Advancing Whole-Person Care in the Face of Uncertainty
By Mike Radu, CEO of AbsoluteCare
The health care landscape is ever evolving, but increasingly we find ourselves at the intersection of innovation and necessity. Recently, I had the privilege of leading a discussion among health care leaders that underscored the challenges and opportunities posed by funding constraints, particularly in the context of Medicaid and social determinants of health (SDOH). As the CEO of one of very few value-based care (VBC) health care companies focused on serving Medicaid and Duals members, I see this as a critical juncture for reimagining how we deliver comprehensive, whole-person care to vulnerable populations.
A Call to Action Amid Crisis
Dr. Jerome Adams, former U.S. Surgeon General and AbsoluteCare board member, eloquently framed the moment as one of both urgency and opportunity. The cuts to HHS and CDC funding are undeniably challenging, but they also compel us to think differently. Dr. Adams urged us to embrace stoicism and innovation, leveraging disruption to drive systemic change. It is a sentiment that resonates deeply with me, as it mirrors my propensity for creativity and a persistence to move forward during difficult times.
Integrating Social Determinants of Health
The role of SDOH in health outcomes cannot be overstated. As Rushil Desai, CEO of Aetna Better Health, highlighted, factors such as housing instability and food insecurity directly impact patient well-being and health care utilization – and, in an increasing constrained world, delivery a positive ROI. His insights on targeted, closed-loop referrals and the integration of community resources into care delivery provide a roadmap for other organizations striving to address these critical issues.
At AbsoluteCare, we have seen firsthand how addressing SDOH can reduce hospitalizations and improve long-term outcomes. In fact, one of our most useful strategies for addressing immediate SDoH needs is the AbsoluteCare Member Fund. This is a self-funded account available to support members in each of our markets when community-based resources aren’t directly available. A recent analysis of that fund showed that for every $1 invested in addressing an SDOH need – housing, transportation, DME, etc., – generated a cost savings of $13, primarily driven by reduced utilization. This was a 16% reduction in monthly total cost of care.
Dr. Beejadi Mukunda, CMO of CareSource Ohio further emphasized the importance of data-driven approaches. By integrating SDOH data into decision-making processes, we can ensure that interventions are not only effective but also aligned with the unique needs of our members. This member-centered approach is critical to not continuing in a cycle of specialist driven, fragmented care that so often plagues the chronically ill.
Building Partnerships for Sustainable Change
The path forward demands collaboration. Public-private partnerships, as suggested by Dr. Adams, can bridge the gap left by reduced federal funding. These partnerships enable health plans, providers, and community organizations to pool resources and expertise, creating more resilient systems of care.
Moreover, the alignment of incentives across payers, providers, and community organizations is essential. Fragmented funding silos remain one of the biggest barriers to integrated care. Payment structures must evolve to support collaboration across physical, behavioral, and social services. Without this alignment, the promise of whole-person care will remain aspirational.
A Vision for the Future
Our discussion illuminated several key takeaways to guide a path forward:
- Aligning Incentives for Integrated Care – Payment models must break down funding silos to promote collaboration across physical, behavioral, social, and dental health.
- Fostering Collaboration Through Training – Cross-disciplinary co-training for providers, including community health workers and navigators, can improve teamwork and patient outcomes.
- Closing Resource Gaps – Addressing space, technology, and policy barriers, like outdated HIPAA restrictions or impediments to telehealth piloted during the PHE , are key to enhancing access and enabling integration.
- Localized, Data-Driven Models – Value-based care succeeds when tailored to regional needs, built on trust, real-time data sharing, and provider engagement.
- Managed Care’s Role in Holistic Health – Payers can drive innovation through telehealth, home medication delivery, and collaboration with community organizations to enhance outcomes beyond clinical settings.
As health care leaders, we face a pivotal moment.
The challenges of funding cuts and resource constraints are undeniable, but they also present an opportunity to redefine how we deliver care. By aligning incentives, fostering collaboration, and addressing the root causes of poor health, we can transform our systems to better serve those who need it most.
At AbsoluteCare, we are committed to participating in this charge, embracing innovation, and driving meaningful change. By suspending our own hubris and siloed thinking, we can build a health care system that not only treats illness but truly supports health and well-being for all.