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How states can serve members more holistically

Lori Halpern and Dennis Vaughan discuss innovations that help states provide whole-person care. At the heart of this effort is improving physical and mental health for all. That means addressing social determinants of health that are part of each individual’s daily life.

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Lori Halpern:

Hi, I'm Lori Halpern, head of government solutions, business development for Optum Behavioral Health.

Dennis Vaughan:

And I'm Dennis Vaughan, chief executive officer for Optum State Government Solutions. State government leaders everywhere are focused on whole person care. They're seeking innovative and efficient ways to bring together all the services and supports people need to stay healthy in their lives and in their communities. So we're here to share examples of some of the critical building blocks that we've helped to put in place across numerous states to help them scale improvements and to serve their constituents more holistically.

Lori Halpern:

Dennis, that's no easy feat. I think the first and most fundamental challenge is improving outcomes in the community, and that includes physical and behavioral health outcomes. COVID-19 created intense economic pressures on state governments, but the pandemic also continues to drive an enormous demand for health services, particularly, around mental health and substance use disorders. Recent federal action has provided funding to address these issues but scaling quickly to meet the demand is the challenge for today. We work with a state expanding the behavioral health services they offer. There are more than 372,000 Medicaid members, including a variety of non-Medicaid services to help fill treatment gaps.

Dennis Vaughan:

Connecting the medical and behavioral needs is critical to your point, Lori, it's important to recognize that clinical care contributes only about 20% to health outcomes. Determinants such as physical environment, social and economic factors, as well as health behavior play a far greater role in overall health outcomes. We've worked with the state developing and operating a truly enterprise-wide analytic system. Today, 21 agencies in this state are using the insights to develop programs targeting specific needs for communities. They've tackled lead contamination and poor water quality, for example. Insights from this enterprise analytic system are helping staff focus their efforts and empowering their decision-making to adapt programs and policies to improve the health of people in their community.

Lori Halpern:

We are seeing efforts at the state level to integrate physical and behavioral health related information and care delivery to provide a comprehensive approach to an individual's care needs. We partnered with one local government agency to use this approach, to create an evidence-based treatment model for people with serious mental illness and substance use disorders. They have reduced their total healthcare spend by nearly 50% while improving the resources available for ongoing resiliency and recovery. This example demonstrates how we partner with government agencies to improve access, fill treatment gaps for the uninsured and underinsured and use integrated information to help transform care delivery.

Dennis Vaughan:

And with a more modern connected system, states can make full use of the recent advances in virtual and in-home care. Lori, this has been a great chat. Thank you for sharing your insights on how states are reimagining the care continuum to help bend the cost curve, to scale quality, and most importantly, to ensure that individuals who rely on public healthcare get equitable access to the care and support services they need.


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