A shared service for medicaid

Address to the Medicaid Managed Care Congress, Baltimore 2016

A Shared Service for Medicaid


By Paul Meyer, Chairman & Co-CEO

I want to share a vision for how the Medicaid community can work together in a new way to address the collective challenges we face in serving the needs of our country’s neediest people.  How we can work together to build a shared digital health utility that provides people with the continuity and support that our fragmented health system does not.

Background

Nearly 20 years ago, I read an article about the challenge of reunifying refugee children with their parents.  The problem was refugee agencies didn’t have a good way of sharing information with each other.   The parents would go to the Red Cross.  The child would be found by Save the Children.  There was no platform for information sharing.  So a friend and I developed a shared database and I flew off to Guinea and Sierra Leone to try to make it work in the refugee camps.  It was a struggle.

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During the Kosovo war, I went to work on reunifying refugee families in Albania.  Again the same problem.  Different refugee agencies maintaining separate lists of refugees.  I found an Albanian engineer who created a master database and we compiled all the refugee lists we could – over 120,000 in all.  And we published a telephone book – the Kosovar Family Finder – organized by hometown in Kosovo.  We distributed 10,000 copies and sent them to all the refugee camps.  People just opened the books, looked up their towns and found their loved ones’ locations.

As soon as the war ended, I saw all the refugee agencies rushing in to Kosovo and struggling to communicate given that the communications networks had been destroyed by bombs.  They all planned to set up their own satellite dishes.  I had a different idea – a shared service.  I’d heard about the crazy idea you could send internet through the air – later know as Wifi.  So I worked with a Kosovar partner and we got one satellite dish and used Wifi to connect the capital and then the country.  We charged the international agencies for service and, for the last 17 years, have given free service to the schools, hospitals and libraries.  17 years later, IPKO is the leading mobile phone and internet company and our technology institute has trained a whole generation of Kosovar engineers.

Technology for Health

My mother and I started Voxiva over 15 years ago with the idea that phones and health should get to know each other.  I knew about mobile networks and she knew about health – having spent her career in global public health.   The first problem we set out to solve was disease surveillance.  Rural health workers had critical, time sensitive information – 3 cases of cholera in my village – and no good way to report.  Our shared service let them use their cell phones to report those cases in real-time so public health officials could respond in real-time.  We first deployed our shared platform in Peru and eventually deployed the service in 17 countries across Latin America, Africa and India.

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8 years ago we turned our attention to this country.  We went around talking to health plans, health systems, public health agencies about the potential of 300 million untapped health behavior change devices – cell phones.  No one was particularly interested.

We launched our text4baby service out of frustration.  We just wanted to show the health industry what mobile health was all about.  Text4baby was supposed to be just a pilot project in Virginia.   But it didn’t stop there.  In short order, we had over 1,000 partners across the country promoting the service to their pregnant women and new moms.  We sometimes joke that the only organizations in the health care system that aren’t Text4baby partners are those that hate babies.  We’re especially proud to be working with the Medicaid division of CMS and four state medicaid agencies: California, Oklahoma, Louisiana and Ohio and the managed care plans in those states to make text4baby available systematically through the Medicaid system.

And I am very proud to announce that last month we enrolled our millionth mom in Text4baby.

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As I reflect on Text4baby, the most remarkable thing about it isn’t the technology or the intervention itself — though we are proud of all the evidence we’ve been able to gather and publish on its effectiveness.  The most amazing thing about Text4baby was that it was a shared service embraced by the whole industry — and especially the Medicaid community.  Rather than everyone building their own baby texting program, they embraced this shared service.

Learning from Text4baby

In the years since launching Text4baby, we’ve expanded our suite of services to include smoking cessation and diabetes support.  Our member engagement platform is now deployed with nearly every Medicaid managed care plan in the country helping to improve quality measures.  And we’ve worked with nearly all of you through our partnership with SafeLink wireless to distribute free cell phones to your members along with proven digital health programs.  

Through that work, we’ve come to understand a lot about the nitty gritty mechanics of how Medicaid works.  And we’ve come to see a fundamental challenge facing all of you who are taking on the hard work of providing services in Medicaid.

I think of the Affordable Care Act as an effort not only to expand coverage but also to create incentives for the health care system to invest in long-term population health outcomes.  It used to be there was public health – the world we come from – that cared about everyone but had no money.  And there was our $3 trillion health care system billing for doctor visits for specific covered people.  I think of the ACA as a way of infusing public health goals into the health care system.

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HEDIS, STARs and other pay-for-performance measures were designed to create financial incentives to invest in long-term public health or “population health” outcomes.   Everyone – health plans, health systems, pharmacies – is working feverishly to build-out member engagement, patient engagement, consumer engagement tools and strategies. “Use my app.  Use my portal.  I want to text you, robocall you…”

That’s why we’re launching Wellpass, the digital health utility built for and around people.

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Our mission is to simplify your interaction with the healthcare system, putting you in control, helping you get the care you need and the service you deserve. Wellpass is designed to make the health care system work for you.

We’re launching Wellpass in January.  We’re starting in a handful of states with a handful of our existing clients.  But over time, we hope that all of you will join us in helping make this vision a reality.