The Industry Initiatives team pictured from L to R: Muriel LaMois (Program Manager), Shruti Kothari (Program Director), Joe Castligione, (Principal Program Manager)
Dear Health Care Transformation Community,
As 2022 comes to an end, we wanted to take a moment to reflect on Industry Initiatives’ work this year to advance health care transformation. Despite feeling like 2022 flew by, we have covered quite a bit of ground in Industry Initiatives’ second year! We are deeply grateful to our many partners who have collaborated with us and made our work possible.
2022 Highlights: Collaborating Virtually and In-Person
Industry Initiatives launched July 2020, during (what turned out to be) just the start of the COVID-19 pandemic. We are so proud of what our team has been able to accomplish in a virtual workplace in bringing together stakeholders from across the health care ecosystem to advance payment innovation, data sharing, and social determinants of health (SDoH).
Our impact in 2022 includes:
Given that our team has been working remotely since starting at Blue Shield of California, we were all thrilled that we were able to gather in-person this year with so many of our external partners at Industry Initiatives-hosted happy hours in both Oakland and Washington, DC. We had a blast connecting with partners from sectors including health plans, providers, digital health, advocacy organizations, government and more to discuss how we can continue to collaborate to improve care and outcomes for all.
A Model for Change
As Industry Initiatives approaches its third year of existence, our model has started to gain national attention as a way to advance health care transformation by addressing systemic challenges such as fragmentation, competition, and misaligned incentives. Industry Initiatives’ Director, Shruti Kothari, was honored to speak at AHIP 2022 this summer on how our team is working to drive industry alignment to bridge gaps in value-based payments as well as data sharing, as well as what it takes to build successful cross-sector industry collaboration and the role of policy in addressing fragmentation across the health care ecosystem.
Industry Initiatives’ Joe Castiglione was interviewed by xtelligent Healthcare Media’s podcast “Healthcare Strategies” on how Blue Shield of California implemented Industry Initiatives to overcome the siloed nature of the healthcare industry to increase momentum towards value-based care and how other organizations can establish their own teams focused on industry collaboration.
Payment Innovation
Primary care is the foundation of a high functioning health care system and a critical component to achieving health equity. Yet chronic underinvestment, aggressive market consolidation, and ever-growing administrative burden have chipped away at our nation’s primary care system, resulting in a deeply alarming rate of burnout, retirement, and decline in a cornerstone of our health system.
Over the past two years, Industry Initiatives has collaborated with other health plans and stakeholders in the California Advanced Primary Care Initiative. This initiative, led by Purchaser Business Group on Health’s California Quality Collaborative and the Integrated Healthcare Association, drives alignment for critical investment in primary care that helps physician practices achieve financial stability while supporting quality outcomes and advancing health equity.
In a huge step forward, this summer Blue Shield of California, along with five other health care organizations participating in the initiative signed a memorandum of understanding (MOU) to increase investment in and access to ‘advanced primary care,’ a model that rewards healthcare providers for practices that deliver on preventive health measures, reduce unnecessary emergency room and hospital admissions, and create a great member experience. It also aims to reduce administrative burdens on providers so they can focus on the delivery of high-quality care.
Earlier this year, Joe wrote a blog outlining how Industry Initiatives has leveraged its advocacy model to drive alignment for primary care and collectively scale transformation across California. These efforts in 2022 included rounding out our three-part event series in partnership with the Milbank Memorial Fund with an expert panel discussing how investments in primary care are critical to addressing SDoH. I was also honored to co-author an op-ed with Milbank’s president Christopher Koller published in CalMatters on the importance of high-quality primary care to address our nation’s mental health crisis.
Data Sharing
Data sharing is a powerful tool to support patients both at the point of care, and at the population level, to give policymakers insights into population-level health needs. When data is shared effectively, it is a critical component of advancing health equity.
Industry Initiatives continued to work this year to improve California’s health data infrastructure and facilitate the sharing of essential health information to drive improvements in patient outcomes and care delivery. In March, Shruti spoke at the 2022 Northern California State of Reform Health Policy Conference in Sacramento, on their “Innovations in Care Collaboration” panel. She was joined by fellow panelists Crystal Eubanks of the California Quality Collaborative and Assemblymember Adrin Nazarian.
