With the ultimate goal of improving population health, a novel initiative launched by Dell Medical School at The University of Texas at Austin and funded by EHF is working to shift the focus to health — not just health care — and creatively aligning unconventional partners to identify, prove and pay for drivers of health outside of more traditional settings like clinics and hospitals.
Known as Factor Health, the program’s first efforts are focused on well-known health challenges among two vulnerable groups: chronic disease management for home-bound older adults and the mental health impacts on youth who have experienced family trauma.
The atypical assortment of players involved, all with a stake in Factor Health’s success, include the EHF, which invested $2.6 million to launch the program; managed care payers Amerigroup Texas and Blue Cross and Blue Shield of Texas; and Austin-based social service providers Meals on Wheels Central Texas and grassroots youth development organization Youth Rise Texas.
“Medical care alone isn’t enough to keep many Texans healthy, because it doesn’t address the non-medical, underlying causes of poor health,” says Elena Marks, EHF’s president and CEO. “Factor Health works outside the doctor’s office to find successful solutions targeting the root cause of health issues. The health care system, with its $3.5 trillion annual expenditures, should pay for successful non-medical interventions, because that is what improves health.”
“The major gap in all of our talk about health care is that we are failing to address health,” said Mini Kahlon, Ph.D., Dell Med’s vice dean and executive director of Factor Health. “There are all kinds of organizations that are, today, contributing to better health. The problem is, the health care system doesn’t pay them for it. That’s where Factor Health and our team at Dell Med come in.”
The Factor Health approach is different, Kahlon said. “It’s about moving beyond traditional, fee-for-service care found in hospitals and clinics, to helping everyone in the health ecosystem — investors, health care payers, community-based organizations, academic medical centers — see themselves and the roles they can play in health differently.”
“Factor Health has already been successful in bringing together unconventional partners who are thinking creatively about health outcomes,” said Karen DeSalvo, M.D., MPH, a Dell Med professor and former acting assistant secretary for health at the U.S. Department of Health and Human Services. “Now the challenge is to demonstrate measurable improvements in health. I expect that payers around the country — not to mention other academic medical centers — will be watching with interest.”
Demonstrating & Measuring Success
As a first step, the Factor Health team is testing health programs that include an anchor provider, payer partners and a funding partner. The team will work with each to maximize opportunities and enable success, including identifying business needs, finding and vetting relevant partners, defining success metrics, addressing policy hurdles, enabling data sharing, defining health outcomes and collaboratively crafting new payment methodologies. Partners will regularly and collaboratively review results and plan for payment models based on outcomes to support the program at scale after the demonstration period. Ultimately, the intent is for payer partners to transition to longer-term funders.
The first two programs, both funded by the EHF, include:
Aging at Home: Diabetes Management for Older Adults
Anchor provider partner: Meals on Wheels Central Texas
Payer partner: Amerigroup Texas
This project is designed to help older adults with diabetes better manage their disease at home, thus improving overall health and decreasing the need for expensive (and preventable) emergency room visits and hospitalization. Meals on Wheels volunteers are already delivering specially made meals and providing essential human connection to more than 5,000 of their neighbors in the Austin area. For this project, the Factor Health team will assess the impact of incorporating additional home health assessments, such as measuring glucose levels and conducting depression assessments, as well as referrals and other services that provide real-life support.
Resilience for Life: Addressing Mental Health Impacts of Family Separation on High School–Age Youth
Anchor provider partner: Youth Rise Texas
Payer partner: Blue Cross and Blue Shield of Texas
This project is focused on supporting youth who have experienced family trauma, such as separation from parents and family due to incarceration and deportation. Depression, anxiety and suicidal tendencies are common among this group, as is self-medication with alcohol and drugs. In an effort to help reduce associated and long-term medical needs, the Factor Health team will support Youth Rise Texas in expanding, scaling and evaluating outcomes for a peer-facilitated learning and leadership curriculum focused on improving mental health for a group of approximately 150 teens.
Factor Health leaders understand that long-term success involves building real-world programs that deliver measurably better health outcomes at scale. Beyond the launch of Factor Health in Austin this summer, the program team is already working to connect organizations, payers and investors in the Houston area.