March 17, 2022

Partnering with Primary Care Providers to Achieve Better, More Equitable Health

written by
Hannah Ratcliffe
Partnering with Primary Care Providers to Achieve Better, More Equitable Health

At Waymark, we believe that the people who face the greatest barriers to being healthy deserve the best possible healthcare. As a result, we’re laser-focused on improving the health and wellbeing of people with Medicaid benefits, who make up nearly 20% of Americans and yet too often fail to have their needs met by the healthcare system.

To achieve our mission, we’re targeting our efforts towards strengthening and augmenting primary care providers. At first glance, this choice may seem odd–high costs and poor outcomes in Medicaid typically come from services provided in emergency departments and hospitals. Yet, evidence from all around the world (much of it generated by our own team) shows that primary care-oriented health systems yield the best health results the most efficiently and the most equitably. At its best, primary care provides a first point of contact for most patients, most of the time–whether that patient needs a well-child check-up, care for disabilities, or management of multiple chronic conditions. Primary care providers (PCPs) and their teams form long-term, trusting relationships with patients while providing patient-centered, whole-person care that is coordinated across providers and locations. By merging preventive, promotive, and curative care services, primary care helps keep people healthy and, when patients do get sick, can manage most needs efficiently and effectively without escalation to expensive hospitals or emergency departments.

Despite the vast evidence base behind the benefits of primary care-centric health systems, here in the United States we’re mostly not fulfilling this potential–especially for the communities that need it most. Primary care in the U.S. is drastically underfunded, particularly whencompared to other wealthy countries. Achieving the maximum value from primary care requires integrating care across the clinic and community levels, connecting with patients, and leveraging multidisciplinary teams–but the fee-for-service models prevalent across the country make it challenging for primary care providers to do it all. As a result, burnout among PCPs is worryingly high (over 50 percent in some studies), and the COVID-19 pandemic has only exacerbated these issues. For all these reasons, the National Academy of Science, Engineering, and Medicine recently called on the US government to make primary care strengthening a national priority, using our estimates of the impact of primary care on life expectancy and health equity to make their case.

We want to be part of the solution. Our approach to primary care strengthening has five fundamental tenets:

  1. We partner with existing PCPs who already know and serve their communities. We’re not interested in further fragmenting an already fragmented system. At Waymark, we engage with established PCPs in their own practices to support their patients with Medicaid benefits.
  2. We create multidisciplinary, community-based teams to support PCPs and provide more comprehensive patient care. When PCPs engage with Waymark, we bring a full team in to support them. These teams include a practice associate based in their office, comprehensively-trained Community Health Workers to support patient activation and address social determinants of health, Social Workers who provide much-needed behavioral health care using the Collaborative Care Model, and pharmacists to support prescription management and medication adherence. Critically, we believe that it is a mistake to introduce health workers without proper training; for that reason, we provide all of our Community Health Workers with evidence-based training, followed by mentoring and support from licensed staff--ensuring clinical needs are upleveled to professionals with the proper credentials.
  3. We make life easier for PCPs. Through our team-based approach, Waymark staff take tasks off the plates of PCPs by doing behind-the-scenes work to close gaps in care, reduce no-shows, take care of pharmacy-related paperwork (e.g., prior authorizations), and improve quality scores.
  4. We see technology as a tool, not a solution. Waymark’s community care teams are equipped with technology to support comprehensive, coordinated patient care that adheres to clinical best practices, and there’s no doubt that technology is a powerful tool in our toolkit. But, we’re more than just a technology platform--we know that people drive our work, and we design all our systems to minimize the burden on PCPs and not create duplicative or additional workflows.
  5. Our services are free for PCPs and their patients. Waymark is paid through contracts with Medicaid Managed Care Organizations seeking to improve their quality scores. As a result, we offer our full suite of services at no charge to patients or their providers.

We know that PCPs are motivated to serve their patients and communities, but that they shoulder a heavy burden. Through partnership, we aim to provide PCPs with the technology-enabled, team-based resources they need to feel supported and enabled in this effort. Together, we can achieve our shared vision of a world in which people with Medicaid benefits everywhere receive the highest quality, community-centered, equitable care they deserve.