Ross Owen Highlights New Challenges of Adding Care for Families and Children

As Hennepin Health expands its focus from the Medicaid expansion population of single adults to families and children, it will need to shift the way it views return on investment since there can be large upfront costs with returns happening years later with this new population, explained Ross Owen, health strategy director of Hennepin County.

How will Hennepin Health adapt the lessons learned from helping high-risk populations as it expands to serve families and children?
We have learned in the past year, as we have augmented our program to serve families and children, that we've had to develop a lot of community relationships and partnerships and knowledge of the policy and funding environment because the services available to families and children are often so different than what are available to single adults. And so it's really been learning that landscape and leveraging the expertise of, for example, our colleagues in children's mental health and pediatrics and child protection, to just identify the opportunity. And I think that's going to take some time to understand and assess.

The second point I'll make to that is, we have been fortunate in this space of taking care of the Medicaid expansion population that often these investments in social determinants are addressing the social drivers of health happen to lead to short-term cost savings. In other words, there are a lot of low-hanging fruit from a financial perspective to see that return on investment quickly in that complex single adult population. However, many of the investments that we hope to make in families and children are actually investments that tend to have significant costs upfront and the return on those investments may take years or decades to accrue to the system.

And we've really shifted our thinking and we've tried to discipline ourselves to move beyond the business case year on year as a healthcare payer and to think more about Hennepin County's role in broad community investment. Both broad in terms of other services that local government finances and delivers, like law enforcement and housing and criminal justice and transportation and how our investments in those sectors impact health and vice versa, but also more broadly in terms of a time horizon. To really think about the fact that we are really deeply invested in the community, not just in the short term but in the long term, and have tried to really bring some of our colleagues' expertise around public health and taking that long-range view of community health more directly as a lens through which we manage healthcare delivery and payment reform.
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