When life gets hard, do you get beat down, or do you pull yourself up by your bootstraps? If something stands in the way of your dreams, do you stop going forward, or do you trudge through the mud until you find a way? 

Welcome to this episode of the What Unites Us, a podcast about building businesses meant to last. We aim to answer some of the toughest questions about branding, leadership, and success while talking to business trailblazers about their biggest lessons learned. 

Today, we’re welcoming Georgina Dukes, a social justice advocate and our own Senior Director of Social Care Impact. After she became a young single mom while still in college, Georgina realized her passion was in helping others who need assistance and making the process easier to navigate. She shares with us her professional journey, the struggles she has faced while working with community organizations, what her future goals with Unite Us are, and so much more. 

In this episode, you will learn: 

• Georgina shares her origin story and how it led her to her passion (4:19) 
• Why Georgina is super driven (16:34) 
• How Georgina went from Duke to Unite Us (22:36) 
• Why Georgina chose to walk away from the security of Duke for Unite Us (27:25)
• Georgina talks about the journey she has experienced at Unite Us (31:51) 
• How Unite Us has helped with community organizations (35:29) 
• How external leadership is different than internal leadership (40:33) 
• What is next in the healthcare realm for Unite Us (42:52) 
• Georgina’s interests outside of work (48:14) 
• What makes Unite Us the company it is (51:59) 

Connect with Georgina Dukes:
LinkedIn
GeorginaDukes.com

Want to learn more about Unite Us? Our newsletter comes out the first Wednesday of every month. It includes our latest happenings, network news, announcements, and ways to get involved with our movement to connect health and social care. Sign up here. Follow our show on Instagram, Twitter, and Facebook and share your thoughts with us by emailing podcast@uniteus.com. 

Episode Credits:
Produced by Ginni Media and Unite Us
Original music by Starling Studios

Copyright ©UniteUs2023 all rights reserved
All opinions expressed by podcast guests are solely those of the guest and do not reflect the opinions of Unite Us.

The post Bootstraps, Village or Both: a conversation with Georgina Dukes. appeared first on uniteus.com.

There is no more complicated system than healthcare in the US. Is it too big to fix? Are there ideas, solutions, technology, and leaders bringing us toward a more effective and lower cost system?

Welcome to this episode of the What Unites Us, a podcast about building businesses meant to last. We aim to answer some of the toughest questions about branding, leadership, and success while talking to business trailblazers about their biggest lessons learned. 

Today, we sit down with Seema Verma, former administrator for Medicare and Medicaid services under former President Trump. She shares what it was like working for the former President, how she handles backlash, her thoughts on technology in healthcare, and so much more.

In this episode, you will learn:

• What CMS is and what it does (2:14) 
• Seema’s origin story (5:56) 
• Seema talks about what it was like working with former President Donald Trump (12:02)
• How Seema deals with the backlash and hate she gets from people (18:13) 
• Seema answers the question ‘Is healthcare too big to fix?’ (22:34) 
• The big change that is coming to healthcare in the future (24:08) 
• What Seema is excited about in healthcare (26:37)
• Seema’s thoughts on technology in healthcare (29:58)

Connect with Seema Verma:
Twitter
LinkedIn

Want to learn more about Unite Us? Our newsletter comes out the first Wednesday of every month. It includes our latest happenings, network news, announcements, and ways to get involved with our movement to connect health and social care. Sign up here. Follow our show on Instagram, Twitter, and Facebook and share your thoughts with us by emailing podcast@uniteus.com. 

Episode Credits:
Produced by Ginni Media and Unite Us
Original music by Starling Studios

Copyright ©UniteUs2023 all rights reserved
All opinions expressed by podcast guests are solely those of the guest and do not reflect the opinions of Unite Us.

The post Too Big to Fix: A Conversation with Seema Verma, CMS appeared first on uniteus.com.

SDoH data and technology will play an even larger role in 2024 ratings, with the increasing focus on health equity and consumer experience. Learn how you can optimize your quality performance by powering your SDoH strategy with Unite Us. 

Improving Medicare Advantage Star Ratings with Unite Us

Unite Us customer performance in 2023 ratings:

• Fifth straight year outperforming the market
• 77 percent earned the Quality Bonus Payment at 4.0+ stars, versus 51 percent of contracts in the total market
• Achieved an average rating of 4.03–0.27 points higher than the market average
• Increased 4.0+ rating achievement by 43 percent since 2019, compared to 12 percent increase for the total market

Improving NCQA Ratings with Unite Us 

Our Managed Medicaid partners’ quality improvement and population health initiatives are driving a strong performance on NCQA ratings (3.56 on average) relative to broad market trends (3.42 on average).

Unite Us Supports Quality Improvement Through Innovation and Best Practices 

How It Works:
One of Our Success Stories

“Health equity is a driving strategic priority at UCare. Improving the health of members through a health equity lens begins and ends with data. Recognizing that every member has unique needs, we try to offer personalized solutions. We couldn’t do that without the timely and accurate data we receive from Unite Us. It helps us identify social and health care needs, connect members to services, and design interventions that have a meaningful impact on health and racial equity.”

– Greg Hanley, Vice President of Quality Management and Population Health, UCare 

Through this approach, UCare has:

• Retained and expanded Managed Medicaid awards across MN, now managing 38 percent of all beneficiaries and growing market share at the strongest pace of all state plans over the past five years
• Achieved an excellent 4-star NCQA rating on its Medicaid plan in 2022, only one of two plans in MN to do so
• Grown its Medicare Advantage membership by 44 percent over the past four years, adding 43,000 members
• Achieved a 4.5 star rating on its largest Medicare Advantage contract and retained 89 percent of its total MA members in a 4.0+ star plan in 2023 ratings

UCare is a community-based, nonprofit health plan providing health coverage and administrative services across Minnesota and in three western Wisconsin counties.

