IPA-Insurer Partnership to Address Social Determinants of Health

August 20, 2019

Two organizations partner to help fund community-based organizations.

Troy, New York-based Healthy Alliance Independent Practice Association (IPA) and Schenectady, New York-based MVP Health Care, which covers 700,000 members in upstate New York and Vermont, partner to provide funding to community-based organizations (CBOs) in the Capital Region.

This first-of-its-kind partnership provides a unique opportunity to identify and act upon the underlying social factors that can hinder our community’s ability to be and stay healthy, according to MVP Health Care’s Chief Medical Officer Bruce Himelstein, MD, MBA, FAAP, FAAHPM .

“At MVP, many of our members have needs that span beyond the traditional walls of a physician’s office,” Himelstein says. “We know that if someone does not have access to healthy food or stable housing, it can be difficult for them to choose between filling their prescription, eating breakfast, or paying rent. Such choices can have short- and long-term effects on a person’s overall health and well-being and must be addressed at the individual level in order to create the healthiest communities possible.”

This initiative is a proactive response to the ever-growing body of research indicating that addressing social determinants of health improves overall health while lowering costs, according to Jacob Reider, MD, Healthy Alliance IPA’s CEO.

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“And for health providers of every size, providing the tools to address this issue is useful for ensuring the long-term health of the clients and patients they serve,” Reider says. “This is very much the direction the healthcare industry is moving-and indeed, must move. The work of our IPA aligns perfectly with the future of how our country will invest in the health of our communities-not just healthcare.”

As risk-sharing contracts become more common, executives in care delivery organizations need to have confidence that the safety-net service providers are going to be available to help individuals avoid the cascade from social and behavioral needs to physical needs, according to Reider.

“In the fee-for-service era, medical care organizations had no business interest in this domain,” Reider says. “Now that medical providers need to prevent unnecessary use of medical services, the importance of social and behavioral health is much better understood. Our goal is to make sure that nobody falls through the cracks, because we’re focused on the whole community-not just individuals served by one health plan or one health system.  Working across these boundaries is an essential part of our mission.”

Himelstein agrees. “We understand that in order to keep our communities healthy and living optimally, we have to transform our delivery system into one that focuses on the value of care, which in itself is a healthier clinical as well as economic view of the challenges before us,” he says. “At MVP, holistic care-ranging from addressing social determinants of health to integrating behavioral health and primary care-is a major priority and will ultimately lead to better coordination, better care at the individual level, and improved outcomes for our communities.”

Reider adds, “We don’t know of another IPA like this-laser focused on helping social and behavioral health providers be their best.”