Paying for Biopsychosocial Care

The system used to pay for health care today does not encourage the integration of health care and social care, nor can it adequately adapt to the trending shift toward value-based payments for care — paying for better quality and better health outcomes. New financing approaches are needed to enable the health care sector to engage in activities that strengthen social care and community resource.

This episode is also available as a blog post: https://healthcare-wiki.com/2021/07/21/paying-for-biopsychosocial-care/

Transcript
Speaker A:

The system used to pay for health care today does not encourage the integration of health care and social care, nor can it adequately adapt to the trending shift toward value based payments for care paying for better quality and better health outcomes. New financing approaches are needed to enable the health care sector to engage in activities that strengthen social care and community resources.

MCOs are obligated to provide care management, which includes the authority for MCOs to use their Medicaid funding to identify social care needs and link people to services.

MCOs can use their Medicaid funds to pay for social care as in lieu of services or as value added services, for example to provide medically tailored meals for a home bound individual or an air conditioner for a severely asthmatic child.

Some states require MCOs to contract with existing community based organizations to provide services such as ombudsman advocacy services, nursing home eligibility assessments, and care management.

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About the Podcast

Value Based Care Advisory (VBCA) Podcast
Demystifying healthcare transformation: Actionable insights and expert strategies for advancing value-based care and improving outcomes for all
The VBCA Podcast is a solution-focused platform dedicated to advancing the transformation of healthcare through value-based care (VBC) models. Our mission is to break down complex healthcare topics into accessible, actionable insights for leaders, entrepreneurs, engaged consumers, and anyone passionate about meaningful change in healthcare. By challenging the healthcare industrial complex, we provide tools, strategies, and expert perspectives that empower our listeners to navigate and accelerate the shift toward better outcomes, lower costs, and improved patient experiences.

Each episode delivers thought-provoking discussions and practical advice from industry experts, spotlighting innovative approaches to healthcare reform and highlighting voices that are often overlooked in traditional dialogues. Whether you're a healthcare executive, provider, payer, policy influencer, entrepreneur, or informed patient, we aim to inspire new ideas and support you in driving transformation in the healthcare space.

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About your host

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Alex Yarijanian

Alex Yarijanian is a visionary healthcare executive with over 15 years of experience in healthcare strategy, payer-provider relations, and value-based care models. As CEO and Founder of Carenodes, Alex has led efforts to integrate nonmedical services into healthcare, promoting a biopsychosocial model that focuses on holistic patient well-being. This initiative has reached 51 million Americans, supported by $1.5 billion in funding for innovative healthcare technologies.

In his role as Enterprise Leader for Value-Based Care and Payer Contracting at Mahmee, Alex spearheaded national expansion and contracting initiatives, negotiating partnerships with major payers across 43 states, saving $58 million for a Medicaid plan by reducing C-section rates.

His strategic insights have also driven significant operational efficiencies at Neuroglee Therapeutics, where as Senior VP, he enhanced Alzheimer’s and cognitive care services through digital therapeutics, expanding payer networks by 95%.

Alex’s career is marked by a commitment to healthcare as a right, advocating for patient-centered, equitable healthcare systems. His educational background includes a Master’s in Healthcare Administration from California State University, Long Beach, and a Bachelor’s in Psychology from the University of California, Riverside.