Learn how we can help you meet your quality goals:

Get in Touch

The post Healthcare Quality: Unite Us Customers Continue to Outperform the Market in Quality Ratings appeared first on uniteus.com.

Watch the Webinar

In this webinar, you will learn about:

• Market dynamics and policy trends regarding SDoH and quality performance
• Securing buy-in and internal alignment
• Data-driven insights on specific social needs and risk in your population
• Managing targeted, effective, community-based interventions
• Tracking and proving the impact on quality scores

Health equity and social determinants of health (SDoH)—such as access to secure housing, adequate nutrition, transportation—have an impact on healthcare utilization, costs, and outcomes. This means social care services are just as important as clinical care services in improving quality scores. However, most health plans still lack a practical understanding of the actual impact of social care services on key quality measures.

It’s time to close the gap between research literature and practical understanding of how social care interventions measurably impact quality scores. Our five-step guide is based on our experience in enabling health plans to successfully address SDoH and our position that quality care is equitable care.

This new resource is designed to give health plans the ability to make strategic decisions around social care with the same rigor and confidence they already apply to clinical care. It describes a practical path for integrating social care services into the strategic goals, operations, and workflows of a health plan’s whole-person quality program.

Integrating social care services and clinical care services is the key to advancing health equity. Watch the webinar and prepare for success in 2023!

Watch the Webinar

The post Integrating Social Care to Improve Quality Performance: A Five-Step Guide for Health Plans appeared first on uniteus.com.

The pilot program sought to:

• Enhance community resilience through designated, capacity-building funds.
• Optimize access to funds based on evolving needs and priorities.
• Increase the visibility of data to support the need for flexible funding streams and identify other funding sources.

The results? Significant improvements in individuals’ mental and physical health with fewer reported unhealthy days.

There is a potential $8.00 per member per month higher medical cost associated with having an unhealthy day. This indicates long-term cost savings could be realized by increasing the number of individual healthy days.

Reaching People in Need with Social Care Funding

Metro United Way demonstrated the ability to have a real and lasting impact on the communities it serves—with Unite Us Payments solution providing the platform to monitor and measure that impact.

Unite Us provides partners in the community with one easy-to-use, secure, and compliant platform to coordinate social care, including social needs screening, referrals, and tracking of funding and outcomes.

Reducing the administrative burden thanks to automated workflows and reporting, our platform increases care teams’ efficiency and impact, as they can focus more on what they do best: helping people.

Download the case study to learn how Unite Us can bring better health outcomes to the people and communities you serve.

Download Case Study

The post Louisville Housing Initiative Case Study appeared first on uniteus.com.

Confirming its long-term focus on advancing health equity, NCQA announces changes for Healthcare Effectiveness Data and Information Set (HEDIS) in measurement year 2023, including:

• Race/ethnicity stratification in eight additional HEDIS measures with integration to additional measures planned over the next several years
• Gender-affirming approaches to ensure HEDIS measures appropriately by acknowledging and affirming members’ gender identity
• New social needs screenings and interventions measure to encourage plans to assess and address members’ unmet food, housing, and transportation needs using prespecified instruments

Understanding Diverse Social Needs Through Risk Stratification

Measuring stratification by race, ethnicity, gender, as well as other social risk factors, is critical to understanding diverse social needs in the population and addressing disparities.

Looking beyond clinical encounters and claims data, health plans can uncover hidden risk and devise proactive, whole-person approaches.

It’s important to note that social and economic indicators such as Z-codes, surveys, and geographic-aggregated data can help but have limitations. On average, 11,000 people live in a single ZIP code. Incomplete information or broad categories can lead to assumptions on larger populations and do not facilitate understanding or action. More detailed and standardized data fields help:

• Generate greater trust in data collection efforts.
• Better capture critical information on hard-to-reach populations.
• Increase efficiency and leverage meaningful and actionable data.

Unite Us’ Social Needs System (SNS) analytics framework helps zero in on the impact of social drivers of health. For example, we have observed that highly socially underserved members represent 30 percent higher regression on mental and physical health (Health Outcomes Survey).

Measure stratification can help not only better assess how social marginalization impacts plan performance and quality outcomes, but also better drive targeted interventions, and measure and prove impact.

Closing the Loop on Care with Social Screenings and Interventions 

Social needs screenings and referral tools should be integrated into systems of record to create a seamless and intuitive experience for care teams and ultimately members.

Feedback from our users highlights the importance of integrating social care in their care management platform and workflows to achieve true community care coordination.

Data standards, pre-built forms, and collaborative workflows reduce errors and improve efficiency in working with the community while also improving the ability to measure impact and close the loop on care.

Health plans can now build on social needs measures, assessments, and referrals to make sure their investments are driving impact on quality outcomes in their population—turning this from an additional effort to the key to unlocking value.

By connecting members with a consistent, accountable community network and real-time, actionable metrics, health plans can monitor and optimize impact on outcomes such as:

• Decreased waiting time
• Percentage of needs resolved
• Co-occurring needs and service gaps that need attention

Dedicated reporting can offer a health equity lens to help ensure and monitor that all individuals are receiving equitable access to care.

HEDIS 2023 updates are part of a larger industry and policy trend to shift focus and funding to effective and preventive whole-person interventions. The business case of health equity interventions rests on the ability to connect these interventions to impact on outcomes, lowering costs while promoting access to care and long-term sustainability.

Explore our solutions to learn how Unite Us enables health plans to succeed in meeting these new requirements, advancing health equity, and increasing value.

The post Health Equity in HEDIS 2023: How to Prepare for Success appeared first on uniteus.com.