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Value-based care report

VBC aims to address social inequities

The next big opportunity in value-based care (VBC) is addressing social inequities for those who face challenges such as income inequity, health inequity, substance use disorders and need family support.

Family-Focused Recovery Program

The Family-Focused Recovery Program supports mothers grappling with substance use disorder (SUD), attending to their comprehensive physical, mental, and behavioral health needs. Specifically designed for pregnant, postpartum, and parenting women, the program adopts an evidence-based approach to prevent family separation, extend critical care for mothers and infants, and mitigate the risk of relapse.

Key insights

  • The majority of participants in the program are young white women with an SUD.
  • Illicit drug use rates have increased over the years, affecting various racial/ethnic groups.
  • Participants are often working but living in poverty, facing challenges like homelessness and parenting multiple children.
  • Commonly abused substances include heroin, opiates, methamphetamine, Xanax and benzodiazepines.
  • Many participants have a history of alcohol use or abuse during pregnancy and are in recovery for both substance and alcohol use disorders.

As the Medicaid population grows and health disparities persist, VBC emerges as a potent tool in addressing equity concerns, especially when fostered through collaborative partnerships within the healthcare industry.

The Institute for Advancing Health Value

The Institute for Advancing Health Value started a thought leadership group to support health equity goals and recently launched educational opportunities that can help identify care gaps, create shared tools and collaborative spaces, facilitate partnerships and develop action plans. Sharing information across market segments can lead to breakthroughs in how physicians, care teams, contracts, and payment terms are built to address health inequities.

The Institute for Advancing Health Value focuses on building a healthier infrastructure in the Rio Grande Valley (RGV), a 50-mile stretch along the Texas/Mexico border.

Key insights:

  • RGV has a 90% Hispanic population and grapples with challenges like income inequality and health disparities.
  • Poverty rate in RGV is double the Texas average (14.7%), with Hidalgo County showing median earnings of $20,574 per year.
  • The 5 counties in RGV have alarming health inequities, including 23–30% of the population with no health insurance and 25–32% struggling to afford doctor visits.
  • The ratio of population to PCPs ranges from 2,200:1 to 5,320:1 in these counties, indicating limited access to primary care.

Value-based care plays a pivotal role in enhancing service sustainability and better serving Medicaid patients.

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