What Is Whole Person Care?: AmeriHealth Caritas

posted by AHIP

on March 19, 2021

On the latest episode of The Next Big Thing in Health podcast, Dr. Andrea Gelzer, Senior Vice President of Medical Affairs at AmeriHealth Caritas, joined hosts Matt Eyles, AHIP president and CEO, and Laura Evans to discuss new advancements in population health management, the future of telehealth, and the health care industry’s response to COVID-19.

Listen to the full interview on Apple, Spotify, Soundcloud, and Stitcher.

Matt Eyles: As you think about the vaccine and getting to a post-vaccine world, what do you anticipate regarding telehealth, and will it continue to grow?

Dr. Gelzer: Telehealth is a natural extension of the patient-doctor relationship out of the four walls of the doctor’s office. We’ve seen our members and providers embrace telehealth at a rapid pace since the beginning of the pandemic—upwards of a 5000% increase in utilization.

However, we’ve seen telehealth utilization trends decreasing and plateau as provider offices began to reopen last summer. It’s been hugely important for behavioral health care and therapy services, and that’s been the biggest trend we’re seeing continue throughout. I think that will continue and further increase post-pandemic.

Primary care practices are also significantly embracing telehealth—more so than we ever thought they would previously. For the underserved communities that AmeriHealth Caritas serves, we’ve seen how telehealth can remove barriers to care, such as transportation or childcare issues. As a result, our network providers have recorded significantly fewer no-show appointments with telehealth. We want these positive impacts to continue post-pandemic.

I believe we’ll continue to see telehealth continue to grow in a post-pandemic world. But that growth will be because telehealth becomes more and more integrated into provider practice workflows. It becomes another modality for providers to reach their patients. Perhaps, post-pandemic we’ll see practices split their time between in-clinic and virtual visits.

Laura Evans: Do you think that we will see the expansion of other remote possibilities beyond telehealth that will help patients in vulnerable communities get the care they need?

Dr. Gelzer: Absolutely. I think that’s going to be the next big thing in health care. The intersection of digital health care technology with traditional, in-person health care is certainly a place to watch. And the pandemic in many ways helped accelerate this convergence, and it’s something we should all pay attention to in our industry, but also from our own personal experiences as patients and caregivers. I think there is much more to come of this in the immediate years ahead.

App consolidation to support virtual care will become a reality—so much so that virtual care may become an equal way to deliver health care, perhaps even the predominant way to deliver health care in the future. And I know that sounds a little like Star Trek Next Generation, but people want to get care when and where it’s convenient for them: in their homes, in their offices, in underserved communities.

We’re going to be able to see that apps can connect to patient controlled, hand-held monitoring devices. And patients will be instructed on how to use them. Apps will be the interfaces to get clinical monitoring data directly into significant technology platforms—and these platforms are going to be game changing in my opinion.

Matt Eyles: Can you talk about some of the on-the-ground activities you’ve utilized to address the health inequities in our country?

Dr. Gelzer: The pandemic has really brought the discussion of health equity to the forefront as communities of color are disproportionately affected by COVID-19. Black and Hispanic individuals are still twice as likely to die from COVID-19 than white Americans, and three times as likely to be hospitalized for the virus.

Health plans have really renewed their efforts to address health equity and are doing it in a much more holistic manner than ever before, to drill down to the systemic root causes. It’s a different and more comprehensive approach than what has been done in the past. And it’s wonderful that collectively, the industry is working towards ways to not only improve health disparities, but really get to equity and equality for all.

A few things we’re doing at AmeriHealth Caritas include continuing to capture individual-level, self-reported race, ethnicity, and language data to more effectively prioritize and engage our members through outreach efforts. We’re also investing in our community-based workforce of community health workers and peer support specialists who will very soon be out in full force in the community.

We’re offering health equity and implicit bias training for our associates and our provider networks, expanding partnerships with community-based organizations in the communities we serve, incorporating social determinants of health and health equity components into our value-based contracting arrangements with providers. We’re working with the Gravity Project for HL 7 to standardize electronic data collection so we can address the social determinants of health and further advance interoperability. And we’re also partnering with state and local governments to support an equitable COVID-19 vaccine distribution and access.

Note: This transcript has been lightly edited for clarity.