Empowered Patient Podcast Connecting Vulnerable Populations to High-Quality Healthcare Services Using Mobile Access and Community-Based Partners with Dr. Nate Favini Pair Team
Dr. Nate Favini, the first Chief Medical Officer of Pair Team, aims to connect underserved communities to high-quality, ongoing healthcare by providing medical, behavioral, and social services. Working with people who rely on Medicaid, who are experiencing homelessness and substance use disorders, and who have had recent interactions with the criminal justice system requires innovation and collaboration of government agencies, community-based organizations, and healthcare providers. With a focus on outcomes and cost, this value-based approach is reaching patients where they are, often using mobile technology and offering virtual care for tracking and improving health outcomes.
Nate explains, "In general, and specifically for the folks that we care for, value-based care means attention to the outcomes that we're delivering. For me, as a physician, that starts with the health outcomes that we deliver. So, are we improving people's health? Are we doing it on the measurable outcomes in terms of the conditions that they have, whether it's their blood sugar control for diabetes or their blood pressure if they have hypertension?"
"On the social outcomes that are drivers of people's health issues. So, are we getting you housed? Are we getting you a reliable and stable source of nutritious food? Because these are the things that make a difference in the health outcomes we're looking for."
"And then, of course, value-based care also implies attention to the cost of care. Are we delivering those outcomes at a cost that makes sense? And we've shown that we're very good at being able to achieve both of those things at the same time. At Pair Team, we have great outcomes in terms of hemoglobin A1C and blood pressure and improvements in depression. At the same time, we're offering people services that allow them to go to the emergency department and be in the hospital last. And so the real sweet spot in value-based care is if you can improve the outcomes for the folks who need it and return those investments to the system in the shape of lower spending."
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