Food for Thought – MedHealth Solutions
September 2, 2021
Food for Thought is a quick chat with some of our amazing partners in the fight against hunger. Today we will be discussing how we’re teaming up to provide fresh and healthy food to families in need with Derrick Taveras, CEO of MedHealth Solutions.
Derrick Taveras is a Healthcare Executive with more than 20 years of entrepreneurial experience developing and growing best-in-class, Risk Adjustment and Eligibility Solutions, for Health Plan and Hospital Systems on a national scale. Successfully grow start-up ventures into full-fledged companies with rising shares within the healthcare market. With a focus on transparent delivery, provides a hands-on approach to developing relationships across the health care spectrum, which driven industry leaders appreciate and seek.
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Can you tell us a little bit more about what MedHealth does?
What we do at MedHealth is focus on working with hospitals and health plans to create customizable programs for specialized populations. So think of the folks who are not as easy to get a hold of or have conversations with. Regarding engagement, we specialize in our ability to engage with these folks and then address their care management needs on a customized basis. One of the programs we’ve developed is called Response 30, and it’s basically a 30-day readmission management program where we follow up with patients that are recently discharged. We manage them through that discharge cycle and then address low-hanging fruit or concerns that can be addressed through education of medication, adherence to a primary care visit, or just information on their current status or evolution of care, and making sure that they can get that information and avoid going back to the hospital for situations that can be avoided.
How do socioeconomic factors – the effects of poverty on many communities and families – impact health?
When we think of socioeconomic factors, we think of income, education, employment, community, social support, and safety. All of those things contribute to the continuum of health, and these factors impact how well and how long we live. Impacting and addressing needs in these areas translates to better medical management, which ultimately translates to better care and health results.
What’s missing in this approach to making a difference in the lives of folks who have enormous socioeconomic pressures as it relates to health?
What it boils down to is really getting to the core of the challenges that exist, complement, or impact the health results. You may have a family member who’s potentially a diabetic, but you’re not realizing that diabetic lives in a food desert that doesn’t allow for them to receive produce such as fresh vegetables or fruits. Or you’re dealing with a person who has issues with hypertension or chronic obstructive pulmonary disease(COPD), and their AC breaks down. Now you’re not just managing a condition of COPD; you’re managing a condition of their environment that’s attributing negative results with their COPD.
It’s having that sort of broad perspective and thinking about care, and not just the condition and the procedure that needs to be addressed for that, but the external elements that impact it and ultimately drive that health result. I think health plans and organizations are becoming wiser to that. I think there’s been a lot of regulation and restriction in the industry not allowing plans for crossing the boundaries into that, but as costs are being analyzed and plans are becoming smarter around what’s attributing to their medical loss ratios, recognizing these external factors are now a driving force to managing those end results.
So you’ve been in this industry for 20 plus years, when did you start to see this very visible change?
I think the term social determinants of health, or the acronym SDOH, became very popular around 2017 or 2018. It’s just another way to categorize what’s been happening throughout our country for years. We have food banks, income assistance programs, rental assistance programs, and there are tons of different initiatives across the country and great people who really do things for the right causes and helping people. I think when SDOH started to evolve in the healthcare space and the buzzword became a prevalent conversation point, was when the federal government started changing how they viewed the allowable spend limits that health plans can have with their constituents. Because as a health plan, they’ve got a specific percentage of revenue that they collect that they have to allocate to medical use. That’s not for them to pay rent or to pay their executives, it has to be used for the care of people.
The care of people didn’t always include paying the rent, buying them food, getting them assistance, or all of those external factors that we just talked about that are contributing to those results. In the last four to five years, the federal government started realizing: “We have to treat this a little differently”. And health plans have been petitioning back to the government over the same situation saying: “I’ve got money left in my pot that could really help some people and would ultimately downstream best effects for care, but I can’t use it to care for them or give them that support because I’ve got restrictions and rules that don’t allow me to do that”. The changes in supplemental benefits and how medical or insured attributed dollars can be used to better the result of care has been sort of the wave of change that has taken place, and every year we’re getting better at it. Every year, the government is adjusting the rules and regulations that allow for these programs to then ultimately have the full effect that we’re looking for.
We see thousands – literally more than 70 plus thousand stories – around food assistance requests, but the stories are not about food. They’re about housing, medical assistance, illnesses, and all types of things such as internet access. We realized very quickly that if you don’t address the root causes of hunger, you don’t really fix the problem. It’s really not about how many we fed, but it’s understanding why they are hungry in the first place. So that’s about food assistance, but I would love to hear your response to that from your standpoint.
I would say it’s very similar; the way we get to understanding that need is in our interaction. For example in our Response 30 program, we get on the phone with folks who have chronic conditions or conditions at discharge like COPD, congestive heart failure, acute myocardial infarction, sepsis, or pneumonia. These are probably the five most prevalent diagnoses at discharge that have a recurrence or readmission risk factor higher than the normal. When we’re talking to these people, our job is to figure out what do I need to let this person know or how do I support this person, to make sure that they don’t go back to the hospital.
What’s amazingly interesting about these conversations, a significant percentage of the time, the conversations are about other external factors that have nothing to do with their conditions. It’s about what they’re dealing with in their personal life and how that’s translating across into exacerbating that condition. Having that sort of conversation and thinking outside of the box and saying: “Okay Mrs. Johnson, I realize you have a condition, but your condition is being exacerbated or worsened because of the living conditions that you have”. Taking that approach from the outside and understanding that, helps you get a better picture of what they really need and how food becomes a prevalent factor for their life.
What I love so much about this approach is we’re taking a minute to understand the person’s story. It’s looking from the perspective of why are they hungry or have health issues. I think from what you’re saying is that it is a symptom and often a result of something else.
On that theme, why is adding food to your continuum of care important to you?
It’s something that you always say that really gets me and I find myself repeating quite a bit. Food unites people. Food brings us together and is that channel that unites the family at that one common place, which is that dining room table. That uniting of families goes hand in hand with health. So there’s a spark that ignites when you put food in the middle of that relationship, and it goes hand in hand with those results. I, or U.S. Hunger I’m sure, would love to be the solution for all the SDOH problems that exist.
We know there are tons of them, but food is a major factor within that. I think the difference is that food opens the door to having a conversation, and that engagement then leads to the end result. Maybe that food isn’t the problem, but that food opened the door to a conversation to identify all the other factors that were the problem. It’s the common ground that everyone all over the world shares. How do we come together to meet and to connect? Food. That’s why for me I think this component of SDOH and what U.S. Hunger is trying to accomplish is such a powerful tool. While you focus on what you do best to make sure that food gets delivered and folks are having the nutrients that they need, all of the backend information that comes off that interaction really drives the change and the difference over time.
You are spot on because I can’t think of an impactful moment in my life when I couldn’t also think of the meal that went along with it. If we can help that a little bit at U.S. Hunger and by working with amazing partners like you, I think we can put a dent in food insecurity. Thanks for coming along, I really appreciate it.
It was my pleasure; thank you for having me. You guys continue the great work.
*This interview has been edited for length and clarity.