These initiatives are a call-to-action for clinical laboratories to contribute their expertise in support of wellness programs

Two of the largest healthcare systems in America are moving in non-traditional directions to proactively address certain healthcare populations. Most recently, Kaiser Permanente announced it will be investing millions of dollars to tackle homelessness and the disease outbreaks associated with it. The health system is even investing in a housing complex in Oakland, Calif., which it hopes will help patients in that area who face housing insecurity.

Kaiser’s new direction mirrors a similar project by Geisinger Health designed to address the health of certain populations. In 2017, Geisinger launched what it calls the “Fresh Food Farmacy” for its adult diabetic and obese patients to give them access to healthy foods. Geisinger finds this service saves substantial money in downstream medical expenses because the patients are healthier.

If these programs are harbingers of things to come, clinical laboratories open to supporting such wellness programs will find opportunities heading their way.

Healthcare and Homelessness

Kaiser Permanente’s announced $200 million investment in the new program begins with a $5.2 million purchase of affordable housing in Oakland, Calif. Kaiser is working with Enterprise Community Partners and the East Bay Asian Local Development Corporation (EBALDC).

The housing complex consists of 41-units and is in an area where existing residents are at risk of displacement due to gentrification. Kaiser Permanente’s purchase means the complex will be blocked from redevelopment and will remain affordable for the residents who live there.

“Housing security is a crucial health issue for vulnerable populations,” Bernard Tyson, Chairman and CEO at Kaiser Permanente, stated in a news release. “Access to affordable housing is a key component to Kaiser Permanente’s mission to improve the health of our members and the communities we serve.”

This unusual move is part of a larger strategy to invest in the economic, social, and environmental conditions that impact the health of Kaiser’s patients. It’s also part of a greater trend toward value-based, proactive healthcare.

“We know that differences in health are striking in communities with poor social determinants of health such as unstable housing, low income, and unsafe neighborhoods,” said Richard Isaacs, MD, CEO and Executive Director of The Permanente Medical Group, in the news release. “These innovative strategies are critically important steps toward the maintenance of health improvement, consistent health outcomes, and California health equity.” (Photo copyright: Kaiser Permanente.)

Proactive versus Reactive Care

Healthcare delivery in the US is transitioning from volume-based to value-based care. The Kaiser and Geisinger projects are championing another equally critical change—proactive care instead of reactive care. This shift in priorities promises to change how health systems and healthcare providers think about healthcare delivery. And clinical pathology laboratories play a critical role in these changes.

“Specifically, in the transition from volume-based to value-based healthcare, clinical laboratories are called upon to provide programmatic leadership in reducing total cost of care through optimization of time-to-diagnosis and time-to-effective therapeutics, optimization of care coordination, and programmatic support of wellness care, screening, and monitoring. This call to action is more than working with industry stakeholders on the basis of our expertise; it is providing leadership in creating the programs that accomplish these objectives,” James M. Crawford, MD, PhD, and co-authors, noted in their paper, “Improving American Healthcare Through Clinical Lab 2.0: Santa Fe Report,” published in the journal Academic Pathology.  

Food as a Prescription

Patients encounter all sorts of challenges in addition to housing. Geisinger Health’s Fresh Food Farmacy program promises to help obese and diabetic patients who face food insecurity maintain healthy diets. Coupled with exercise, the program acts like medication in helping regulate blood sugar and improving long-term outcomes for people with diabetes.

Patients in the program are given a referral, called a prescription, by their primary care physician. Once enrolled, they receive a welcome kit that includes food measurement instruments, recipes, and nutritional information. Each week, they also receive enough food to prepare healthy, nutritious meals twice a day for five days for their families.

Enrolled patients attend weekly support groups to learn about self-management. And they complete an online wellness class to help them learn about nutrition. The program also offers free cooking and nutrition classes taught by dieticians and health coaches.

Proactive, Value-Based Care and Population Health

“With what’s happening in this nation right now, there’s never been a more important time for us to focus in on this population and to do that through a united front,” Lloyd Dean, CEO at CommonSpirit Health (formerly known as Dignity Health), told Forbes.

The housing program at Kaiser Permanente and the Fresh Food Farmacy at Geisinger are just two of the latest examples that healthcare providers are increasingly focusing on population health. The fee-for-service model of healthcare pays health systems, hospitals, and other providers, based on the number of sick they treat. These new programs, however, move the entire healthcare system toward keeping people from getting sick in the first place.

“I think there’s no doubt that we need to emphasize both health needs and social service needs, and we should be thinking about these collectively and not in silos,” Signe Peterson Flieger, PhD, Assistant Professor of Public Health and Community Medicine at Tufts University, told Forbes.

As progressive health networks such as Kaiser Permanente and Geisinger move the traditional sites and types of medical care into new settings and new directions, medical laboratory managers and personnel need to stay alert for opportunities to support innovative, new health and wellness programs in their communities.

—Dava Stewart

Related Information:

Kaiser Permanent Just Invested in a Housing Complex. Here’s What It’s Doing with It

3 Initiatives to Tackle Housing Insecurity

Improving American Healthcare Through “Clinical Lab 2.0”: A Project Santa Fe Report

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