
  • Alliance for Better Health, $27,865,422, Albany, Fulton, Montgomery, Rensselaer, Saratoga and Schenectady counties;
  • Better Health for Northeast New York, $15,748,286, Albany, Columbia, Greene, Saratoga and Warren counties;
  • Leatherstocking Collaborative Health Partners, $7,921,320, Delaware, Herkimer, Madison, Otsego and Schoharie counties.

“Just because DSRIP is over doesn’t mean we are over,” Reider said of the Alliance for Better Health. 

Over the last year, the Alliance for Better Health PPS has formed Healthy Alliance, which is an IPA, or independent practice association. It has financial commitments that will allow at least two more years of operation.

The DSRIP experience has been a mixed bag for the healthcare industry in New York state, Reider said. The target was a 25 percent reduction in unnecessary hospitalizations and emergency department visits over five years, and New York on the whole saw a 20 percent drop in four years, with some facilities faring better than others. (Fifth-year results are not yet available.)

On the other hand, he added, the goal of moving hospitals’ reimbursement model from fee-for-service to value-based billing has been less successful, particularly in the Capital Region.

INDIVIDUAL PROJECTS

Projects announced Thursday include:

  • Center for Disability Services: Case coordination services for patients; screening for social determinants of health; linkage to community resources such as transportation; psychiatric collaborative services.
  • Equinox: Early engagement health and benefits navigation support; referral to primary and specialty care; referral to services for social problems.
  • Northern Rivers: Pilot project to screen, identify and address social determinants of health to improve families’ health and well-being.
  • Trinity Alliance: Benefits navigation; accompanying individuals to benefit providers; advocating for benefits applicants; assisting with benefits re-certification; assistance using benefits.
  • City Mission of Schenectady: Provide connections to primary care and mental health services; offer supportive services such as drop-in hours, on-site psychiatric nurse and pre-employment screening.
  • Unity House: Hire community health navigation specialists to leverage the Circulation transportation service; screen for social determinants of health; link consumers to health care services; train residents on using CDTA services.
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