The panel focused on how health care and community organizations are collaborating and coordinating in new and innovative ways, how this work takes shape, the implications for quality care moving forward, and how we can foster new ideas.
March was a busy month for us as we also hosted a two-part event series on strategies to improve the collection and use of race, ethnicity and language (REaL) data and sexual orientation and gender identity (SOGI) data. The first part was a public webinar, “Activating Health Data to Achieve Health Equity: An Event to Drive Strategies and Solutions for Demographic Data,” and featured an expert panel including:
- Lynne Chou O’Keefe, Founder and Managing Partner, Define Ventures
- Sandra Hernández, CEO, California Health Care Foundation
- Naomi Senkeeto, Managing Director of Health Equity Policy, Blue Cross Blue Shield Association
- Andy Slavitt, General Partner, Town Hall Ventures
- Shruti Kothari, Moderator
The second event featured small break out discussions with 37 individuals whose roles and organizations vary from health information technology, payers, providers, and government. From these conversations, we developed the strategy guide, “Activating Health Data to Achieve Health Equity: Recommended Strategies for REaL and SOGI Data.” This guide charts a path forward to how health care, government, research institutions, and business partners can each advance the collection, use, and sharing of REaL and SOGI data to help achieve health equity.
Social Determinants of Health
The communities in which we live have a tremendous impact on our health. Social determinants of health (SDoH), holistic health factors such as availability of affordable housing and healthy foods, or educational or employment opportunities, influence as much as 50 percent of the factors that contribute to health outcomes. Unaddressed, SDoH and the resulting social needs people experience due to these SDoH factors adversely impact health equity through worse health outcomes, widened disparities, and increased health care costs for vulnerable communities. In communities where these basic needs are met, people experience better health outcomes.
This year, Industry Initiatives joined the California Health Care Foundation and CommonSpirit Health in supporting research by Health Leads on how we can design and implement community-anchored referral networks that advance community health and racial health equity. We worked together to identify key areas of inquiry including data integration, community engagement and governance, and financing models. We look forward to sharing findings and recommendations in the coming year.
We partnered with the California Endowment this fall to host a three-part event series focused on how innovation and collaboration on critical components such as workforce, data, and payment can be used to address SDoH and social needs.
Dr. Bob Ross, president and CEO of the California Endowment, kicked off our first event recounting his introduction to SDoH working as a young pediatrician during the surge of crack-cocaine use in the United States and discussing the vital connection in addressing SDoH to advancing social justice.
In addition to our three-part event series, we also hosted a webinar focusing on the vital role Community health workers and promotores de salud play in providing culturally relevant care to meet medical and social needs and how technology and recent policy changes can be leveraged to support their work. From this discussion Shruti co-authored a blog with panelists Abner Mason, CEO of SameSky Health and Janet Martinez, Co-Founder and Vice Executive Director of Comunidades Indigenas en Liderazgo, “To Advance Health Equity, California Must Shed “One Size Fits All” Approach to Care.”
Finally, this fall Industry Initiatives worked with Peter Long, Blue Shield of California’s Executive Vice President of Strategy and Health Solutions to write the white paper, “Closing the Gap Between Needs and Solutions: How Health Plans Can Support the Use of Data to Address Social Needs and Social Determinants of Health.” Informed by stakeholder interviews with 40+ experts from across the health care ecosystem, this paper explores the challenges to collecting and leveraging SDoH and social needs data and outlines actionable recommendations for health plans to help unlock the potential of these data. To effectively address SDoH in a community, instead of working individually, health plans must work collaboratively towards the shared goal of a healthier member population, whose health and social needs are being met.
The Year Ahead
As 2022 winds down, we are gearing up to continue our work in 2023 to advance health care transformation through industry alignment and policy movement. We could not do our work without our many partners across health care, government, and technology. We look forward to building new partnerships and strengthening existing ones in the coming year to keep pushing for better care for all.
Happy holidays and see you in the new year!
-Shruti, Muriel, and Joe
