Cardinal Innovations Healthcare is the largest specialty health plan in the country, insuring more than 850,000 North Carolinians with complex needs. Using a community-based model of care management, Cardinal Innovations has led the way in developing services, processes and solutions that improve the lives of our members and their families. Recognized for operational excellence, innovative solutions and superior outcomes for members, accuracy and speed of payments to providers, and cost-effective funds management, Cardinal Innovations is a leading healthcare company in the United States.
Although healthcare organizations across the United States have begun to focus on how social determinants of health impact outcomes, the ability to address many of these elements often rests outside of the services that managed care providers offer. That's where community partnerships come in.
Elliot Clark is the senior community executive at Cardinal Innovations Healthcare.
Personalized care extends well beyond an individual’s clinical needs. In reality, numerous factors contribute to the overall health and well-being of the individuals we serve, including housing, transportation, and other social determinants of health (SDOH). Although healthcare organizations across the United States have begun to focus on how SDOH impact outcomes, the ability to address many of these elements often rests outside of the services that managed care providers offer.
For example, it’s one thing to ensure a patient receives medical treatment for anxiety. However, helping that individual successfully treat their condition requires a better understanding of their unique nonclinical needs. It’s then important to connect them with resources that can address the outside factors that may be contributing to their health concerns. Having resources at the ready can make all the difference.
That’s where strong community partnerships come in. To impact SDOH—and to provide truly personalized service to members—managed care organizations must create both a network of resources and a way to easily access the services that can help members deal with the whole picture. One way to do that is to tap into the wide variety of expertise that already exists within the community—from public health groups to school systems, housing authorities, civic organizations, social services departments, judicial systems, county governments, and many other organizations.
There are several steps managed care organizations that are seeking to increase their engagement in community initiatives can take:
It Takes a True Partner
Ultimately, the important thing is to start having these conversations. Strong partnerships make strong communities.
Improving care quality requires all of us to be willing to be a little vulnerable. We have to share our experiences and show where care gaps exist before we can move forward together to fill them. Managed care organizations seeking to heighten their impact on the community and pave the way for better health outcomes can start by looking outside of their own walls and partnering with organizations that stand ready to drive positive change.